ACE Special Population Considerations 3 — Questions and Answers
Question 1: Which of the following is a contraindication to exercise during pregnancy according to ACOG guidelines?
- Mild gestational hypertension
- Placenta previa diagnosed after 26 weeks (Correct answer)
- A pre-pregnancy BMI of 25
- Mild lower back discomfort
Correct answer: Placenta previa diagnosed after 26 weeks
Placenta previa after 26 weeks is an absolute contraindication to exercise due to the high risk of hemorrhage.
Question 2: A client with multiple sclerosis (MS) reports increased fatigue and symptom exacerbation during hot weather. What should the trainer do?
- Schedule sessions in the warmest part of the day to build heat tolerance
- Exercise in a cool environment and monitor for Uhthoff's phenomenon (Correct answer)
- Eliminate aerobic exercise entirely to prevent fatigue
- Focus only on strength training in any environment
Correct answer: Exercise in a cool environment and monitor for Uhthoff's phenomenon
Uhthoff's phenomenon causes temporary MS symptom worsening with heat, so cool environments and cooling strategies are essential.
Question 3: When designing a program for a client with fibromyalgia, what is the best initial approach?
- Begin with high-intensity exercise to break through pain barriers
- Start with very low-intensity exercise and progress slowly based on tolerance (Correct answer)
- Focus exclusively on passive stretching three times per day
- Avoid exercise until pain levels drop below a 3/10
Correct answer: Start with very low-intensity exercise and progress slowly based on tolerance
Fibromyalgia clients are highly sensitive to exercise load, so starting at low intensity with gradual progression minimizes flare-ups.
Question 4: What is the primary concern when a client with peripheral arterial disease (PAD) experiences claudication pain during walking?
- The client is not stretching adequately before exercise
- Reduced blood flow to the muscles causes ischemic pain that limits exercise (Correct answer)
- The client's shoes are causing nerve compression
- Electrolyte imbalance is triggering muscle cramps
Correct answer: Reduced blood flow to the muscles causes ischemic pain that limits exercise
Claudication in PAD results from insufficient arterial blood flow to working muscles, causing ischemic pain during activity.
Question 5: A client with Down syndrome is cleared for exercise. Which precaution is MOST critical before engaging in cervical spine loading exercises?
- Checking resting heart rate
- Screening for atlantoaxial instability (Correct answer)
- Assessing hip flexor tightness
- Evaluating grip strength
Correct answer: Screening for atlantoaxial instability
Atlantoaxial instability is common in Down syndrome and can cause spinal cord injury with certain neck movements.
Question 6: For a client with Parkinson's disease, which training component most directly addresses the disease's hallmark motor symptoms?
- High-volume aerobic endurance training
- Balance, coordination, and rhythmic movement training (Correct answer)
- Maximal strength training with heavy loads
- Static flexibility training only
Correct answer: Balance, coordination, and rhythmic movement training
Parkinson's disease causes tremor, rigidity, and bradykinesia, so balance and rhythmic movement training directly targets these deficits.
Question 7: What is the recommended maximum heart rate target for a client with an uncomplicated pregnancy who was previously sedentary?
- 120 bpm
- 140 bpm (Correct answer)
- 160 bpm
- 180 bpm
Correct answer: 140 bpm
ACOG recommends that previously sedentary pregnant women target around 140 bpm to maintain safe maternal and fetal perfusion.
ACE Special Population Considerations 3
Which of the following is a contraindication to exercise during pregnancy according to ACOG guidelines?