Exercise Induced Asthma or Broncho Spasm

• Consult a physicial for treatment/prevention.
• Have an inhaler available at all times.
• Exercise intensity should start low and progress to high.
• Avoid exercising outside in extreme cold/high pollen. 
• Exercise in humid areas (indoor pool).
• Use of inhaler prior to workout. 
• Breath through the nose.
• Extended warm-up and cool down periods.

• CVD participants should be screened.
• Comply with physician guidelines.
• Record of current medications and their effects of exercise.
• Comply with target heart range and RPE guidelines for each participant.
• Alert instructor about any signs of symptoms.
• Do not exceed your level of expertise.
• Intensity should start low and progress slowly.

• Low-impact cardio, indoor cycling and water exercise type classes should be encouraged.  Classes that avoid quick ballistic movements that can be stressful of the skeletal system.
• Frequent, low-intensity exercises should be performed.
• Decrease intensity and duration during bouts of pain and inflammation.
• Stretch Daily to enhance mobility of muscles and joints.
• Isometric exercises may be preferable.
• Extended warm-up and cool down periods.
• Monitor all changes in medication and fluctuations in pain levels.
• Be aware of the 2 Hour Pain Rule (if pain persists 2 hours after a session, reduce intensity or duration of future sessions)
• Obesity and overweight are risk factors for osteoarthritis.  Assist participant is appropriate weight loss/management strategies.

• Blood Glucose should be monitored frequently.
• Inject insulin into a muscle that is not being actively exercised (abdomen).
• Avoid exercise during peak insulin activity.
• Patricipants should carry a carbohydrate snack to alleviate hypoglycemia attacks.
• Schedule exercises during the same time of day.
• Encourage participants to consume a carbohydrate snack prior to an during exercise.
• Increase carb intake of decrease insulin dose before exercise.
• Work with the participant's physician to follow all recommendations.
• Keep the emergency response number and plan handy.
• Know the symptoms of hypoglycemia (fatigue, nausea, lightheadedness, dizziness, exessive perspiration, spotted eyes, confusion, shakiness, headaches, rapid HR and seizures)

Exercise Guidelines for Hypertension

(High Blood Pressure)

• Emphasize cardio exercise to reduce high blood pressure.
• Exercise daily for 30-60 minutes.
• Avoid High-intensity and Isometric activities.
• High reps and low weights during resistence training.
• Avoid the Valsalva Maneuver (holding breath).
• Utilize RPE as certain hypertensive medications alter HR during exercise.
• Avoit positions putting feet higher that head.
• Teach relaxation and stress management techniques.

• Shouder, chest, arm discomfort.
• Fainting
• Dizziness
• Fatigue
• Nausea
• Shortness of breath
• Orthostatic hypotension
• Uncontrolled, spastic movement

• Cardio performed at a low-moderate pace.
• RPE scale of 5-6 (noticeable increases in HR and breathing).

Concentric and Eccentric exercises are preferred over isometric exercises since isometric exercises have a tendancy to elevate blood pressure leaving the older adult at possible risk.

List two (2) methods of stretching

that are recommended for older adults.

• Patricipants should monitor own workload.
• Be aware signs of overexertion among new participants.
• Monitor intensity every 4-5 mins during Cardio.
• Slow and controlled movements working through the full ROM.
• Avoid forward spinal flexion if osteoporosis condition is present.
• Dizziness from rapid movements.
• Participants with prosthetics should follow doctor recommendations on exercise and range of motion.
• If incorporating stepping exercises, utilize support equipment (chair, bench, etc.)

• Cardiovascular changes. Blood volume will increase from 30-50%.  This places increased demands on the cardiovascular system.
• Hormona and anatomical changes. Increase in secretion of various hormones to include relaxin, estrogen, progesterone, and elastin.
• Pelvic floor muscles. Maintenance of the  puboccygeal muscles that support the pelvic organs.
• Leg Cramps. Chances of cramp or "Charley Horse" increase during pregnancy-expecially at night.
• Diastasis recti. Stretching of the linea alba that prevents muscles in the uterus from over stretching.
• Hydration and heat. Pregnant women should take time to drink before, during, and after exercise.

1. Have a client experience a renewed sense of energy from exercise and avoid exhaustion.
2. What is 9 months compared to a lifetime?  -Slow Down.
3. Watch for signs of exhaustion (pain, dizziness, chest pain, uterine contractions or difficulty walking).
4. Provide modifications with each exercise modality.
5. Refer uncertain or adverse reactions to a program to a client's physician before continuing with a program.

Discuss exercise modalities that pregnant women can perform along with any risks and modifications that should be taken.

• Switch from high impact to low impact aerobic activities during pregnancy.
• Modify tough movements.
• Modify suspine weighted work after 20 weeks (roll on side).
• Use buoyancy devices on the extremities during aqua aerobics.
• Use equipment that supports the body when weight or resistance training.
• Tempo adjustments when using music.
• Make sure that the participant is comfortable at all times.

List exercise recommendations outlined by the US Department of Health and Human Services (USDHHS) and the American College of Sports Medicine (ACSM).

• 60 minutes of activity 3-4 days per week.
• Encourage activities that use large muscle groups.
• Incorporate a variety of activities to create interest and fun in physical activity.
• Heart rate monitoring is optional.  Using the OMNI scale is preferable.

What are some General Guidelines to resistance training in children and adolescents.

• Resistance Training Movements- exercise performed against an opposing force.
• Free Weight Training- 10-12 years. Using correct form and technique.
• Weight Training Machines-10-12 years. Providing machines can be adjusted to the smaller body sizes.
• Manual Resistance Training- Exercises using the help of a partner with safe technique.
• Isometric Training- Use proper breathing techniques.