In today’s fitness classes, many personal trainers encounter clients who require exercise as a form of rehabilitation, aiming to relieve pain and improve overall health. As professionals in the field of personal training, it is essential to understand and master sports rehabilitation techniques for common conditions such as hypertension and peripheral arterial disease (PAD). This article provides an overview of simple rehabilitation methods suitable for coaches with a solid professional foundation.
Exercise has long been recognized as an effective method for preventing and managing high blood pressure. In 1988, the American Hypertension Association officially endorsed exercise therapy as part of the comprehensive treatment for hypertension. Scientific studies have shown that regular physical activity can reduce sympathetic tone, decrease catecholamine release, and improve vascular compliance and baroreceptor sensitivity, leading to lower total peripheral resistance. Exercise also helps regulate the renin-angiotensin-aldosterone system, reducing vasoconstriction and sodium retention. Long-term exercise can enhance brain function, improve neuromodulation, and help manage risk factors like high cholesterol, obesity, and poor diet. It also promotes better blood circulation and helps maintain the elasticity of blood vessels, which can delay the progression of arteriosclerosis and prevent the worsening of hypertension.
When considering exercise rehabilitation for hypertensive patients, it is important to assess their condition. Patients with mild to moderate hypertension who respond well to exercise can benefit from it as a primary treatment. Those with higher blood pressure or longer duration should combine exercise with antihypertensive medication. The goal is to keep blood pressure within a normal range (≤140/90 mmHg). However, certain conditions make exercise unsuitable, such as uncontrolled high blood pressure (>180/110 mmHg), unstable angina, or adverse effects during exercise like hypotension or bradycardia.
For optimal results, the intensity and duration of exercise should be tailored. Low to moderate intensity workouts, such as walking or cycling, are often recommended. Studies show that low-intensity exercise (40% VO2max) can still help lower blood pressure, while moderate intensity (60% VO2max) may offer greater benefits. Typically, sessions last 20–60 minutes, performed 3–5 times per week, with intensity set at 40–70% of VO2max or 60–85% of maximum heart rate.
Aerobic exercises like walking, swimming, and jogging are particularly beneficial for hypertension. Resistance training, such as lifting weights, can also help. Combining both types of exercise is often recommended for best outcomes. Additionally, traditional practices like Qigong have been shown to effectively reduce blood pressure, offering new perspectives in rehabilitation.
Safety is crucial during exercise. Before starting, a thorough assessment is needed to determine suitability. During training, monitoring blood pressure and symptoms is essential, especially for those with cardiovascular conditions. If systolic blood pressure exceeds 220 mmHg or diastolic exceeds 110 mmHg, exercise should be stopped immediately.
Key precautions include understanding the effects of medications on exercise response, warming up before workouts, cooling down afterward, avoiding breath-holding during resistance training, and following structured programs that avoid isometric exercises.
For peripheral arterial disease (PAD), exercise rehabilitation is a valuable treatment option. PAD is a common form of atherosclerosis, often causing leg cramps during walking. While medical treatments have limited effectiveness, exercise has been shown to significantly improve functional capacity and quality of life. A treadmill test is typically used to assess the patient's claudication threshold and monitor responses.
Guided exercise is highly recommended for patients with intermittent claudication. Walking programs, involving 30–45 minutes of exercise 3–5 times a week for at least 12 weeks, have proven effective. These programs increase pain-free walking distance and improve overall mobility.
Overall, exercise rehabilitation offers a safe, cost-effective way to manage chronic conditions like hypertension and PAD. It not only improves physical health but also enhances mental well-being and quality of life. With proper guidance and monitoring, it can be a powerful tool in the hands of trained professionals.
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