Some of your clients may have one or more chronic health conditions. In order for you to be able to deliver your sessions to them safely, you need to have a basic understanding of some of the most common conditions and we have included them below. If you are unsure of a condition, it is important that you research it thoroughly using a recognised and trusted site (not Wikipedia) to understand any symptoms and limitations that they may have.
Some symptoms of chronic health conditions may be exacerbated by certain exercises and you will need to monitor and adapt where required. In certain circumstances, it is acceptable to work through discomfort – osteoarthritis – but not reported pain .
A Long term Physical Health Condition is one that cannot currently be cured but can be controlled with the use of medication and/or other therapies.
This includes a wide range of health conditions including:
- Non-communicable diseases (e.g. cancer and cardiovascular disease);
- Communicable diseases (e.g. Human Immunodeficiency Virus (HIV) / Acquired Immunodeficiency Syndrome (AIDS));
- Certain mental disorders (e.g. schizophrenia, depression) and
- Ongoing impairments in structure (e.g. blindness, joint disorders).
Examples of Long Term Physical Health Conditions include:
- Cardiovascular (e.g. Hypertension, Angina)
- Chronic Respiratory (e.g. Asthma, Chronic Obstructive Pulmonary Disease (COPD))
- Chronic Neurological (e.g. Multiple Sclerosis)
- Chronic Pain (e.g. Arthritis)
- Other Long Term Conditions (e.g. Chronic Fatigue Syndrome, Irritable Bowel Syndrome (IBS), Cancer) etc.
For the purpose of Pilability, we will be focusing on some of the conditions in the latter group. We need to be aware of how the symptoms of the people living with these long term conditions can be affected when taking part in an exercise programme. Strict completion of a PAR-Q is vital to be able to monitor your clients and to assess how they will cope with the sessions. Always ask the client or refer back to the clinician or GP if you are unsure about their suitability for the programme.
This information is vital as it will impact how you deliver adaptations around their individual needs to enable health and safety, but also retention on the programme as goals and outcomes will be realistic and achievable for the attendees.
We know that people with medical or long term conditions may need to take a variety of medications to treat the conditions and symptoms. Anybody taking 4 or more medications will be at a greater risk of falling due to some of the side effects of the drugs. With multiple conditions therefore, treatment is usually with more medication therapy – polypharmacy – and with this, comes an even greater risk of falling.
Some of the more common medical conditions that you may see in the elderly populations can be categorised into different groups;
Brain and mental health disorders such as Dementia which include Alzheimer’s disease, Lewy Body, Vascular, Mixed and Fronto-temporal dementia and CJD. Some dementia types are seen in other diseases such as MS, Parkinson’s, Huntington’s, long term alcohol use and traumatic brain injuries. Depression, Bipolar affective disorder and Parkinson’s disease also sit within this group.
Cancer, a condition where cells in a specific part of the body grow and reproduce uncontrollably. The cancerous cells can invade and destroy surrounding healthy tissue, including organs. The most common types of cancer are breast, lung, prostate and bowel cancer.
Cardiovascular diseases which include Peripheral vascular disease, Ischaemic heart disease or Coronary heart disease, Atherosclerosis, Stroke, Hypertension (high blood pressure), Postural hypotension (an abnormal drop in blood pressure when standing), Angina, Arrhythmias and Heart failure.
Chronic Respiratory diseases including Asthma, Chronic Obstructive Pulmonary Disease COPD and Emphysema.
Chronic Neurological disorders such as Multiple Sclerosis – MS, Epilepsy, Migraine and Parkinson’s disease.
Endocrine and diseases affecting the metabolism such as Osteoporosis, Diabetes Types 1 and 2.
Orthopaedic conditions including joint replacements, Osteoporosis, Osteoarthritis and Rheumatoid Arthritis.
Sensory system diseases including Meniere’s disease, Blindness, Cataracts, Glaucoma, Deafness and Hearing loss.
Obesity and Hypercholesterolaemia (high cholesterol)
We will go into more details in the following pages