Exercise and Special Populations

While instructing a class, a group fitness instructor (GFI) will encounter various individuals who might have different health needs and potential concerns.  Having each person fill out a health questionnaire prior to attending the class will let the instructor know if special considerations are required. The participants might have:

Coronary Heart Disease:

Avoid extreme heat and/or cold that may put a greater stress on the heart

Use heart-rate monitors, and avoid sudden and extreme fluctuations in heart rate. Teach the individual ratings of perceived exertion (RPE) so that the participant can be aware of what level they are while working out

Stay within the target heart rate and blood pressure zones as approved by the participant’s doctor

Report all symptoms of concern, especially light-headedness, dizziness, or chest pain to the participant’s doctor

Make sure the resting heart rate and blood pressure return to resting areas before the participants leaves the work out center

If the participant complains of chest pain at any time, stop the activity and call ems


Choose a work out the participant will enjoy doing, and one that is as pain-free as possible

Stress the caloric balance equation: calories in= calories out

Since arthritis is usually a common condition, protecting the joints is a must

Take care to provide seat comfort with work outs including using bikes or cycles

Resistance training should be done 10-15 minutes per day, 2-3 days a week


Keeping blood glucose levels regulated means choosing the right time to exercise, usually between meal times and insulin dosage

Aim to keep blood glucose levels between 100 and 200 mg/dl, one to two hours after a meal

If blood glucose levels are lower than 100 mg/dl, the participant should consume a rapidly absorbing carb to increase blood glucose

If blood glucose is greater than 300 ml/dl before exercise doctors might recommend that exercise not commence. Make sure insulin has been taken. In some instances, the participant might lower the levels by drinking water

No one with diabetes should be allowed to exercise if his or her blood glucose level doesn’t fall within a safe range before exercise

Check blood glucose levels at the end of the work out, to make sure the person won’t become hypoglycemic

Make sure the participant has had plenty of water before the work out. Be cautious in hot environments, since glucose levels can be impacted by dehydration


It’s important that the work out is timed with the administration of the asthma meds

Lights warm-ups and short bouts of exercise may be helpful in reducing the risk of an asthma attack

The intensity of the work out should be based on the participant’s comfort zone

Carrying an inhaler is a good idea

Cold weather can be hard on someone with asthma. Wearing a scarf or surgical mask may help. Also, after a cold/flu, people with asthma are at a higher risk for problems during exercise. Exercise should be picked back up slowly and carefully


It might be necessary to exercise for 30-60 seconds, and then rest for 30-60 seconds until fitness level is improved

The exercise should address the interest level and what the participant is able to do

Perform low variable exercises, like walking, stationary cycling, and low intensity weight training

Those with COPD benefit greatly by doing warm-up and col-downs

Teach participants to slow down their breathing frequency and increase the amount of air they take into their lungs with each breath


Any work out that causes pain during, two hours after, or 24-48 hours after exercise should be discontinued

Fine other ways to work muscles around painful joints

Warm up and cool downs are essential

Resistance training should be done, but anything that causes pain to a particular joint should be replaced with isometric movement

In water, keep the temperature between 85-90 degrees

Use smooth, repetitive movements

Keep exercise level below the discomfort threshold

In individuals with rheumatoid arthritis (RA), flare ups may occur. Discontinue until the flare up subsides

Those with osteoarthritis do better in the morning, while those with RA do better several hours after waking


Do aerobic work outs 20-4o minutes, 2-3 days per week, working on the length of the work out vs. the intensity of it

Controlled, dynamic movements for flexibility is good, as long as it’s in a pain-free zone

Performing movements that held aid household tasks are a good idea


A GFI must know if any participants have osteoporosis. Since many people haven’t been checked or diagnosed, it’s important for the GFI to go through a checklist in order to see if a participant needs to be screened by their physician: did the person go through early menopause? has the person had a hysterectomy? does he or she drink excessively or smoke? do they have a low calcium intake? are there signs of osteoporosis (stooped posture, previous fracture)? does the person have a thin, small build? are they taking medication that may increase bone loss

If a participant has been diagnosed with osteoporosis, resistance work outs should be approved by a doctor first. Start out slow if it’s approved. Resistance work outs should be done 2-3 days/week. Avoid anything near the spine if pain is present

Plyometric moves are fine, as long as it’s in someone without advanced osteoporosis

Circuit training work outs that require short periods of work using various muscle groups is recommended

Avoid jarring or high load work outs

Low Back Pain:

Individuals with low-back pain should check with their doctor for specific recommendations for exercise

Warm ups and cool downs are very important

Proper form and alignment is a must

Don’t work through the pain

Do not lift heavy objects while twisting, and keep objects close to the body

In Children:

Promote physical fitness

Youth sports

Community activities like bike rides and walking

60 minutes of physical exercise almost daily

Children sweat less than adults do. Be mindful of this in hot weather

Older Adults:

Endurance activities with continuous movement that involves large muscle groups is sustained for roughly 10 minutes

Strength activities increase muscle strength like lifting weights or elastic bands

Flexibility activities help with greater range of motion around the joint

Balance activities are a must




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