Instructors leading FitLot training sessions should be aware of apparent risk factors that may affect individuals participating in the program. Class participants may be dealing with specific issues, chronic health related conditions, and physical challenges. While a trainer should never go beyond their scope of practice, awareness is paramount so that appropriate modifications, regressions and/or progressions can be provided. Please note the information in this section is not all inclusive and serves to be a reminder of the training you should have received during your fitness certification process. We recommend and expect that all practicing fitness professionals be certified, self insured and hold a current CPR certification. 

Pre-Screening

Since health risk assessment questionnaires and liability release forms are included in the registration process, a trainer’s responsibility lies in ensuring all class members have officially completed the process before participating in a training session. All participants will be informed of the importance of obtaining a doctor’s clearance before engaging in any fitness classes. Trainers and park staff members should be familiar with factors that contribute to increased health risk when exercising, in the event that appropriate action needs to be taken. Please reference Appendix B for ACSM’s intake form that may be used to assess risk.  

Common Cardiac Conditions

Coronary Heart Disease (CHD)

CHD is a condition resulting from the development of atherosclerosis in the coronary arteries. The accumulation of hard plaque narrows the artery walls, blocking the flow of blood and oxygen. CHD is the most common cause of sudden death in people over age 65, and men are 10 times more likely to experience this than women (Matthews et al. 2016). 

Hypertension

Hypertension is the term for high blood pressure, categorized by a systolic blood pressure of >140 mmHg and/or a diastolic blood pressure of >90 mmHg. According to the Centers for Disease Control, about 75 million American adults (32%) have high blood pressure, which is equivalent to 1 in 3 adults (Nwankwo et al. 2013). 

Recommendations for Instructors:

• – Encourage participants to continually self-monitor exercise intensity
• – Offer modifications to avoid abrupt changes in position, specifically seated or lying down to standing, which may cause dizziness
• – Encourage participants to avoid holding their breath during the exertion phase of an exercise (also known as the Valsalva maneuver).

Exercise causes an increase in heart rate and blood pressure, which adds additional stress to the heart during training sessions and increases the risk of a cardiac event. Instructors should be aware of participants affected by both CHD and hypertension. 

Common Pulmonary Conditions

Chronic Obstructive Pulmonary Disease (COPD)

COPD refers to a group of diseases that cause respiratory conditions that obstruct airflow, including emphysema, asthma and bronchitis. According to the CDC, 16 million Americans suffer from COPD (National, 2018).

Asthma

Asthma is a chronic inflammatory disorder that causes obstruction to airflow. Afflicted individuals may experience difficulty breathing, coughing, wheezing and overall feelings of chest tightness. Exercise and physical activity can induce an asthmatic response in some individuals, which is referred to as exercise-induced asthma.  

Recommendations for Instructors:

• – Encourage participants to hold off from participating in class if symptoms are active
• – Guide participants through extended warm ups and cool downs, in order to avoid sudden changes in intensity
• – Remind participants to stay hydrated and to keep airways moist before, during and after class sessions.
• – Check in with participants throughout class to observe the rate of perceived exertion (RPE) and possible shortness of breath.
• – Become familiar with techniques that may help people with COPD breath better, ie. pursed-lip breathing and diaphragmatic breathing.
• – Require participants to carry inhalers or other necessary medication on their person.
• – Be aware of environmental factors that may exacerbate COPD symptoms, including cold temperatures, air quality, and allergen levels.

Responding to Cardiorespiratory Emergencies

All outdoor fitness park instructors are required to be trained in CPR and AED safety and hold current certifications.