Below is a list of the various considerations a trainer must be aware of when exercising a client with a specific condition(s). 

High Blood Pressure 

Considerations:

• Must have a medical clearance prior to training

• If the client has been a cardiac patient: ONLY strength train after a minimum of 12 weeks of cardiovascular training

• Extended, gradual full body warm-up and cool-down

• Strength training should complement low intensity cardio training

• No isometrics

• Perform compound exercises

• Prescribe unilateral exercises to avoid increased blood pressure

• No lifting over head

• Keep head above heart at all times. No decline activities.

• Do not take sets to absolute failure

• Light loads with high reps (10+ reps)

• Do not perform high intensity overload techniques

• Progress loads slowly without over exerting

• Beware of breathing, no valsalva (Always breathing through sets, NEVER HOLD BREATH)

• Monitor blood pressure often

Low Blood Pressure 

Considerations:

• Be sure client does not stand or rise too quickly from a sitting, crouching or lying position

• Care to be taken when moving suddenly from one position to another

• Do not perform exercises where head is below heart (e.g. decline bench press)

• Extended, gradual full body warm-up so blood pressure does not rise too fast

Arthritis 

Considerations:

• Medical clearance

• Cardiovascular activity and pool work is recommended for arthritic clients

• Avoid training when joint pain is severe

• ALWAYS perform exercises within the capabilities of the client

• Extended warm-up and cool-down (e.g. may need to use low-impact cardiovascular exercises)

• The trainer can move the clients limbs which may be helpful in warming-up the joints

• Perform pain free exercises and stay within a pain free range of motion

• Aim for functional exercises

• Use isometric training if there is no other constraints

• Use light weights and high reps (10-20 rep range)

• Create a good base strength around major joints: knees, pelvis, shoulder

• Emphasise good posture, technique, control and execution

• Perform stability exercises where possible (e.g. single leg balances)

• Introduce more challenging functional body weight exercises when the client is capable

• If there is excess pain in joints 2 hours after exercise, then reduce the workout intensity

• Combine weight training with cardiovascular exercise and stretching to increase blood flow and range of movement

• Do not take sets to absolute failure

• No high intensity training

• You are not trying to create a super-hero. Just improve quality of life for the client

Mature Age (60years old or more) 

Considerations:

• Medical clearance

• Perform postural analysis prior to exercise

• Encourage client to empty bladder prior to workout

• Ensure training takes place close to toilets due to urinary frequency or incontinence

• If severe joint discomfort, then incorporate non-weight bearing exercises: water training, bike riding

• Use light weights and high reps (10-20 rep range)

• Do not take sets to absolute failure

• Emphasise good posture, technique, control and execution

• Once lifting technique is correct, progressively increase loads

• Low impact extended warm-up (e.g. exercise bike)

• Introduce more challenging functional body weight exercises when the client is capable

• Ensure client exercises in a pain free range of movement

• Combine weight training with cardiovascular exercise and stretching, to increase blood flow and range of movement

• Exercises should be compound and functional

• Perform exercises within the capabilities of the client

• Create a good base strength around major joints: knees, pelvis, shoulder

• Perform stability exercises to aid in exercise progression

• You are not trying to create a super-hero. Just improve quality of life for the client

Pregnancy

Considerations:

• Medical clearance prior to training

• Do not train client unless they were strength training for a minimum of 6 months prior to pregnancy

• Encourage client to empty bladder prior to workout

• Ensure training takes place close to toilets due to urinary frequency

• Train with light loads and 12-15reps

• Use unilateral exercises

• No isometric training

• Keep client well hydrated

• Ensure adequate rest between sets and exercises

• Monitor pulse regularly. Keep below 140bpm

• Body temperature must stay below 38 degrees

• Encourage pelvic floor exercises (Kegel exercises)

• Must not be in supine position (lying on back) for longer than 60 seconds as it affects blood flow to the foetus

• Reduce exercise levels as pregnancy progresses

• Use non-weight bearing exercises in the last trimester

• No specific abdominal exercises (i.e. crunches)

• NEVER take sets to absolute failure

• As pregnancy progresses, you may need to remove leg exercises entirely from the workout

• Be aware client does not exceed natural range of movement during stretches and exercise

• Be aware of pre-eclampsia (preeclampsia)

• Be aware of diabetes

• Be aware of bladder issues

• Be aware of client back pain and breast tenderness

• Do not train a pregnant client in hot and/or humid weather
  

Diabetes (Type 1 & 2) 

Considerations:

• Get a medical clearance if unsure client should train

• Exercise 60 – 90mins after insulin injection

• Client should eat 20 – 30grams of carbohydrates every 30mins of activity

• Encourage client to monitor blood glucose levels

• Keep well hydrated

• Possibility of ketosis occurring (muscle breakdown). If this does occur, the client will smell of urine (stop exercise)

• Ensure weight training session is planned in conjunction with insulin injections and eating patterns

• Ensure training times stay the same

• Avoid sudden postural changes

• Always check complexion and breathing

• Watch for early signs of hyperglycaemia or hypoglycaemia (see below)

Signs of Hyperglycaemia (high blood sugar levels):

• Fatigue

• Light-headed

• Poor coordination

• Slurred speech

• Frequent need to urinate

• Excessive thirst

• Blurred vision

• Hot, dry skin

Signs of Hypoglycaemia (low blood sugar levels):

• Light-headed

• Poor coordination

• Slurred speech

• Tremor

• Irritability

• Profuse sweating

• Hunger

• Rapid pulse

• Pale complexion

Asthmatics

Considerations: 

• Get a medical clearance if unsure client should train

• Discover what aggravates/triggers the asthma, and avoid it

• If asthma is triggered by exercise, then avoid cool, dry environments and keep exercise intensity low to moderate

• Avoid air-conditioned environments

• Perform extended warm-up

• Ensure client brings their inhaler to training sessions

• Always pay special attention to breathing and colour of lips

Obese/Severely Over-weight

Considerations: 

• Medical clearance prior to training

• Keep training well within clients capabilities to prevent them being discouraged

• Encourage low-impact swimming pool activities (if client is willing)

• Keep cardiovascular exercises low impact

• Always ensure client is comfortable

• Prescribe stabilising and balancing exercises (however, nothing outside of their abilities)

• Progress exercise intensity and loads slowly

• Train with light loads and 12-15reps

• Use unilateral exercises as they are more comfortable

• Do not lie client down flat (supine or prone) for exercise or stretches

• Ensure adequate rests between sets and exercises

• Client will usually have abnormally tight muscles (particularly in the lower body), so prescribe an easy and suitable stretching routine

• Be aware of hypoxia symptoms

• Be aware of other conditions such as diabetes, high blood pressure, arthritis

• Be aware of client back and knee pain

Children

Considerations:

• Bodyweight activities and high reps

• Keep well hydrated and remind them to drink water

• No high intensity training or single set training

• Keep exercise fun and safe