The one person who I consider high-risk is a client with Parkinson’s disease.
Our fitness journey goes years back before he was even diagnosed with that disease, and all I had to contend with then was deconditioning and an arthritic condition.
The changes and adaptations in exercise programming were gradual. Once Parkinson’s was diagnosed and started to show noticeable effects, the programming began to shift towards maintaining as much strength and balance as possible. Cardiovascular exercise eventually was out of the question. The overriding principle was always to prevent falling; first, of course, during exercise, but also outside the studio when he was at home.
Dealing with Parkinson’s has been a very difficult situation for me, more on an emotional level than as a challenge in training. I now train my client at his home, and I insist to have another person attending because of increasing frailty. I often have to cut the 30 minute session short because he sometimes is quickly tired, particularly if there had been another item on his daily agenda. We just always ‘play it by ear’.
His physicians are aware that he is working out with me. I cut back on exercises as safety requires but I promised him that I would not terminate the training on my end. I know that that would signal to him that I have given up on him.
I am not sure whether you can even call this an exercise programming solution because the training now has at least as many psychological as physical aspects.
Right now I work with an 85 year-old male, who had a quadruple bypass surgery 2 years ago and also had a hip replaced few years back. I did an assessment on him when he started working out (about 3 months ago) and now he is able to walk with little rest for about 20 minutes and does some upper body exercises to help him increase his flexibility and strength. Some exercises to improve his balance are also part of his training program.
In the past I have worked with people with diabetes (type 1), heart surgery patients and with clients who were wheelchair dependent.