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CHAPTER 13 Considerations for Clients with Chronic Disease


Muscular Training Frequency Intensity


Time Type


� 2–3 days per week with a minimum of 48 hours separating exercise for the same muscle group


� 40–60% 1-RM, or a load that can be lifted 10–15 repetitions without straining � RPE of 11–13 (6–20 scale)


� No specific session duration has been found to be most effective


� Various equipment can be used for resistance training, including: ƒ Elastic resistance ƒ Free weights ƒ Pulleys ƒ Selectorized machines


� Each major muscle group should be trained initially with one set � Multiple-set routines may be introduced later, as tolerated


Progression � Progress following the ACE Integrated Fitness Training Model based on client goals and availability.


� Progression can be introduced through increases in resistance, number of repetitions or sets, or decreasing rest periods between sets.


� Progression should be slow and dependent on tolerance.


ƒ Volume can be increased 2–10% once clients comfortably complete 1–2 repetitions beyond the target range on two consecutive training sessions.


*Moderate intensity = Heart rates <VT1 where speech remains comfortable and is not affected by breathing; Vigorous intensity = Heart rates from ≥VT1 to <VT2 where clients feel unsure if speech is comfortable.


Note: HRR = Heart-rate reserve; V •


O2 R = Oxygen uptake reserve; RPE = Rating of perceived exertion; bpm = Beats per minute; HR = Heart rate; RHR = Resting heart rate; 1-RM = One-repetition maximum; VT1 = First ventilatory threshold; VT2 = Second ventilatory threshold


Source: American College of Sports Medicine (2018). ACSM’s Guidelines for Exercise Testing and Prescription (10th ed.). Philadelphia: Wolters Kluwer.


EVALUATE AND CREATE 1.


Cardiorespiratory Training


Frequency ≥5 days/week of moderate exercise, or ≥3 days/week of vigorous exercise, or a combination of moderate and vigorous exercise on ≥3–5 days/week is recommended


� 3–7 days per week


� 3 days of vigorous or 5 days of moderate intensity (greater regularity may facilitate diabetes management)


Most, but preferably all, days of the week


General Evidence-based Recommendations


Diabetes


Hypertension


THE EXERCISE PROFESSIONAL’S GUIDE TO PERSONAL TRAINING STUDY COMPANION


American Council on Exercise


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