chap 11

1. Exercise Prescription for
Special Population (ACSM, 2000)
Courtesy from YM Raja Mohammed Firhad
Bin Raja Azidin
Faculty of Sport Science & Recreation

2. Exercise Prescription for Special Population
• Children
• Elderly
• Pregnant Women
• Obese

3. Exercise Prescription for
Children

4. Benefits (ACSM, 2000)
• Greater strength & endurance
• Enhance bone formation
• Weight management
• Reduce anxiety & stress
• Improved self esteem and self efficacy
• Minimize HD risk factors
• Fun & enjoyment
• Social interaction
• Skill development

5. Exercise Prescription for Children
• Person more than 6 years – at least 30 min of
moderate intensity physical activity on most &
preferably all days of the weak
• Young children – active play, enjoyment &
creative activity
• Children doesn’t need HR prescription to
regulate intensity
• Variety of exercise – weight bearing activity
(basic skill development), weight management,
aerobic fitness and bone mineral content

6. General Guidelines RT program for Children
• Should be supervised and monitored by trained staff
• Physiologically immature participant
• Primary focus – learning proper technique & develop
interest
• Controlled movement
• Avoid practice power lifting & body building
• Full ROM, multi joint exercise
• Ensure participant can understand & follow instruction

7. Dose Response RT
• Intensity
– Avoid reps use of
maximal loads until
reaching (adolescence)
– Weight load – permits >
8 reps
– Don’t performed to the
point of severe muscular
fatigue
– Increase no of reps first,
& then increase the no
of loads
• Duration
– 1 to 2 sets of 8 to 10
exercise (with 8 – 12
reps)
– Early stage – 1 set
– Rest 1-2 min between
exercises
– Intersperse rest days
• Frequency
– 2x/week

8. Physical Activity
For Pre Schoolers

9. Dance & Rhythmic Activities
Safety Precautions
• Proper warm up & cool down
• Allow for intermittent rest periods within the class activity
• Avoid movement that result in hyperextension of any joint
• Do not repeat a movement more than 4 consecutive times on one
leg
• Avoid any quick, jerky movements of the arms, head or leg
• Be cautious of dance moves that use a crossover step
• Participant must maintain proper posture & body alignment
• Initially, teach a dance at a slow tempo without music
• Gradually moving from simple to advance movement
• Proper attire – no jewelry, wear general cross training sneakers
instead of running shoe, socks

10. Motivational Strategies
• Teach basic skills
– e.g., how to jog, curl up – proper
form and technique. Participants
assume you care about improving
their physical development
• Choose success-oriented
activities
– Design activities at the
appropriate developmental level
that include challenges that
participants can achieve through
practice.
– e.g., activities choice such regular
push up, open stance push up or
wall push up.
• Have fun, fun, fun
– Participant should laugh, sing play
and interact while engaged in
physical activity.

11. Motivational Strategies
• Add creative equipment
– Add unusual items such as
rubberized exercise toners, heavy
jump rope or heart rate monitor to
renew interest.
• Create colorful environment
– Decorate the gym with colorful
posters, exercise charts and
bulletin board.
• Provide incentives
– Occasionally provide participants
with positive, healthy incentives
(fitness certs, yogurt etc) for
active participation.
• Be a role model
– You need to keep trim, exercise
with your classes, eat healthy
foods, keep nutritious snack at
your desk and talk to your
participants about after school
activities such as volleyball,
baseball, soccer etc.

12. Motivational Strategies
• Accentuate the positive
– Practice using the gestures
(laugh, smile, give thumb up,
give high five etc) and words
of encouragement (e.g., great
job, I’m impressed, wonderful
etc.)
• Involve parents
– Student will gain additional
support and reinforcement
when they know their parents
are interest and involved with
physical activity.
• Vary your teaching strategies
– Use a variety of teaching
strategies such as small
groups, independent activities
and partner workout to meet
the participant needs and
interests.

13. Exercise Prescription for
Elderly

14. Benefits
Refer Resistance Training
Program Notes

15. ACSM Physical Activity Guidelines for
Older Adults (age 65 and older).
• Moderate intensity aerobic 30min/day, 5
days/week OR Vigorous intensity aerobic
20min/day, 3 days/week
• Do 8-10 strength training exercise, 10-15 reps,
2 to 3 times/week
• For older adults who are at risk for falling,
perform balance exercises
• Have a physical activity plan

16. Exercise During
Pregnancy & Lactation

17. “..Contrary to advice in years
gone by,exercise now encouraged
during pregnancy..”
(ACSM, 2005)

18. Contraindications for Exercising
During Pregnancy
• Pregnancy-induced hypertension
• Preterm rupture of the membrane
• Preterm labor during the prior or current
pregnancy
• Incompetent cervix
• Persistent bleeding in the second to third
trimester
• Intrauterine growth retardation

19. Benefits
• Improved aerobic & muscular fitness
• Facilitation of recovery from labor
• Enhanced maternal psychological well being
• Establishment of permanent healthy lifestyle
habits
• More rapid return to prepregnancy weight,
strength & flexibility level
• Fewer obstetric interventions
• Shorter active phase of labor & less pain
Next page…

20. Benefits
• Less weight gain
• Improved digestion & reduced constipation
• Greater energy reserve
• Reduced “postpartum belly”
• Reduced back pain during pregnancy
• Improvement in sleep
• Fewer obstetric interventions
• Less chance of miscarriage
• “Fit mums, brainier babies”

21. American College of Obstetricians &
Gynecologists (ACOG) Recommendations for
Exercise in Pregnancy & Postpartum
• Mild-moderate exercise routine (THR < 140bpm)
• Start exercise only after the first trimester
• Gradually reduce intensity, duration, & frequency
during 2nd and 3rd trimesters
• Avoid exercise in supine position (reduce Q - low blood
supply to the uterus)
• Avoid prolonged period of motionless standing
• Avoid exercise to exhaustion

22. American College of Obstetricians &
Gynecologists (ACOG) Recommendations for
Exercise in Pregnancy & Postpartum
• Avoid mild abdominal trauma – sit up, crunches
• Avoid overstretching (joint laxity)
• Must augment heat dissipation – adequate hydration,
cloth, environment
• Post pregnancy exercise can start after 4-6 weeks of
child birth
• Ensure adequate diet (additional 300kcal/d)

23. Reasons to Discontinue Exercise
• Any sign of bloody discharge from the vagina
• Any “gush” of fluid from vagina
• Sudden swelling of the ankles, hands or face
• Persistent, severe headache, and/or visual
disturbance
• Swelling, pain & redness in the calf of one leg
• Elevation of HR or BP after exercise
• Excessive fatigue, palpitations, chest pain
• Unexplained abdominal pain
• Insufficient weight gain (<1.0kg/month)

24. Exercise Programs
• Pregnant women should be instructed to begin exercise
at low intensity and gradually increase time and intensity
to avoid overuse injuries. Starting with 15 minutes of
continuous activity 3 days per week and gradually
increasing to 30 minutes 4 days per week is
recommended
• Swimming or pool-based aerobic exercise easiest to do,
but walking, yoga for pregnancy, stationary biking, and
other low-impact aerobic machines may also be well
tolerated.

25. Exercise Prescriptions for
Obese Population

26. Program Objective
• Exercise component of a weight loss
program should promote a high total
calorie expenditure (300 to 500 kcal per
day and 1000 to 2000kcal per week for
adults).

27. Criteria of an Appropriate
Weight-Loss Program
• Well trained/qualified staff
• Your client should receive a medical screening
• A reasonable weight goal should be establish (0.5-1kg/week)
• Individualized treatment based on weight loss goal
• The program should disclose in writing all health risk and benefits
associated with the program
• Diet program should be
– Contains no less than 1000 – 1500 cal/day
– In between 10-30% fat
– Has at least carbs 100g/day
• The program should have a exercise/nutrition-education component that
stresses permanent lifestyle changes
• Component of exercise program should include both aerobic and
resistance training
• Individualized behavior modification technique
• The program should include weight maintenance phase

28. Dose-Response
• Frequency
– 5 x week or daily
• Intensity
– 40/50 – 85% of HRR
– The lower level of
intensity is for
individual who is quite
unfit
– Increase duration
rather than intensity
• Duration
– 40 – 60 min OR
– 2 sessions/day of 20 –
30 min
Max weight loss of 1kg/week

29. Dose-Response
• Mode
– Use low impact
activity (e.g.,
walking, jogging,
cycling)
• Resistance Training
– Low load, high reps
(muscular endurance
– circuit training)
• RT Exercise Selection
– Modified push up
– Modified chin up
– Ball Squat
– Half Lunges
• Precautions
– Increased risk of
orthopedic injury, CVD
& hyperthermia.
– Equipment/exercise
modification may be
necessary