Exercise Prescriptions for High Risk Individuals

Exercise has been proven to help many medical conditions and reduce inflammation. However, those who are high risk do not usually feel comfortable exercising. Treating disease and developing a program for long-term health is the overall goal with exercise prescriptions. To begin, all patients must undergo an assessment of physical capabilities as well as physiological. The hard push of exercise is not something all patients are mentally ready to tolerate. 

Identifying Patients Psychological Predisposition for Exercise

The following are specific phrases a patient may use during a screening indicating they are not ready for exercise:

• I don’t know if I can find the time
• I get bored easily 
• Family obligations may make it difficult to exercise 
• The exercise setting available to me does not meet my needs
• I am only doing this for my health 
• Work demands make it difficult to exercise 
• I feel intimidated or embarrassed in an exercise setting 

Classifications

Once the initial assessment is finished, the patients are classified into three groups.

Level 1: Very obese/Diabetic/ Vardiovasuclar Concerns/ Significantly De-Conditioned/ Very Limited Mobility 

Level 2: Overweight/ Diabetic/ Cardiovascular Concerns/ De-Conditioned/ Mobile 

Level 3: Overweight/ Pre-Diabetic/ Active 

At the beginning of a program, the distinct goals and areas of focus are improved athletic performance and health. While keeping these the center of attention, patients are more likely to comply and continue with their exercise regime.

Exercising Large Muscle Benefits 

Exercise in general has a vast list of benefits. However, when considering the high-risk population, one of the most important benefits is the glycemic factor and the muscle changes in the body. With many high-risk patients, their metabolism is not optimally functioning. By working for the largest muscle groups in the body, the endocrine system starts being challenged and handing blood glucose more effectively. 

For those who are trained and used to exercise, utilizing the small muscles may be beneficial. On the other hand, those who fall into one of these three categories, exercising the small muscle groups does not provide large beneficial effects on the cardiovascular system nor does it stimulate the nervous system. Exercising large muscle groups improves overall HbA1C as well as the increase of protein synthesis post-exercise. This utilizes more active tissues and results in more sugars being shuttled out. We use a cardiovascular assessment from Genova diagnostics to assess overall cardiovascular health. A sample is shown below: 

Take-Aways 

Each protocol that is created is patient specific. This will result in optimal patient compliance, leading to the best results. The first month of the journey should always be about enjoyment and feeling accomplished. Patients who enjoy the first month are more willing to continue, thus seeing the optimal benefits. Additionally, patients should be encouraged to stay away from the scale in the first month. After the first month is over and the program continues, patients may begin to minimally weigh themselves to use the number as a benchmark factor to measure further progress. 

To get started, take this metabolic questionnaire below: 

I firmly believe that exercise benefits nearly every single individual. Exercise is highly important not only from a cardiovascular standpoint but from the musculoskeletal standpoint as well. Exercise helps to increase bone health and strength while reducing inflammation! It does not have to be much, but even two days a week of 15-30 minute exercise will improve overall health. -Kenna Vaughn, Senior Health Coach 

References:

Bramos, Rick. “New Perspectives on Clinical Exercise (What Works) .” Functional Medicine University. 2020.

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