Training someone with central core disease

Training Q&A [Moderated]
1

Hi,

I have a friend that has central core disease, and he has asked me to train him. Unfortunately, we do not live close to each other and he does not have the money to hire a proper trainer. He purchased a 10lb kettlebell and wants to use it to start building a base of physical fitness. I am aware this is likely to have suboptimal outcomes compared to other forms of training, but this is where I think your compliance argument holds well because he simply would not train if it required that he had to go to a gym.

Some basic information about him:

  1. 6’1"
  2. His gait is inconsistent, almost as though he is slightly intoxicated.
  3. When standing from a seated position, it can take up to 10 seconds and he uses a significant amount of momentum.
  4. Training sessions can be arbitrarily long.

That being said, I did a pass over google scholar to try to find some sort of starting point on what others have done to train these individuals, but with no luck. So, I have the following questions:

  1. Are you familiar with any research on training similar types of patients you can point me to? I do not have a medical background, but I am a researcher in a scientific field, so I might be able to get some benefit out of it.
  2. Any tips on load management? Given issues with stability (and that he will training by himself with me on video chat), I want to make sure we avoid injuries. Based on my understanding, we plan to experiment with rep ranges between 5-8 at a low RPE, with many sets (that we build up to over time). This is so we can still get a large amount of volume in without any particular set risking anything bad occurring.
  3. Given your experience, do you think there are any specific exercises we should experiment with first / avoid?
  4. Should he be getting small daily doses of training stress, or larger doses of training stress with rest days? Hopefully your medical background can give some insight into how we should start, given his condition.

Also, we intend on testing both dumbbells and kettlebells alongside a broader distribution of weights to determine what works best for him.

2

Unfortunately I had never heard of this condition until your post, or seen any patients with it. So I cannot provide any specific recommendations here; however, if he is cleared to exercise, I’d probably use a similar approach to what we do with everyone else. Find a tolerable starting dose of training stimulus, progress gradually, and observe / adjust based on response.

I don’t think there are any specific exercises to do / avoid here, although from what I looked up it seems congenital hip dislocations are common in these patients, which may be a limitation if present in his case.

Wish I could be of more help. Good luck!