General Programming and Common Issues

General Programming

Considerations

• Clients need to self-identify tasks and activities of daily living they feel are important
• Improvement in the execution of tasks can be used to determine progress
• Group activities are very beneficial for physical and more importantly mental health
• Four strands of fitness – strength, flexibility, balance, and endurance.

Safety First

• Good footwear- non-slip
• Floor surface – not slippery, uncluttered, no mats or other trip hazards
• Good lighting – possible vision issues
• Mirrors – feedback mechanism – checking technique and posture
• Music – choice, level, balance with microphone – auditory issues, hearing aids, frequency sensitivities
• Prepare for varying participant ability levels – have a choice of exercise options
• Temperature – older bodies have more difficulty with temperature regulation- feel the cold and the heat more. The temperature will also affect some conditions like asthma and arthritis
• Intensity monitoring – need to make exercisers aware of signs when intensity may be too great – difficulty breathing, weakness and muscle fatigue, pain in any form and dizziness. The instructor will need to keep a close eye on all participants to ensure intensity and load is appropriate.

Medication Alert

• Instructors need to be aware of the possible effects of medication on the clients when participating in an exercise program
• Commonly prescribed are beta-blockers and other blood pressure medication, diuretics, angina medications, anti-depressants, aspirin, and arthritis medications
• Beta-blockers reduce heart rate and cardiac output – use rate of perceived exertion rather than heart rate to determine intensity. They can also cause fatigue and dizziness
• Other anti-hypertensives lower blood pressure and can contribute to dizziness and fatigue
• Angina medications – the side effect of postural hypotension and reduced cardiac output
• Diuretics can be used in conjunction with blood pressure medication so encouraging water intake is important to prevent dehydration
• Nitrates can be used for angina – they dilate the blood vessels and side effects include headaches, nausea, and hot flushes
• Anti-depressants – side effects can include weight gain, fatigue, dry mouth, constipation, dizziness, and anxiety
• Arthritis medications – stronger ones are associated with rheumatoid arthritis. Stomach upsets and rashes can occur.

Other Issues

Challenge

• Add demands on other body systems
• e.g. unstable surfaces, altered lighting conditions, add a second task.

Accommodation

• Fluctuating health
• e.g. the varying effects of multiple medications, varying pain levels.