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Exercise Program Design For Special Population

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The document discusses factors to consider when designing exercise programs for special populations, including medical conditions, age, and fitness level. It also outlines principles of exercise prescription and potential hindrances to address.

Factors to consider include medical conditions, age, fitness level, current health status, and recommendations from the individual's healthcare provider. The program should start at a low-to-moderate intensity and progress gradually based on the individual.

Principles that should guide exercise prescription are FITT (frequency, intensity, type, time), SAID (specific adaptation to imposed demands), overload, specificity, adaptation, recovery, reversibility, and individuality. Stages of behavior change and the five A's model for behavior change should also be considered.

Exercise program

design for special


population
ALAGAPPAN THIYAGARAJAN
ORTHOPAEDIC AND SPORTS PHYSIOTHERAPIST
Who are special population?
 Cardiovascular – Myocardial infarction, angina, peripheral vascular disease, congestive heart
failure, revascularization, heart valve disorders, and/or conduction disorders.
Pulmonary – Chronic obstructive pulmonary disorder, chronic restrictive pulmonary disorder,
pulmonary hypertension, and/or asthma.
Metabolic – Diabetes (Type I and II), overweight/obesity, pre-diabetes, metabolic syndrome,
thyroid disorders, and/or end-stage renal disease.
Immunological – AIDS/HIV, fibromyalgia, chronic fatigue syndrome, anaemia, autoimmune
disorders (e.g., lupus, rheumatoid arthritis), and/or blood clotting disorders.
Musculoskeletal – Osteoporosis, limb amputations, osteoarthritis, lower back conditions, frailty,
joint disorders, joint replacements, sarcopenia, posture disorders, and cystic fibrosis.
Neuromuscular – Stroke, brain injury, spinal cord disorders, multiple sclerosis, cerebral palsy,
Down’s syndrome, Parkinson’s disease, epilepsy, balance disorders, and muscular dystrophy.
Cancer – Multiple body systems affected.
Psychological/behavioral – Disordered eating, body image disorders, depression, and chemical
dependency. Special populations also include those groups of people with unique traits that are not
necessarily afflicted by a chronic or temporary health condition.
 Females that are pregnant, postpartum and menopausal.
 Older adults.
 Children and adolescents with specific exercise prescription needs
What determines exercise program
design
 24 years old male with no co morbid, has problem on l5-s1 disc
pathology, whats your exercise program design ?
 74 years old female with recently diagnosed parkinsonism, has
history of DM,HT,Heart disease, what your home care exercise plan?
 A 6 years old female, has diagnosed with costochondirtis whats your
program design?
 A 24 years old football athlete with post acl reconstruction with 6
weeks old wants to do skill specific program, whats your plan?
 60 years old sedentary male admitted in hospital followed by post
hernia repair, the general consultant refers chest physiotherapy
what's your treatment plan?
Theory behind exercise prescription
 FITT (frequency,intensity,type,time)principle
 SAID("Specific Adaptation to Imposed Demands.“) principle
 Overload ,specificity, Adaptation,Recovery,Reversibility, indiduvality
principle(sports practice)
 Look for where you patient physical activity stages of Precontemplation,
contemplation, Preparation,action, Maintenance
 The Five-A's Model to Facilitate Behavioural Changes of Patients in the
Context of Promoting Physical
Activity.(assess,advice,agree,assist,advice)
 Consider implementing health and skill related fitness on your
prescription
 Use theories like learning, and periodization on to your prescription
 Depend on varieties of protocol, get knowledge with patient set point
For patients who need special
considerations, keep the following in
mind:
 The program should begin with low-to-moderate intensity and then
progress gradually.
 The nature of the program depends on the current health status and
physical condition of the client, as well as any other factors identified in
the interviewing or screening process.
 To cater to the needs of clients with chronic illnesses or who require
special considerations, be sure to acquire the necessary education and
skills.
 Maintain close communication with the patients primary healthcare
provider, as well as obtain and adhere to his or her recommendations
and guidelines for programming.
 When providing information to a patients healthcare provider, utilize
SOAP notes for documentation of client encounters, health status, and
progress.
 Plan according to patient needs, always work on progression
Hindrance to our plans of
prescription
 The team work in clinical set up
 Other related professionals(eg- yoga, fitness guru, new varieties of
training)
 Lack of planning by the physiotherapist
 Patients who feel always they are right ,therapist is wrong
 Passive bound therapy application (pain management)
 Sticking to one monotonous protocol and the owner and his team
mates
 Relaying on new techniques both on active and passive application
What evidence says

 There are lot of documents related to your patients requrirement


 Depend on books
 Implement your past experiences
 Seek for evidence
 Follow the patient requirement with a tailored made protocol
Recommended readings

 Paul chek program design


 American council on exercise- medical exercise specialist /health
fitness
 Thank you

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