FSHP Academy
Geriatric Fitness — all lessons

Module 1: Foundations

Introduction to geriatric fitness and the specialist’s rolePhysiology of ageing: sarcopenia, dynapenia, osteopeniaAge-related conditions, multimorbidity and frailty

Module 2: Assessment & Screening

Health screening, risk stratification and medicationsFunctional fitness assessment: SFT, SPPB, TUG, gait speed, grip

Module 3: Programming

Principles of programming: FITT-VP, progression, periodisationResistance and power training for sarcopeniaCardiovascular and aerobic conditioningBalance, mobility and fall preventionFlexibility, functional mobility and ADL training

Module 4: Chronic Conditions

Cardiovascular and pulmonary conditions (HTN, CAD, HF, COPD)Metabolic conditions in older adultsMusculoskeletal: osteoporosis, osteoarthritis, joint replacementNeurological and cognitive: Parkinson’s, stroke, MS, dementia

Module 5: Coaching, Safety & Business

Nutrition, hydration and recovery for older adultsBehavioural coaching, communication and adherenceSafety, emergencies and scope of practiceBusiness, settings and career pathwaysCase studies and sample programme templates

Health screening, risk stratification and medications

Screening older adults before exercise — preparticipation algorithms, medical clearance, red flags, and how common medications affect exercise responses.

Advanced Evidence: Strong evidence 3 min read Reviewed 2026-10-31 Status: draft

Learning objectives

  • Apply preparticipation screening to older adults
  • Identify when to seek medical clearance
  • Explain how common medications affect exercise
  • Manage polypharmacy risks

Before this lesson

Why this matters

Older adults have more conditions and medications, so screening matters even more.

Preparticipation health screening logic (ACSM 2015) A grid. Columns separate people who do not currently exercise regularly from those who do. Rows separate people with no known cardiovascular, metabolic or renal disease and no symptoms; people with known disease but no symptoms; and people with signs or symptoms. Recommendations range from no medical clearance needed, to clearance recommended before vigorous exercise, to stopping exercise and seeking clearance. Not exercising regularly Exercising regularly ≥30 min, moderate, 3 d/wk, last 3 months

No known CV, metabolic or renal disease, no signs/symptoms

No medical clearance needed. Start light–moderate; progress gradually.

No medical clearance needed. Continue moderate or vigorous; progress gradually.

Known CV, metabolic or renal disease, no signs/symptoms

Medical clearance recommended. Then start light–moderate; progress gradually.

Clearance not needed for moderate; continue. Clearance recommended before vigorous.

Any signs or symptoms suggestive of CV, metabolic or renal disease

Medical clearance recommended before starting.

Stop exercise; seek medical clearance before resuming.

 CV = cardiovascular. Simplified from Riebe et al. (2015). Clinical judgement and local regulations still apply.
Figure 1. ACSM preparticipation screening flow. — Original diagram, FSHP Academy (schematic, not to scale).

Screening

Base decisions on current activity, known cardiovascular, metabolic or renal disease, and symptoms [riebe2015]. Also screen falls history, cognition, pain and recent hospitalisation.

Medications

MedicationExercise effectAction
Beta-blockersLower HR responseUse RPE
AntihypertensivesPost-exercise hypotensionGradual cool-down
DiureticsDehydration, electrolytesHydration
Insulin/sulfonylureasHypoglycaemiaGlucose checks, carbs available
AnticoagulantsBruising, bleeding with fallsFalls caution
SedativesDrowsiness, fallsBalance caution
StatinsPossible muscle painReport symptoms

Older adults benefit from exercise even with multiple conditions [chodzko2009].

Common mistakes and misconceptions

Case study

A 76-year-old on a beta-blocker and diuretic joins a class. The specialist uses RPE, schedules water breaks and extends the cool-down; she trains without issues.

Further learning: video lessons

Video links are only marked “verified” after a human has watched them. Unverified entries open a YouTube search for that channel and topic rather than a guessed link.

Practical demo needs verification — opens a YouTube search

Health screening, risk stratification and medications

geriatric exercise specialists and physiotherapists (search)

You will understand: health screening, risk stratification and medications

Why: Clinician-led content; verify the specific video.
Introductory needs verification — opens a YouTube search

Exercise for healthy ageing

geriatric medicine educators (search)

You will understand: why exercise matters in later life

Why: Clinical overview.

Knowledge check

Knowledge check · 0/5

1. Beta-blockers affect exercise by…

Answer B. HR unreliable.

2. A medication class raising hypoglycaemia risk is…

Answer B. Glucose lowering.

3. Polypharmacy is linked to…

Answer B. Side effects.

4. ACSM 2015 screening is based on…

Answer B. Riebe et al. (2015).

5. A cool-down is especially important with…

Answer B. BP drop.

Short-answer & application questions

  1. Create a medication-effects reference card.
  2. Screen a fictional 72-year-old using the ACSM algorithm.
  3. Write a clearance request letter.

Key takeaways

  • Use preparticipation screening (e.g., ACSM 2015 algorithm) based on activity, disease and symptoms.
  • Beta-blockers blunt heart rate — use RPE.
  • Antihypertensives and diuretics raise risks of post-exercise hypotension and dehydration; insulin and sulfonylureas raise hypoglycaemia risk.
  • Polypharmacy increases falls risk — note sedatives and multiple medications.

Connected topics

geriatric fitness

Functional fitness assessment: SFT, SPPB, TUG, gait speed, grip

geriatric fitness

Safety, emergencies and scope of practice

geriatric fitness

Cardiovascular and pulmonary conditions (HTN, CAD, HF, COPD)

References

  1. Riebe D, Franklin BA, Thompson PD, et al. (2015). Updating ACSM's recommendations for exercise preparticipation health screening. Medicine & Science in Sports & Exercise, 47(11):2473–2479. doi:10.1249/MSS.0000000000000664 Position stand check pending
  2. Chodzko-Zajko WJ, Proctor DN, Fiatarone Singh MA, et al. (2009). American College of Sports Medicine position stand: exercise and physical activity for older adults. Medicine & Science in Sports & Exercise, 41(7):1510–1530. Position stand check pending

Educational content only — not medical advice. Consult a qualified clinician for diagnosis or treatment.