You are designing an exercise program for a new client who has type 2 diabetes. She has a physician’s release for exercise as tolerated to lose weight and improve blood glucose regulation. During the initial session, you learn that she has been sedentary for the past few years. What initial cardiorespiratory program would be most appropriate for her?
a. walking 5-6 days per week for 40 minutes at an RPE of 11-13, working up to 60 minutes
b. cycling 3-4 days per week for 40 minutes at an RPE of 13-15, working up to 60 minutes
c. walking 5-6 days per week for 10-20 minutes at an RPE of 11-13, working up to 40-60 minutes
d. cycling 3-4 days per week for 10-20 minutes at an RPE of 13-15, working up to 40-60 minutes
How long can she walk now without any issues? Does she have any gait issues? Does she have any postural issues, over pronation of the feet, valgus/vargus knees, hip int/external rotation, pelvic tilt issues, etc.?
Personally, when I want to get clients moving before I have all the necessary information to design the program (I need movment/postural infromation from several sessions first), I put them in deep water if they are comfortable in a pool/body of water, shallow water if they don’t know how to swim. Water walking/jogging is very low stress to even damaged joints. If they aren’t comfortable in water or have no access, they march in place or walk very slowly on a treadmill if I am comfortable with it.