WEBER STATE UNIVERSITY
Department of Health Promotion & Human Performance

COURSE OUTLINE

COURSE:  P.E.P. 4370:  Exercise Management for Special Populations

CREDIT: Two (2) Semester Hours

PREREQUISITES: PEP 2300 and PEP 3510

CLASS SCHEDULE: Two One-Hour Sessions Per Week

INSTRUCTOR:

Dr. Molly M. Smith, Professor Exercise Science
Office: SB 125H; Phone: (801)626-7361
E-mail: mmsmith1@weber.edu

Aim: This course provides practical information on exercise for persons with a wide range of special diseases and disabilities. An overview of each unique physiology, effects of the condition on the exercise response, effects of exercise training on the condition, and recommendations for exercise testing and programming is presented in a selected topics format.

General Course Objectives:

1. Administer and interpret results of exercise testing on individuals with specific challenging conditions.
2. Develop competencies in exercise prescription and delivery of exercise programs to special populations.

Course Competencies: This course is designed to assist students in becoming able to:

1. Demonstrate an understanding of the risks and benefits associated with exercise participation.
2. Describe appropriate emergency procedures in a variety of exercise settings.
3. Demonstrate the ability to administer a testing program to individuals with common handicapping conditions which assess fitness characteristics.
4. Explain the use and value of the results of the exercise test and fitness evaluation for various populations.
5. Write an exercise prescription which has been modified appropriately to meet the needs of the individual with common special conditions.
6. Demonstrate knowledge of proper equipment arrangement and facility modifications to accommodate use by individuals with special needs.
7. Demonstrate knowledge and skills in the delivery of unique exercise programs to special populations.

Course Requirements:

1. Attend and participate in all class and laboratory experiences.
2. Successfully complete all weekly quizzes. No make-up quizzes allowed.
3. Successfully complete a final examination on Case Studies representing a variety of diseases, disorders, or conditions.
4. Research and deliver an oral presentation on a selected chronic disease or disability.
5. Test and assess the needs of a client with a selected condition and submit an an individualized exercise program (IEP) utilizing the problem-oriented techniques presented in class.
6. Observe a clinical setting for one of the special population topics covered in the course.

Evaluation:

1.  Quizzes	Points
Ten-point multiple choice type quizzes will administered each week. (13)	130
2.  Final Examination	100
Four case studies will be assigned the last day of class to be submitted and evaluated during the scheduled final examination period.
3.  Oral Presentation	50
Thirty-minute oral presentation and 10-minute exercise testing on a selected chronic disease or disability delivered to the class and evaluated by the instructor.
4.  Individualized Exercise Program (IEP)	200
Develop an individualized exercise program for a patient with a specific disease or disability.
5.  Clinical Observation	20
Observe and evaluate an exercise program for a special condition covered in the course.
Total Points	500

Required  References:
American College of Sports Medicine. (2009)  ACSM=s Exercise Management for Persons with Chronic Diseases and Disabilities, 3rd ed. Champaign, IL: Human Kinetics.
American College of Sports Medicine. (2010) ACSM's Guidelines for Exercise Testing and Prescription, 8th ed. Baltimore: Lippincott, Williams & Wilkins. ISBN: 9780781769037.
Secondary Reference:
Howley, E.T. & Franks B.D.  (2007) Health Fitness Instructor's Handbook, 5th ed. Champaign, IL: Human Kinetics. 

Grading Criterion: Grades will be based upon percentage of points earned accordingly:

Ethical Conduct:  The Weber State University policy regarding all forms of academic dishonesty, including cheating, fabrication, facilitating academic dishonesty, and plagiarism will be strictly enforced.  Penalties for academic dishonesty may include failure from the course.  The policy can be found online at: http://documents.weber.edu/ppm/6-22.htm

Students with Disabilities: Any student requiring accommodations or services due to a disability must contanct Services for Students with Disabilities (SSD) in Room 181 of the Student Service Center.  SSD can arrange to provide course materials (including this syllabus) in alternative formats if necessary.

TOPICAL OUTLINE

UNIT	TOPIC	SESSION	CHAPTER
1	INTRODUCTION Orientation and Problem Oriented Management Approach to Exercise and Disease Management	1 2	1 2
2	HEALTH APPRAISAL AND EXERCISE TESTING Gathering Subjective Data: Health Screening Gathering Objective Data: Fitness Testing Basic Electrocardiography Clinical Exercise Testing	3 4 5 6	Guidellines 2, 3 Guidelines 4 Guidelines 6 Guidelines 5
3	SAFETY, INJURIES, AND EMERGENCY PROCEDURES Safety of Exercise Testing and Participation Emergency Plans and Procedures for Exercise Facilities	7 8	Guidelines 1 (Resource 79)
	CLINICAL OBSERVATION RELEASE TIME	9
4	CHRONIC DISEASES AND DISABILITIES
	Cardiovascular and Pulmonary Diseases Myocardial Infarction Revascularization Atrial Fibrillation Hypertension Chronic Obstructive Pulmonary Disease Asthma	10 11 12 13 14 15	6 7 9 14 17 19
	Metabolic Diseases Hyperlipidemia Diabetes Mellitus Obesity	16 17 18	22 24 25
	Immunological/Hematological Disorders Cancer (Part 1 Individualized Exercise Program Due) Immune Suppressed (AIDS, Organ Transplant) Chronic Fatigue Syndrome/ Fibromyalgia (Part 2 IEP Due)	19 20 21	27 28 30, 31
	Orthopedic Disease and Disabilities Arthritis Low Back Pain Syndrome Osteoporosis	22 23 24	34 35 36
	Neuromuscular Disorders Stroke and Brain Injury/ Spinal Cord Disabilities (Complete IEP Due) Multiple Sclerosis/ Parkinson's Disease	25 26	38, 39 42, 46
	Cognitive, Emotional, and Sensory Disorders Alzheimer's Mental Illness	27 28	48 49

EXAMINATION: THURSDAY, APRIL 19, 2012, 1:00 P.M. - 2:50 P.M.

Case Studies Submitted and Evaluated During Scheduled Exam Period.

PEP 4370: Chronic Disease or Disability

Oral Presentation

Students will select a topic for presentation through a lottery conducted the first day of class. The possible topics are identified in the topical outline of the course syllabus. Each disease or disability is briefly described in a chapter of the textbook. The textbook "does not provide detailed instruction on exercise physiology or disease, so the reader must do supplementary reading as needed in order to fully understand exercise management. For detailed information on diseases and disabilities, the reader should refer to standard physiology, medical, and adapted physical activity texts."

The special condition will be presented the first 30 minutes of the day scheduled in the syllabus.  The student will research the topic from a minimum of five sources (textbook excluded), including journal articles, book chapters, and one internet site which may be listed at the end of the particular chapter.

The report will describe and the presentation will follow this outline:

1. Definition of the Chronic Disease or Disability.

2. Epidemiology: Incidence or Prevalence

3. Clinical Aspects

a. Symptoms
b. Laboratory Diagnosis
c. Tests and Evaluation
d. Complications

4. Treatment: Medical or Surgical

5. Effects of Exercise

a. Effects of Disease or Disability on Ability to Exercise
b. Effects of Medications on Exercise
c. Effects of a Bout of Exercise on Patient with Disease or Disability
d. Effects of Training on Patient with Disease or Disability

6.  Exercise Testing

7.  Exercise Prescription

8.  Summary and Conclusion

9. References

The presenter will conduct an exercise test for the selected disease or disability as outlined in the textbook on a classmate during the class period.  Students will need to review exercise physiology textbooks and laboratory manuals and prepare the human performance laboratory to conduct the suggested test.  Practice operating all apparatuses you will use (treadmill, ergometer, sphygmomanometer, stethoscope, electrocardiogram, goniometer, spirometer, etc.) prior to performing the test in class.  Each student presenter will serve as a subject for the following student presenting a topic.

Students are encouraged to use multi-media presentation methods and involve class members in activity or demonstration. Each presenter will provide other class members with a handout of the presentation and references used. Class members will evaluate the presentation and be accountable for all information presented and all information in the textbook chapter. Knowledge of the topic, including textbook information, will be assessed via a weekly quiz.

PEP 4370: INDIVIDUALIZED EXERCISE PRESCRIPTION (IEP)

FORMAT

200 POINTS TOTAL

All material should be typed and placed in manila folder, print your name on the top left corner.

Cover Sheet - Name of client, primary chronic disease or disability, exercise specialist, date.

I. Patient Profile and Assessment. Due: Thursday, March 8 (10th Week)

Part A. Subjective (27 pts)
The patient's profile: health history; physical activity patterns, status, preferences; eating practices, alcohol, drugs, and smoking behaviors; stress and coping status; social health; safety practices; medical care practice; and health view including readiness and confidence to change. These are categories from the Personal Wellness Profile Questionnaire. Current medical conditions.

Part B. Objective (24 pts)
The raw data: an easy to read outline of the pre-assessment tests and results including height, weight, BMI, waist and hip girth, body composition, desired weight, resting pulse, resting blood pressure, cholesterol profile (total, HDL, LDL), triglycerides, glucose, graded exercise test results, muscle strength/endurance test results, flexibility test results, gait and balance analysis, functional tests, psychometric evaluations. Complete list of all current medications and results of any recent medical and exercise tests.  Note: Problem Oriented Management includes current medications in subjective data but chapter Case Studies include as objective data.

Part C. Assessment (27 pts)
Analyze and interpret the data. Compare test results to age-gender norms. Percentile rankings may be used to classify your client's performance.Display and compare the client's test results to normative data. Create graphs to display the individual's physical fitness profile, so that you can easily pinpoint strengths and components in need of improvement. As an example of an overall fitness graph, see the Health and Wellness graph in PWP report.

Part D. Plan (20 pts)
Treatment plan including exercise therapy.  Develop two plan reports: 1) for the client and 2) for physician. 
1. The client's report. A one page summary including the purpose of the prescription, a description of the pre-assessment results, a general description of the enclosed prescription, a description of the SMART goals (general: e.g., waist size, energy level, general feeling, etc.) and objectives (measurable: e.g., 5 mm reduction in resting systolic blood pressure, 5 beats per minute reduction in heart rate response to 1 mile walk at a given speed, 2 more bench presses at 50% of body weight, etc.).  The plan includes a general outline of MFIT.

2. The physician's report. This plan is written to the patient’s physician, a medical professional.  It is similar to the client's report but now you address the technical prescriptive parameters, e.g., MET levels, heart rate intensities, areas of concern, intended results, etc.  You may want to focus more on physiological outcomes and intensity and duration of exercise and less on behavior.

II. Detailed Workouts. Due: Thursday, March 22 (11th week)

Part E. Training Schedule. (20 pts)
Three month calendars of training. Coding workouts may be an advantage if the workout will be used on more than one occasion.

Part F. The Workouts. (30 pts)
Ten detailed workouts, one workout per page. Include phase 1 (warm-up), phase 2 (aerobic and strength stimulus), and phase 3 (cool down) with target heart rate ranges for each phase. Detailed workouts include the rest component of interval activity and safety considerations specific for the patient and the specific prescribed activity (e.g., see special considerations for exercise prescription in textbook).

III. Finishing Touches. Due: Tuesday, April 3 (13th week)

Part G. The Log Book. (20 pts)
Create a format for the client to record all physiological and psychological responses to exercise workouts for at least the first mesocycle of the training program.

Part H. Appendices. (16 pts)
This may include, but is not limited to, stretching exercise diagrams, resistance exercise descriptions, 10- second heart rate conversions, Borg Rating of Perceived Exertion, pamphlets on nutrition concepts, blood chemistry norms, safety considerations (do's and don'ts), any reference (reading) that may be important to the client's specific illness, a book on relaxation, a web site for medications, especially the client's medications and their potential impact on physical activity, signs of a good warm up and cool down.  Be resourceful.

Part I. Bibliography. (10 pts)
All references used must be cited in the IEP and referenced in the bibliography according to APA style.  Be sure to use and cite the American College of Sports Medicine guidelines.