1. Brenton Orullian
OBESITY & OVERWEIGHT

2.  Overweight and Obesity can be classified as
extra body weight with a BMI most
commonly used to describe the condition.
 Overweight and Obesity are linked to
numerous chronic diseases such as
CVD, many forms of cancer, and diabetes.

3. Classification of BMI
 Underweight= <18.5
 Normal= 18.5-24.9
 Overweight= 25.0-29.9
 Obesity
 I
30.0-34.9
 II 35.0-39.9
 III ≥40.0
*Studies show that 68% of adults are in the
overweight category, 32% are in class I
obesity, and 5% are in class III.

4. Exercise Guidelines
 F= ≥5 days per week
 I= Moderate to vigorous intensity aerobic
activity
 T= Minimum of 30 min per day progressing to
60 min per day
 T= Primary mode of exercise should be
aerobic involving large muscle groups
 P= 40%-<60% of VO2R progressing to more
vigorous intensity ( ≥60% VO2R )

5. Resistance Guidelines
 F= Large muscle groups (i.e. chest, back





upper and lower, shoulders
Legs, 2-3 days a week
I= 60-70% of 1 RM
T= No specific Duration
T= Resistance Exercises involving each major
muscle group are recommended
P= A gradual progression of greater
resistance and or more repetitions per set

6. Works Cited
 Exercise Works. (2011, 09). Exercise for
Obesity Patients. Retrieved from
http://www.exerciseworks.org/storage/Obesitychapter.pdf
 Lippincott, Williams & Wilkins. ACSM’s
Guidelines for Exercise Testing and
Prescription. Baltimore, MD: 2014

7. By Ben Bergdorf

8. Arthritis
 Description: degenerative joint condition that causes
inflammation and pain.
 Types: >100 types of arthritis. Most common are
osteoarthritis and rheumatoid arthritis. Osteoarthritis is a
local degenerative condition. Rheumatoid arthritis is a
systemic joint condition.
 Causes: Disuse or overuse can cause cartilage degeneration
(osteoarthritis), rheumatoid arthritis is immunological in
origin.

9. Arthritis (cont.)
 Prevention and prescription: Moderate
mechanical loading has been shown to
preserve articular cartilage (Sun, 2010).
Moderate exercise can help arthritis
sufferers manage pain better and increase
function (ACSM, 2013).

10. Cardiorespiratory exercise
prescription
 Frequency: 3-5 days/week
 Intensity: Undetermined. Light to moderate intensity is
recommended 40-<60% of the VO2R (or HRR)
 Time: ≥ 150 min/week. Shorten bouts if lengthy exercise sessions
can not be tolerated (e.g. shorten bouts to 10 minutes).
 Type: Walking, cycling, swimming or other low joint stress
activities. Not recommended: running, stair climbing, etc.
 Progression: progression is individual, and should increase
gradually as they are able to tolerate it.

11. Resistance training prescription
 Frequency: 2-3 days/week
 Intensity: Undetermined. Light and high intensity resistance training
has shown improvements. Most research has focused on
light/moderate intensity: higher repetitions (10-15) at 40-60% of the 1
RM.
 Time: Undetermined. Same as for healthy adults.
 Type: Major muscle groups are targets. Flexibility and ROM should be
emphasized.
 Progression: progression is individualized and should be gradually
increased depending on the person’s pain or symptoms.

12. Special considerations
 Strenuous activity that exacerbates pain during
inflammation or flare-ups should be avoided.
 Some discomfort is normal after exercise, but if after 2
hours this pain is greater than before exercise, the training
intensity or time should be reduced.
 Rheumatoid arthritis patients may experience a worsening
of symptoms through intense training. So keep grandma
away from the heavy preacher curls.

13. References
 American College of Sports Medicine. (2013). ACSM's
guidelines for exercise testing and prescription. (9th
ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
 Sun, H. (2010). Mechanical loading, cartilage
degradation, and arthritis. Annals of the New York
Academy of Sciences, 1211, 37-50. doi: 10.1111/j.17496632.2010.05808.x

14. Osteoporosis
Logan Kupitz

15. What is Osteoporosis?
Osteoporosis is a disease that affects the
skeletal structure in the body. It is characterized
by a low bone mineral density, which causes the
bones to become fragile, and more susceptible to
fracture. 44 million American’s are at risk for this
disease and is responsible for over 1.5 million
fractures a year in the U.S.A.

16. Guidelines for Cardiorespiratory
Fitness (CRF) exercise prescription
Frequency:
3-5 days per week
Intensity:
Moderate intensity; 40-60% VO2R or HRR
Time:
30-60 minutes a day
Type:
Weight-bearing aerobic activities (i.e stair
climb/descent, walking, jogging)
Progression:
Start at lower intensities recommended and progress as situation
permits

17. Guidelines for Resistance Training (RT)
exercise prescription:
Frequency:
2-3 days per week
Intensity:
Moderate intensity; 60-80% 1-RM, 8-12 reps involving all major muscle groups
Time:
30-60 minutes a day
Type:
Resistance training involving major muscle groups
Progression:
Start at lower intensities, if situation permits raise intensity levels

18. Contraindications
Individuals who have osteoporosis don’t have
many contraindications to exercise or physical
activity. Activity/exercise should be
discontinued/changed if it causes, or
exacerbates pain. Those with severe
osteoporosis should start at lower intensities as
to lessen risk of injury. Max testing may be
contraindicated for those who have severe
osteoporosis. There are no established
guidelines for contraindications for osteoporosis
patients.

19. ASTHMA

20. ASTHMA
• Asthma is a disorder that causes inflammation of the
airways.
• Symptoms
• Bronchial Hypertension
• Airflow Obstruction
• Recurring Wheezing
• Dyspnea (labored breathing)
• Chest Tightness
• Severe Coughing (can be worse in the morning and
at night)
Exercising can provoke and worsen symptoms

21. CRF Guidelines
 Exercise at least 2-3 days a week
 Intensity
• 60% of VO2 Peak
• 80% of max walking speed
 20-30 minutes
 Mode
• Walking
• Running
• Cycling
• Swimming

22. Resistance Prescription
• Resistance Prescription is the same as healthy
adults
• 2-3 days a week
• 48 hrs. rest between workouts of the same
muscle group

23. Contraindications
• Experiencing Symptoms do not exercise
• Use of inhalers (short-acting bronchodilators)
may be necessary
• Treatment with Corticosteroids
• Exercise in cold environments or with airborne
allergens or pollutants restricts activity
• Bronchoconstriction triggered by high intensity
exercise

24. Hypertension
and Exercise
Presented By: Michael Roller

25. Hypertension

Approximately 76 million Americans have
hypertension.

Systolic Blood Pressure ≥140 mm Hg and/or
Diastolic Blood Pressure ≥ 90 mm Hg.

Hypertension leads to an increased risk of
cardiovascular disease, stroke, heart
failure, peripheral artery disease, and chronic
kidney disease.

26. Cardiorespiratory Fitness

Frequency - Most days of the week, preferably all days.

Intensity - Moderate Intensity (40% - <60% VO2max) (RPE of
11 - 13 on Borg scale)

Time - 30 to 60 minutes per day. Can be broken up
intermittently in at lease 10 minute bouts.

Type - aerobic exercise that they feel comfortable doing.
(Walking, Cycling, Jogging, etc.)

Progression - Gradual progression. Avoiding any quick or
large increases in intensity especially.

27. Evidence

28. Resistance Training

Frequency - 2 to 3 days/week.

Intensity - 60% to 80% of 1 RM.

Time - At least one set of 8 - 12 repetitions for all
major muscle groups.

Type - Machine or Free Weight exercises.

Progression - Gradual progression. Avoiding any
quick or large increases in intensity especially.

29. Contraindications

Must have medical exam and be managing blood pressure to begin exercise training.

Patients with target organ diseases should have non-symptomatic exercise test monitored
by a physician.

if Systolic Blood Pressure is ≥ 200 mm Hg and/or Diastolic Blood Pressure ≥ 110 mm Hg
exercising testing should be done ONLY if benefits outweigh risks.

Anti-Hypertensive medication can cause sudden excessive drops in post exercise blood
pressure.

Avoid Valsalva maneuver in resistance training.

Patients with severe uncontrolled hypertension (SBP ≥180 mmHg and/or DBP ≥ 110 mmHg)
exercise training should only be started after being evaluated and cleared by a physician.

30. References
 (2013).
Acsm's guidelines for exercise
testing and prescription. (9th ed.).
Lippincott Williams & Wilkins.
 Nelson,
L., Jennings, G.L., Esler, M.D. and
Korner, P.I. (1986) ‘Effect of changing
levels of physical activity on bloodpressure and haemodynamics in essential
hypertension’, Lancet 2: 473-6.

31. Cerebral Palsy
Megan Galane

32. Cerebral Palsy
 Non-progressive lesion of the brain
occurring before, at, or soon after birth
 Interferes with normal brain
development.
 It is caused by damage to areas of the
brain that control and coordinate muscle
tone, reflexes, posture, and movement.

33. Cardiorespiratory Fitness (CRF)
 Base on principles of ACSM guidelines, alter per
client.
 Modifications
 Functional mobility abilities
 Number
 Type
 Short bouts of exercise at an RPE of 12-13
 Include recovery period because this population
fatigues easily
 Stationary bikes and arm ergometers are
recommended
 Can change the power output depending on client

34. Resistance Training (RT)
 Target weak muscles that oppose to stronger
muscle groups.
 Improves strength of weak muscles to
balance body
 Example: agonist/antagonist relationship
 Neuromuscular stimulation
 Fatigue can throw off what they have been
working well on during exercise.
 Pair resistance training with stretching and
flexibility
 Dynamic stretching: full ROM

35. Contradictions/Special directions
 Concentrate on positioning of client
 Because of weak muscles and hypertonic
muscles posture can need correction
 Example: Velcro gloves to hold hands in
place, try to avoid strapping down because not
helping with stabilizing and increasing strength
 Difficulty generating sufficient muscle force
 Possible overuse because prone to obesity and
sedentary behaviors.
 Fatiguing quicker so split exercise prescription
into two parts, try and combine exercise

37. Pregnancy is the fertilization and
development of offspring, known as an
embryo or fetus, in a woman's uterus.
 Childbirth usually occurs about 38 weeks
after conception occurs.
 Exercising during pregnancy minimizes
losses, and can decrease the postpartum
recovery time.
 Effects such as diabetes mellitus, loss of
balance, and extreme muscle fatigue/loss
are all possible consequences of the
pregnancy process.


38. › Frequency: 3-4 days per week (frequency has been shown
to be a determinant of birth weight)
› Intensity: ACSM suggests maintaining a HR correspondent
to a moderate intensity is recommended for women with
a pre-pregnancy body mass index (BMI) ˂25, along with
age and fitness levels taken into account. Light intensity
exercise is recommended for women with a prepregnancy BMI ≥25.
 Nothing more than a moderate fatigue level should be achieved,
and a maximal test should never be performed without a
physician present.
 *Intensity depends on mothers BMI, fitness level, age, weight
› Time: ≥15 minutes per day gradually increasing to a
maximum of 30 minutes per day of accumulated
moderate intensity exercise to a total of 120/week.
 10-15 minute warm up and 10-15 cool down is highly suggested,
resulting in 150 total minutes.

39. › Type: Dynamic, rhythmic physical activities that use large
muscle groups such as walking and cycling.
› Progression: Optimal time to progress is after the first
trimester (13 weeks) because the discomforts and risks of
pregnancy are lowest at that time. Progress from a
minimum of 15 minutes, 3 days a week to a maximum of
30 minutes, 4 days a week, at the appropriate HR and RPE.

40. › Frequency: ≥5 days per week
› Intensity: 1-2 Sets of 12-15 repetitions or until 12 repetitions
›
›
›
›
can be achieved. Heart rate does not exceed 140-150
BPM OR 60-70% max HR. An RPE of 12-14 should be
maintained.
Intensity: 1-2 Sets of 12-15 repetitions or until 12 repetitions
can be achieved. Heart rate does not exceed 140-150
BPM OR 60-70% max HR. An RPE of 12-14 should be
maintained.
Time: 30 -60 minutes per day. (Workouts greater than 30
minutes have been attributed to heavier baby weights).
Type: Walking, swimming, stationary cycling (due to the
low impact), workouts that generally include the entire
body.
Progression: women should not start exercising once they
are pregnant if they were not doing so before. They should
stick to a routine their body was accustomed to before
pregnancy, but retain the opportunity to build up to daily
recommendations.

41. Development of muscular strength
 Added flexibility may help
compensate for the progressive
biomechanical changes that occur
during pregnancy
 Condition abdominal muscle
against weakness and back pain.
 Will contribute to an enhanced
ability to minimize exaggerations in
posture such as thoracic kyphosis
and lumbar lordosis


42. › Physical activity should be avoided in the supine position.
› Relative: severe anemia, unevaluated maternal cardiac
dysrhythmia, chronic bronchitis, poorly controlled type 1
diabetes mellitus, extreme morbid obesity, extreme
underweight, history of extremely sedentary
lifestyle, intrauterine growth restriction in current
pregnancy, poorly controlled hypertension, orthopedic
limitations, poorly controlled seizure disorder, poorly
controlled hyperthyroidism, heavy smoker
› Absolute: hemodynamically significant heart
disease, restrictive lung disease, incompetent
cervix/cerclage, multiple gestation at risk for premature
labor, persistence second or third trimester
bleeding, placenta previa after 26 wk of
gestation, premature labor during the current
pregnancy, ruptured
membranes, preeclampsia/pregnancy-induced

43. 



Graves, J. E., & Franklin, B. A. (2001). Resistance training in
women. Resistance training for health and rehabilitation
(pp. 133-146). Champaign, IL: Human Kinetics.
Brown, L. E. (2002). Resistance training during pregnancy.
Strength and Conditioning Journal, 24(2), 53.
Martens, D., Hernandez, B., Strickland, G., & Boatwright, D.
(2006). Pregnancy and exercise: physiological changes
and effects on the mother and fetus. Strength and
Conditioning Journal, 28(1), 78.
Whaley, M. H., Brubaker, P. H., Otto, R. M., &
Armstrong, L. E. (2013). Exercise prescription for healthy
populations with special considerations and
environmental considerations. In ACSM's guidelines for
exercise testing and prescription (9th ed., pp. 194-200).

44. Special Population
Exercise Rx
Myocardial Infraction
P Jordan Meldrum

45. Myocardial Infraction
Myocardial Infraction: is inflammation to the
coronary artery walls that causes coronary
atherosclerosis that slows blood to the myocardium
which leads to muscle injury and or death.

46. • Frequency: 2 to 4 times per day of the first 3 day of hospitalization.
• Intensity: From a sitting or standing position take resting heart rate
then target about 20 beats for MI and 30 beats for surgery patents
above resting heart rate. RPE of <13 on 6-20 scale
• Time: 3-5min as tolerated rest period may be a slower walk that
shorter than the duration of the exercise bout. Attempt to achieve a
2:1 exercise/rest ratio.
• Type: Walking
• Progression: When patients reach 10-15 min increase intensity as
tolerated within the RPE and Heart rate limits.
Inpatients Prescription

47. • Frequency: 3 days to most days of the week with several factors to
consider: exercise tolerance, intensity, and fitness of the patient.
• Intensity: Based on results from the baseline exercise test, 40%-80%
of heart rate reserve. 11-16 RPE 6-20 scale.
• Time: Warm up and cool-down 5-10min with the goal of 20-60min/
session
• Type: Aerobic should include rhythmic movement using large
muscle. Example: Arm ergometer, Rower, Elliptical, or Recumbent
bike
• Progression: Progression should be individualizing to patients
tolerance.
Outpatient prescription

48. • Frequency: 2-3 days with at least 48hr rest.
• Intensity: 30-40% of 1 RM for upper body and 50-60% for lower body.
• Time: Perform 8-10 exercise 10-15 rep
• Type: Elastic bands, cuff and hand weights, free weights and machines
etc.
• Progression: Increase slowly as the patient adapts to the program.
Resistance Training

49. •
•
•
•
•
•
•
Unstable angina
Uncontrolled hypertension
Significant aortic stenosis
Uncontrolled atrial or ventricular arrhythmias
Third-degree atrioventricular block without pacemaker
Orthostatic BP drop of >20 mm hg with symptom
Recent embolism
Contraindications

50. • Kluwer, W. (2014). Acsm's guidelines for exercise testing
and prescription. (9th ed., pp. 236-256).
Baltimore, Maryland: Williams & Wilkins.
• Thygesen, K., Alpert, J. S., & White, H. D. (2007).
Universal definition of myocardial infarction. Journal of
the American College of Cardiology, 50(22), 2173-2195.
Reference

51. By- Tailor Pili

52. 

Osteoporosis is a skeletal disease that increases
your risk of bone fracture due to having low
bone mineral density.
There are more than 10 million people in the
United States who currently suffer from
osteoporosis and that number is continuing to
grow.

53. 


There are 2 categories for designing exercise
prescriptions for this population.
Category #1- Patients who are at risk for
Osteoporosis : > or = 1 risk factor for
osteoporosis. Risk factors are: Current low
bone mass, age, and being female.
Category #2- Patients with osteoporosis.

54. 




Frequency: 3-5 days per week of weight bearing
activity.
Intensity: - moderate(40%-60% HRR) to vigorous
(>60% HRR).
Time: 30-60 minutes per day of aerobic exercise
Type: Weight-bearing aerobic activities such as
tennis, stair-climbing, walking with intermittent
jogging.
Progression: Based on each individuals level of
fitness and disease progression, but generally
keeping intensity moderate and working to
prevent further progression of the disease.

55. 




Frequency: 3-5 days per week of weight bearing
activity.
Intensity: Moderate (40%-60% HRR)
Time: 30-60 minutes per day of aerobic exercise
Type: Weight-bearing aerobic activities such as
stair-climbing, walking, other activities as
tolerated.
Progression: Based on each individuals level of
fitness and disease progression, but generally
keeping intensity moderate and working to
prevent further progression of the disease.

56. 




Frequency: 2-3 days per week .
Intensity: Moderate (60%-80% 1-RM) 8-12
repetitions or vigorous (80%-90% 1-RM) 5-6
repetitions focusing on large muscle groups.
Time: 30-60 minutes or as long as it takes to
complete the number of sets and repetitions.
Type: Focus on large muscle groups using both
free weights as well as machine weights.
Progression: Increase load force only if no pain is
present, and only after proper form is
accomplished for each exercise . Again, you are
working to prevent further progression of the
disease.

57. 




Frequency: 2-3 days per week.
Intensity: Moderate (60%-80% 1-RM) 8-12
repetitions focusing on large muscle groups.
Time: 30-60 minutes or as long as it takes to
complete the number of sets and repetitions.
Type: Focus on large muscle groups using both
free weights as well as machine weights.
Progression: Increase load force only if no pain is
present, and only after proper form is
accomplished for each exercise. Again, you are
working to prevent further progression of the
disease.

58. 




There are currently no specific
contraindications for individuals at risk, or
individuals with osteoporosis.
However, some general guidelines should be
followed:
No explosive movement exercises
No high-impact loading
Exercises that involve twisting of the spine
should generally be avoided

59. 

Pescatello, L. S. (2014). ACSM's guidelines for
exercise testing and prescription (9th ed.).
Philadelphia: Wolters Kluwer/Lippincott
Williams & Wilkins Health.
Todd, J. (n.d.). Osteoporosis and exercise. -Todd and Robinson 79 (932): 320. Retrieved
November 18, 2013, from
http://pmj.bmj.com/content/79/932/320.shor
t

60. By: MaKenzie Shumway

61.  Pregnancy
is the fertilization and
development of one or more offspring in a
woman’s uterus.
 40
weeks
 Average
pounds
healthy weight gain is about 25-35

62.  Exercise
programs should consist of a warm
up, cool down, and Kegel exercises.
 Kegel



exercises
Pelvic floor exercise
Repeatedly contracting and relaxing the muscles
that form part of the pelvic floor
Help in the preparation for physiological stresses
of pregnancy

63. Frequency: > 3 days per week
 Intensity: Moderate intensity – because of heart
rate variability during pregnancy, use the RPE
scale or (12-14 on a scale of 6 – 20) or the “talk
test”
 Time: At least 15 minutes a day, increasing to 30
minutes a day
 Type: Dynamic, rhythmic physical activities that
use large muscle groups




Weight bearing – walking, jogging
Non-weight bearing – swimming
Progression: gradually increase from 15 to 30
minutes a day

64.  Frequency:
2 days per week
 Intensity: 1 set of 12 – 15 repetitions for
multiple muscle groups
 Time: until moderate fatigue is reached
 Type: light weight – participate in activities
that won’t cause imbalance
 Progression: gradually increase duration and
then increase weight.

65.  Pregnant
women should avoid contact
sports
 Pregnant women should avoid exercising
in the supine position after first trimester
 Pregnant women should avoid Valsalva
maneuver
 Pregnant women should exercise in a
thermoneutral environment and stay well
hydrated

66.  Absolute:





Restrictive lung disease
Incompetent cervix
Risk of premature labor
Persistent 2nd or 3rd trimester bleeding
Ruptured membranes
 Relative:





Severe anemia
Chronic bronchitis
Extreme morbid obesity
Heavy smoker
Poorly controlled seizures and diabetes

67. Diabetes
Special Populations Prescription
Alyssa Kriss

68. • Metabolic disease
• Hyperglycemia ( >200 ml/dl)
• Inability to secrete (Type 1) or utilize (Type II) insulin
• Sustained hyperglycemia can put patients at risk for CVD
and vascular disorders
• Effects 7% of US population, 90% of cases are preventable
type II.
A Little bit About Diabetes

69. • Frequency: 3-7 days/week with no more than two
consecutive days of non-activity
• Intensity: 40%-60% of VO2R or 11-13 RPE
• Time: >150 min/week moderate + activity and increase
to 300.
• Type: Emphasize use of large muscle groups and
rhythmic motions
• Progression: Maximizing caloric expenditure is highest
priority, progressively increase duration and to >2000
kcal EE/week
Cardiovascular Fitness
For people with Diabetes

70. • Guidelines for Resistance Training (RT) exercise prescription,
• Same as general population
• Frequency- 2-3 days / week with 48 hours in between same
muscle groups
• Intensity: 40-60% RM
• Type: each major muscle group at least once a week
• Reps:15-20
• Sets: 2-4
• Pattern: 2 min rest intervals, 48 hours b/t same groups
• Progression: add resistance as client is not being challenged.
Muscle Strength and
Edurance

71. • Exercising at moderate intensity (40-80%) of VOsR for
40-80 minutes improved expression of GLUT-4
significantly after exercises, and continued 3 hours after
exercise.
• Increased GLUT-4 expression lead to increased glucose
sensitivity
• Proving that exercise helps to reverse the main causes of
type II diabetes
Affect of Exercise on
Insulin Receptivity

72. •
• Hypoglycemia- rapid drops in blood glucose my occur with
exercise, resulting in headache, visual
disturbances, confusion, shakiness, weakness, abnormal
sweating, loss of breath, amnesia, seizures, coma
• Dehydration from polyuria my contribute to a compromised
thermoregulatory response
• Retinal detachment and hemorrhage
• Ketosis
• Complications due to nephropathy
Contraindications

73. • References
• Craniou, G. N., Smith, D. C., & Hargreves, M. (2006).
Acute exercise and GLUT4 expression in human skeletal
muscle: influence of exercise activity. Journal of Applied
Physiology, 101.
http://dx.doi.org/10.1152/japplphysiol.01489.2005
• Lupash, E. (Ed.). (2014). ACSM's guidelines for exercise
testing and prescription (9th ed.). Philadelphia, PN:
American College of Sports Medicine.
References

74. Exercise in Older Adults
Brock Duke

75. Definition of Older Adults
• Older adults are defined as individuals 65
years of age or older
• Or
• Individuals 50-64 with clinically significant
conditions or physical limitations that affect
movement, physical fitness or physical ability

76. Goals
•
•
•
•
Improve Quality of Life
Improve health
Improve Activities of Daily Living
Improve Self-efficacy

77. Cardiorespiratory Fitness
• Frequency
• Moderate 5+ days/wk, Vigorous 3+ or 3-5 of a combination of the
two
• Intensity
• Use a 0-10 scale for RPE, 5-6 moderate, 7-8 for vigorous
• Time
• Mod 30-60 per day or 150 total
• Vig 20-30 per day or 75 total
• Type
• Activities that don’t put excessive orthopedic stress on
joints, walking most common. Spin Bike and swimming also good
choices
• Progression
• Increase duration before intensity, 5-10 min every 1-2 weeks

78. Resistance Training
• Frequency
• 2 or more days per week
• Intensity
• Light 40-50% 1RM, Moderate 60-70% 1RM, Vigorous 70-80% 1RM
• If 1RM not measured use RPE 0-10, Light 4-5 Moderate 5-6
Vigorous 7-8
• Type
• Progressive weight training programs or weight-bearing
calisthenics using large muscle groups
• 8-10 exercises, 1+ sets of 10-15 reps
• Time
• Adequate rest should be given between sets, 1-2 minutes. If
fatigued give 3-5 minutes
• Progression
• gradual increase in progression, increase set, reps and frequency

79. Contraindications
• Balance is a large issue, put in good situations
with trained instructor
• Specific to each clients needs
• Tailor to meet their needs
• Work with them to improve weakness
• Remember we are trying to help them be
healthy, improve ADL’s and self-efficacy

80. References
• Phillips, S., Wójcicki, T., & McAuley, E. (2013). Physical activity and
quality of life in older adults: an 18-month panel analysis. Quality Of
Life Research, 22(7), 1647-1654. doi:10.1007/s11136-012-0319-z
• Pescatello, L. S., & American College of Sports Medicine.
(2014). ACSM's guidelines for exercise testing and prescription.
Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins Health.

81. MULTIPLE SCLEROSIS
Matt Brotherton

82. MULTIPLE SCLEROSIS
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MS is a chronic inflammatory disease of the central
nervous system
Causes a decrease in the amount of myelin surrounding
neurons
Exact cause is still unknown and there is no cure
Disease is marked by periods of regression and
exacerbation
Treatment often involves management of symptoms
Common issues include poor balance, poor
coordination, pain, weakness, poor vision, bowel and/or
bladder dysfunction, impaired thermoregulation, and
possibly psychological disturbances

83. CARDIORESPIRATORY FITNESS
RECOMMENDATIONS
Frequency – 3-5 days/week
 Intensity – 40%-70% VO2reserve or HRR; RPE 1114
 Time – 20-60 mins per session or minimum 10 min
bouts
 Progression – progress according to individual’s
performance and personal goals
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Endurance-type activity resulted in improved CRF
and even strength gains in some individuals; No
contraindications to exercise found (Romberg et
al, 2004)

84. RESISTANCE TRAINING RECOMMENDATIONS
Frequency – 2 days/week
 Intensity – 60-80% 1 RM
 Time – 1-2 sets of 8-15 repetitions
 Progression – as with CRF, progress according to
individual’s progress and personal goals
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Resistance training can be highly beneficial to
individuals with MS and even elicit reductions in
chronic symptoms (Dalgas et al, 2009)

85. FLEXIBILITY RECOMMENDATIONS
Frequency – 5-7 days/week, 1-2 times/day
 Intensity – stretch to the point of tightness or mild
discomfort
 Time – hold static stretch 30-60 seconds, 2-4 reps
 Progression – progress as needed remaining
mindful of the goals and progress of the individual
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86. CONTRAINDICATIONS TO EXERCISE
Exacerbations of the disease; acute symptom
presentation
 Uhthoff Phenomenon
 The key is risk prevention – make the environment
safe and easy to navigate; make restrooms easily
accessible and have access to temperature
regulation
 Pool exercises and cycling may be preferable
exercise modes for MS patients
 Be aware of possible psychological disturbance that
can be secondary to the disease
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87. REFERENCES
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Pescatello, L. S. (2013). ACSM’s Guidelines For Exercise Testing and
Prescription: Ninth Edition. (pp. 311-315). Wolters Kluwer.
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Dalgas, U., Stenager, E., Jakobsen, J., Petersen, T., Hansen, H.
J., Knudsen, C., Overgaard, K., & Ingemann-Hansen, T. (2009). Resistance
training improves muscle strength and functional capacity in multiple
sclerosis. Neurology, 73(18), 1478-1484. Retrieved from
http://ovidsp.tx.ovid.com.ezproxy.lib.utah.edu/sp-3.10.0b/ovidweb.cgi?
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Romberg, A., Virtanen, A., Ruutiainen, J., Aunola, S., Karppi, S.
L., Vaara, M., Surakka, J., & Pohjolainen, T. (2004). Effects of a 6-month
exercise program on patients with multiple sclerosis. Neurology, 63(11), 20342038. Retrieved from http://ovidsp.tx.ovid.com.ezproxy.lib.utah.edu/sp3.10.0b/ovidweb.cgi?

88. MULTIPLE SCLEROSIS
Exercise Prescription
By: Aubri Poulsen

89. WHAT IS MULTIPLE SCLEROSIS?
Autoimmune disease
 One's own immune system damages the nerves of the
brain and spinal cord.
 Buildup of scar tissue
 Demyelination of the CNS nerves
 Disruption of electrical signals
 Loss in muscle control, balance, sensation, vision
 More common among females
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90. F.Y.I.
Expanded Disability Status Scale (EDSS) is a
method of quantifying disability in multiple sclerosis.
The EDSS quantifies disability in eight Functional
Systems (FS) and allows neurologists to assign a
Functional System Score (FSS) in each of these.
 “The following recommendations are limited to MS
patients with an EDSS score of less than 7,
because too little is known about the effects of
exercise in the more severely impaired group of MS
patients.” (Dalgas, Ingemann-Hansen & Stenager,
2007)
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91. CARDIORESPIRATORY FITNESS
RECOMMENDATIONS
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The FITT recommendations
3-5 days a week working at 40-70% VO2R or HRR.
RPE of about 11-14.
 The subject should be begin with a minimum of ten
minutes of exercise before increasing the intensity.
 If the subject has excessive fatigue they should start
lower on the intensity scale and do discontinuous
sessions of exercise.
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93. RESISTANCE TRAINING RECOMMENDATIONS
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Resistance training “must be performed under
supervision from experienced personnel, until the
MS patient is comfortable with the training
program.” (Dalgas, Ingemann-Hansen
& Stenager, 2007)
2 days a week at 60-80% of 1 RM.
 1-2 sets of 8-15 repetitions.
 Higher rest time of 2-5 minutes to allow for muscle
recovery.
 In order to maximize their ADL’s, the prescription should
include functional activities.
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94. PHYSICAL ACTIVITY/
EXERCISE CONTRAINDICATIONS
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“resistance training more rarely than endurance training
will cause unpleasant experiences, because of
increases in body temperature.” (Dalgas, IngemannHansen & Stenager, 2007)
Exercises, “affecting core temperature should always be
considered and minimized, in order to make exercise as
pleasant as possible”. (Dalgas, Ingemann-Hansen
& Stenager, 2007)
Don’t perform exercises in extreme heat environments.
Don’t exercise above the level of tolerance based on
any acute exacerbation of MS symptoms.
During an acute exacerbation of symptoms, avoid
testing.
Avoid a large amount of exercises in one bout of
exercise.

95. +
Special Population:
Osteoporosis
By: Brianna Turner

96. + Osteoporosis…
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is a progressive bone disease that is characterized by a
decrease in bone mass and density which can lead to an
increased risk of facture.
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This disease classified as primary type 1, primary type 2, or
secondary
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Most common is Primary Type 1, refers to postmenopausal
osteoporosis.

97. +
Types of activities recommended…
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Strength training exercises
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Weight-bearing aerobic activities
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Flexibility exercises
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Stability and balance exercises
Importance: work directly on your
bones to slow mineral loss!!!!

98. +
Resistance Training
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Importance: Strength training works directly on you
bones to slow the mineral loss, helps reduce
harmful stress on your bones and maintain bone
density.
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Frequency: ACSM: 2-3 days/week
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Intensity: <60% of 1-repetition maximum (1RM)
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Type: Free weights, resistance bands. 1-3 Sets, 812 Reps, 4-6 exercises
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Time: 15-30 minutes
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Progression: Additional weight added gradually, up
to 10 pounds using weighted vest.

99. +
Cardiorespiratory
Fitness
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Frequency: 3-5 days/week
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Intensity: Moderate
Intensity(40-60% HRR)
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Time: 30-60 min.
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Type: Walking, dancing,
elliptical, stair climber
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Progression: Add time of
activities as tolerated.

100. +
Contraindications
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No current guidelines regarding contraindications.
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Recommendations….
*Avoid explosive movements
*Avoid High-impact loading
*Avoid exercises involving twisting at the waist
*Avoid exercises with spinal extension, and spinal flexion