Exercise Program for Special Population Part 2

Intro: I had done the special population and the exercise program PART 1. This is good for those who want to live a longer and better life. It is recommended to find personal trainer and a doctor that focuses on exercise and physiology. Exercise testing of cardiorespiratory fitness, muscular fitness, body composition, and flexibility is highly required before you start prescribing guidelines or exercise program. Part 2 will focus on arthritis, cancer, HIV, Down syndrome, Multiple Sclerosis, Kidney disease, Osteoporosis, Parkinson disease, Spinal cord injury, and multiple disease/health condition.

*The information provided below came from the textbook ACSM’s Guidelines for Exercise Testing and Prescription 9th edition.*

This information is good for personal trainers who might encounter clients with these kind of health conditions. Notes like VO2R and 1-RM are based on fitness assessments, so I’ll be using words like low, moderate, and vigorous for intensity. For flexibility, each guideline will follow the general healthy population. Look at my blog content for flexibility. This information should be considered after exercise testing and health assessments.

Photo by OpenStax from Wikimedia Commons


Arthritis for aerobic, resistance, and flexibility

Frequency 3-5 days a week

2-3 days a week


Intensity Light to moderate

Light or moderate

Time More or equal to 150 min a week, 10 min bouts
Type Walking, cycling, swimming, exercises targeting large muscle groups


Cancer for aerobic, resistance, and flexibility

Frequency 3-5 days a week

2-3 days a week


Intensity Moderate to vigorous


Point of tension due to ROM restriction

Time 150 min a week, 1 set 8-12 reps, 5-10 min
Type Walking, cycling, swimming

Weights, resistance machines, weight-bearing functional tasks

Stretch major muscle groups but be careful with restriction due to surgery, radiation, or steroids


HIV for aerobic, resistance, and flexibility

Frequency 3-5 days a week

2-3 days a week


Intensity Light to Moderate

8-10 reps at 60% or moderate

Time 10 min then progress to 30-60 min a day

30 min 2-3 sets of 10-12 exercises

Time same for general health population flexibility

Type Varies depending on health status and interests of the individuals, no contact and high-risk sports

*Aerobic and resistance exercise programs must start at low volume and intensity due to the virus and drug side effects.*

Down Syndrome for aerobic and resistance training

Frequency 3-7 days a week but 3-4 days a week for moderate and vigorous intensity combined

2-3 days a week

Intensity Low to moderate then moderate to vigorous depending on current fitness status

12 reps at low intensity then progress to 8-12 reps of moderate to vigorous intensity

Time 30-60 min, may use 10 min bouts

2-3 sets with 1-2 min rest between sets

Type Walking and progress to activities like running and swimming

Machines targeting 6-8 major muscle groups and use supervision for the first 3 months


Multiple Sclerosis

Frequency 3-5 days a week

2 days a week

5-7 days a week, 1-2 times a day

Intensity Low to moderate to vigorous (11-14 RPE)

Moderate to vigorous

Stretch to point of tightness or mild discomfort

Time 10 min bouts, 20-60 min

1-2 sets of 8-15 reps

30-60 sec with 2-4 repetitions

Type Exercises like walking, swimming, or cycling

Target major muscle groups

Stretch major muscle groups


Kidney disease for aerobic, resistance, and flexibility training

Frequency 3-5 days a week

2-3 days a week

Same for general health population flexibility guideline

Intensity Moderate intensity

Moderate to vigorous

Time 20-60 min

1 set 10-15 reps with 8-10 exercises for major muscle groups

Type Walking, cycling, swimming

Machine weights or free weights


Osteoporosis (This is for those with Osteoporosis) for aerobic and resistance training

Frequency 3-5 days a week

2-3 days a week

Intensity Moderate intensity

Moderate intensity

Time 30-60 min (same for resistance training)
Type Weight-bearing aerobics like stair climbing

Weight lifting

*There is a guideline for those at risk for Osteoporosis, so I might add the guideline at the end of the article.*

Parkinson disease

Frequency 3 days a week

2-3 days a week

1-7 days a week

Intensity Low to moderate (11-13 scale)

Low to moderate then moderate (somewhat hard)

Stretch to point of slight discomfort

Time 30 min

1 set of 8-12 reps or 10-15 reps for adults

10-30 sec, repetitions depend on client desire

Type Walking, cycling, swimming, or dancing

Focus on trunk and hip muscles to prevent posture problems and major muscles of lower extremities

Stretch major muscle groups

*Balance training is good to improve posture instability and balance performance.*

Spinal cord injury

This is different from the rest because the FITT principle is the same for general population. There is special consideration so personal trainers need to look at that before programing exercise training.

Multiple disease/health condition

The FITT principle will follow the same for healthy adults. Take into special consideration for those with multiple chronic disease and health condition. Contact the client’s doctor to enhance the exercise prescription.


Before the exercise testing and guidelines should be given to the clients, be sure to have the clients to fill out the health history questionnaire and Par-Q form, especially for personal trainers, because this can determine what to look for before getting approval for doctors to clear them for exercise. Exercise testing is important, so look at the textbook “ACSM’s Guidelines for Exercise Testing and Prescription” to look at what kind of testing is appropriate for the following health conditions mentioned above. Special consideration is crucial for clients. Contact the client’s doctor and discuss what to include and not to include for exercise prescription. Have a safe exercise and stay alive.

Strawberries And Measuring Tape
Image by Lisa Fotios from Pexels


Pescatello, L. (2014). ASCM’s Guidelines for Exercise Testing and Prescription (9th edition). Philadelphia: Wolters Kluwer.

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