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Quarterly ERP drills ensure readiness, clarify roles, and minimize liability. Sole reliance on EMS, informal plans, or reactive responses delay care and increase risk. ACSM guidelines require documented ERP training and practice.

Peripheral neuropathy increases risk of foot ulcers and injury. Non–weight-bearing modes minimize trauma while still providing cardiovascular benefits. High-impact or plyometric training increases injury risk. ACSM recommends low-impact, non-weight-bearing aerobic training for these patients.

ACSM obesity guidelines recommend ≥250 min/wk of moderate-to-vigorous aerobic activity for clinically significant weight loss, with resistance training to preserve lean mass. Very low frequency or intensity is insufficient. HIIT may supplement but not replace moderate training. Excluding resistance training risks lean tissue loss. Combined training is optimal.

ACSM recommends progressing duration before intensity in deconditioned patients. This reduces risk while building endurance and adherence. Rapid increases in intensity may cause injury or cardiac events. Avoiding progression prevents meaningful adaptation.

Motivational interviewing encourages patients to connect exercise with personal values (e.g., playing with grandchildren). This builds intrinsic motivation and long-term adherence. Confrontation, rigid schedules, and fear-based messaging reduce compliance. ACSM emphasizes MI as a core behavior-change tool for CEPs.