I’ve worked with individuals with a colostomy bag. However, they were wheelchair bound.
Personally, I would be more concerned about what other health conditions your client has been diagnosed with and design the program around her clinical conditions.
The American College of Sports Medicine is a good resource, however, I have not found anything regarding training an individual with a colostomy bag.
A good way of thinking about the colostomy bag is refreshing your understanding of the digestive system. The colostomy bag is essentially the finish line of her gastrointestinal tract. Don’t let it frighten you. She simply evacuates differently than you and I. However, it is still evacuation.
Since she clearly is accustomed to living with a colostomy bag, she recognizes the precautions she has take as far as bodily fluids and odor are concerned.
I, however, have never had an uncomfortable experience with my clients.
If you feel unsure, you can always speak with her doctor or speak directly to your client. She will likely be your best resource.
A close family friend had a ileostomy (very similar to colostomy) ten years ago. She is still able to be extremely active (running, yoga, weight training, etc) and doesnt have any doctor-imposed restrictions on movement. She’s told me that her biggest complaint is the tendency to get heat rash around the area the pouch rests on her abdomen when she sweats for long periods of time. She also occasionally gets “twinges” doing twisting or crunching motions & modifies as needed (because the muscles of the abdominal wall were affected by the surgery). She jokes that she’ll never ride a bike because it is uncomfortable on her bottom (the rectum is usually sealed off during surgery & muscles/ scar tissue affect that area as well). Another consideration is that since a section of the intestine has been removed it’s harder for these clients to stay hydrated & properly fueled nutritionally. It may take some practice on the client’s part to determine how much water is enough if they aren’t accustomed to exercise. I hope that’s helpful!
Sara’s answers are so correct. Depending on the anatomical site of the colostomy excision, abdominal exercise may be limited. I would focus on shoulder girdle (lateral raise, chest press, rowing, both supine and half-prone wrist, elbow flexion and exetension), and lower extremity exercises.