Resistance Training Special Populations

There are many conditions and diseases in which resistance training is tolerable, and in many cases, beneficial. Clients may be categorized into one of the areas which we refer to as “special populations”. There may be any number of special concerns or protocols you might have for each area. However, resistance training, in general, even at higher intensities is safe and effective for most clients who may fall into the following special populations. If you find yourself serving people in these populations, you need not fear. Thoroughly educate yourself on the subject, but you can be confident knowing that there is evidence already in existence to support what you may design for these clients.

  • Cardiovascular/heart disease
  • Osteoporosis
  • Rheumatoid/Osteoarthritis
  • Diabetes/Pre-diabetic
  • Lower back pain
  • Neck pain
  • Hypertension
  • Obesity
  • COPD
  • Parkinson’s
  • Fibromyalgia
  • Thyroid and other Metabolic conditions
  • Pre/post natal women
  • Cancer
  • Seniors
  • Adolescents (12 years and older)
  • Athletes of all ages
  • Orthopedic problems (post-rehabilitation clients)
  • Paralysis

Let’s take a look at some of the scientific information that’s out there supporting specifically resistance training exercise for some of the more common diseases and conditions at the beginning of the list and how it can benefit these clients you might encounter.

General Studies:

Prescription of resistance training for health and disease.
“When prescribed appropriately, resistance training is effective for developing fitness, health, and for the prevention and rehabilitation of orthopedic injuries. Because resistance training is an integral component in the comprehensive health program promoted by the major health organizations (e.g., American College of Sports Medicine, American Heart Association, American Association of Cardiovascular and Cardiopulmonary Rehabilitation, Surgeon General’s Office), population-specific guidelines have recently been published. The current research indicates that, for healthy persons of all ages, and many patients with chronic diseases, single set programs of up to 15 repetitions performed a minimum of 2 d/wk are recommended.”

Cardiovascular Studies:

cardiostudyA comparison of combined running and weight training with circuit weight training.
“The purpose of this study was to compare the physiologic effects of a program of combined running and weight training (RUN-CWT) with a program of circuit weight training (CWT).” “Statistically, one training program was not shown to be superior to the other; thus, both programs of RUN-CWT and CWT were effective in improving measures of physical fitness.”

Circulatory response to single circuit weight and walking training sessions of similar energy cost in middle-aged overweight females.
“It was concluded that both CWT and walking training sessions were acceptable forms of physical activity to increase cardiovascular fitness in middle-aged overweight and normal body weight females.”

Weight training and strength, cardiorespiratory functioning and body composition of men.
“Due to a high drop out rate (55%) and injury related problems, the Explosive technique is not recommended. The Endurance and Strength 2 programs were most effective for improving physiologic functioning, as assessed in this study.”

A Comparison of the Cardiovascular Effects of Running and Weight Training.
“After training, both runners and weight trainers decreased their percent body fat. O2 peak was increased among runners, while only the weight trainers increased strength. These effects are comparable to aerobic exercise during isometric and mixed isometric and dynamic activities, and can occur without enhancement of peak oxygen uptake.”

Strength training and hemodynamic responses to exercise.
“Resistance exercise prolongs the onset of peak cardiovascular responses, decreases the cardiovascular response to exertion, and improves recovery from maximal exertion.”

Improved cardiorespiratory endurance following 6 months of resistance exercise in elderly men and women.
“Significant improvements in aerobic capacity and treadmill time to exhaustion can be obtained in older adults as a consequence of either high- or low-intensity resistance exercise. These findings suggest that increased strength, as a consequence of resistance exercise training, may allow older adults to reach and/or improve their aerobic capacity.”

The Surprising History Of The ‘HRmax= 220-age’ Equation’. (PDF)
Target and max heart rate training zones are not scientifically established.

Rheumatoid/Osteoarthritis Studies:

Effects of strength training on the incidence and progression of knee osteoarthritis.
“Quadriceps weakness is a risk factor for incident knee osteoarthritis (OA). We describe a randomized controlled trial of effects of lower-extremity strength training on incidence and progression of knee OA.”

Physical activity programs for chronic arthritis.
“The purpose of this review is to evaluate recent trials and studies of different types of physical activity programs for individuals with chronic arthritis and to discuss recommendations and findings from systematic reviews of physical activity interventions. RECENT FINDINGS: Recent randomized control trials of different multicomponent land-based, aquatic, Tai Chi, and strength training programs report moderate benefits after intervention and at 6 and 12 months for individuals with various types of chronic arthritis.”

Effectiveness and safety of strength training in rheumatoid arthritis.
“Moderate or high-intensity strength training has been an effective and well-tolerated method to increase or maintain muscle strength in patients with rheumatoid arthritis. No deleterious effects on disease activity and pain were observed. More information is needed regarding long-term effects of strength training on functional capacity, bone mineral density, and radiologic progression.”

Diabetes Studies:

High-intensity resistance training improves glycemic control in older patients with type 2 diabetes.
“High-intensity progressive resistance training, in combination with moderate weight loss, was effective in improving glycemic control in older patients with type 2 diabetes. Additional benefits of improved muscular strength and LBM identify high-intensity resistance training as a feasible and effective component in the management program for older patients with type 2 diabetes.”

Back Pain Studies:

neckpainLow back strengthening for the prevention and treatment of lower back pain.
“These improvements occur with a low training volume of 1 set of 8 to 15 repetitions performed to volitional fatigue one time per week. Chronic lower back pain patients participating in isolated lumbar extension PRE programs demonstrate significant reductions in pain and symptoms associated with improved muscle strength, endurance, and joint mobility. Improvements occuring independent of diagnosis, are long-lasting, and appear to result in less re-utilization of the health care system than other more passive treatments. Lower back strengthening shows promise for the reduction of industrial back injuries and associated costs.”

Neck Pain Studies:

Active neck muscle training in the treatment of chronic neck pain in women: a randomized controlled trial.
“Both strength and endurance training for 12 months were effective methods for decreasing pain and disability in women with chronic, nonspecific neck pain. Stretching and fitness training are commonly advised for patients with chronic neck pain, but stretching and aerobic exercising alone proved to be a much less effective form of training than strength training.”

There are few conditions or diseases where proper exercise is totally contraindicated. A few conditions like Type II diabetes, hypertension, and osteoporosis may even be reversed through exercise and dietary manipulation. Sensible training, in a progressive manner, can provide benefits to clients that may fall into these special populations. Feel free to research the conditions and other special populations on the list further in the linked databases and journals I’ve referenced here. You may even get thoroughly immersed in one of these subjects and find yourself specializing in it as a new niche market. There are many people out there who will appreciate you being able to serve them appropriately by having the knowledge and experience in these areas.


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Chris Lutz

Chris Lutz

Chris Lutz is the owner and founder of S.P.A.R.T.A. – Sports Performance And Resistance Training Association. He has a degree from George Mason University in Exercise Science and has over a decade of professional experience as a certified personal trainer. Teaching, reading and writing about proper exercise methodology are his biggest passions. Chris can properly teach you how to obtain a full body workout in 30 minutes, 2-3 times per week using a safe, effective and efficient method.

Chris is nationally certified by National Strength Professionals Association (NSPA) as a Certified Personal Trainer. He attended George Mason University and obtained a Bachelor of Science in Exercise Science from the Health, Fitness, and Recreation Resources Dept. in Fairfax, VA 2000 – 2004.

Chris' combination of B.S. degree, high intensity training CPT certification, and over 5 years of experience managing a training facility, earned him his Master Trainer status.

Chris is also the author of 2 books for the fitness industry: Start, Operate, and Grow Your Personal Training Business and High Intensity Metabolic Training. 
Chris Lutz


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