Musculoskeletal, Cardiopulmonary, and Metabolic Condition Management
Musculoskeletal
Osteoarthritis responds to low-impact aerobic work plus quadriceps and hip strengthening; avoid prolonged high-impact loading during flares. In osteoporosis, weight-bearing and resistance work is protective, but deep spinal flexion, combined flexion-rotation, and high-impact jumping raise vertebral fracture risk. For chronic low back pain, graded activity beats bed rest; red flags such as night pain, unexplained weight loss, bowel or bladder change, or progressive neurological deficit require referral.
Cardiopulmonary
Cardiac rehabilitation runs from inpatient mobilization to lifelong maintenance; monitor for angina equivalents including jaw, arm, and epigastric discomfort or unusual dyspnea. In heart failure, interval work with generous rest and avoidance of heavy isometric loads is generally better tolerated. COPD clients benefit from pursed-lip breathing, interval walking, and dyspnea ratings of 3-4/10; do not withhold prescribed oxygen. In peripheral artery disease, walk to moderate claudication (3-5/10), rest, and repeat - stopping at the first twinge defeats the therapy.
Metabolic
Type 1 diabetes: check glucose before, during long sessions, and after; avoid exercise with ketones present, and remember hypoglycemia risk can persist 24-48 hours. Type 2 diabetes adds foot inspection and hydration. Hypertension: avoid breath-holding and Valsalva, and be cautious with heavy isometric work.
Traps
Deep spinal flexion in osteoporosis; refusing exercise for a desaturating COPD client instead of adjusting the dose; treating claudication as a reason to stop; ignoring delayed hypoglycemia; and missing atypical cardiac symptoms in women and older adults.
Rule of thumb
Match the dose to the disease: modify intensity, duration, and mode before removing exercise entirely.
Worked example: a PAD client walks three minutes to claudication 3/10, rests two minutes, and repeats for 30 total minutes.