Abstract
Exercise is an important aspect in the rehabilitation and treatment of obese patients, those with heart disease, diabetes and pulmonary diseases. However, patients with these conditions require special modifications in their exercise prescription as each condition is unique and produces a different physiological response to exercise. This paper will discuss the modifications and considerations that are involved for testing and exercise prescriptions among patients with these underlying conditions.
Patients with cardiac conditions like a heart disease need modification in the intensity levels of their exercise. In the presence of a pre-existing hypertension there is a high risk of an increased blood pressure with exercise. Patients with a high blood pressure need to take an anti-hypertensive medication prior to their exercise and they should be prescribed with a low level and short duration exercise with close monitoring of their blood pressure. Resistance exercises should be contraindicated among patients with heart disease and their exercise should be focused more on aerobic exercise training.
The oxygen demand and carbon dioxide removal increase among patients with pulmonary diseases, most particularly among asthmatic patients during exercise. Exercise testing should be performed among these patients in order to determine their cardiopulmonary capacity, arterial blood gases and arterial oxygen saturation as well as their pulmonary function (Williamson, 2011). Exercise prescription among these patients is usually walking or stationary cycling. Excessive movements among patients with pulmonary disease might trigger shortness of breath because of their ventilation limitation owing to their condition.
Diabetic patients require special considerations in their exercise prescriptions. Loss of sensation is common among diabetics therefore they should not be prescribed with a treadmill exercise, jogging and prolonged walking. Instead, rowing, swimming, chair exercise, arm exercise and non-weight bearing exercises are most ideal for their condition (American Diabetic Association, 2002). For diabetics without any loss of sensation problem, weight bearing aerobic exercises such as walking are recommended as it could help in reducing their risk of developing complications like heart disease, hypertension, obesity and metabolic abnormalities. Proper hydration should also be appropriately included in their exercise prescription.
The cardiac workload among the obese individuals may rise during exercise and in certain cases, exercise tolerance may be compromised in any given form of exercise to an obese individual. Moreover, obese individuals have heat intolerance which also contributes to the cause of exercise limitation among these groups. The recommended exercise prescription for obesity is one that involves a moderate exercise intensity that uses large muscle groups. Rhythmic and aerobic exercise is the most appropriate exercise for the obese as it lowers the risks of injury and exercise intolerance. Low intensity and non-weight bearing exercise is most appropriate for an obese who has a low exercise tolerance as it promotes endurance and weight loss in the long term of exercise performance (Skinner, 2005).
Reference
American Diabetic Association (2002). Diabetes Mellitus and Exercise. Diabetic Care, 25 (1).
Williamson, P. (2011). Exercise for Special Populations. Philadelphia: Lippincott Williams and Wilkins.
Skinner, J.S. (2005). Exercise Testing and Exercise Prescription for Special Cases: Theoretical Basis and Clinical Application. Philadelphia: Lippincott Williams and Wilkins.
