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Millions of people around the world are suffering from various chronic conditions. This segment of our society needs qualified personal trainers with specialized knowledge, skills, and abilities to train these individuals safely and effectively.

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Acc. to NSCA, fitness professionals who are qualified to train the special population are the ones who “using an individualized approach, assess, motivate, educate, and train special population clients of all ages regarding their health and fitness needs, preventively, and in collaboration with healthcare professionals. They design safe and effective exercise programs, provide the guidance to help clients achieve their personal health/fitness goals, and recognize and respond to emergency situations.”

Acc. to ACE, these specialists “guide those suffering from injuries and chronic disease towards a healthier life by designing programs that not only help alleviate the symptoms of chronic health conditions, but prevent them from occurring altogether.

This is an extremely powerful credential to possess for a fitness professional. Here are my top preferences for medical exercise courses / certifications to become a Special Population trainer:



NSCA CSPS, is one of the finest medical exercise courses you can do to earn a credential in training special population. The NSCA Certified Special Population Specialist (CSPS) credential was established in 2012 to address the fitness needs of individuals afflicted by chronic or temporary health conditions. Anyone interested in pursuing a CSPS must first understand the types of health conditions that require special exercise intervention.


Health conditions are typically categorized according to the body system and physiological implications involved:

  • Cardiovascular – Myocardial infarction, angina, peripheral vascular disease, congestive heart failure, revascularization, heart valve disorders, and/or conduction disorders. 

  • Pulmonary­ – Chronic obstructive pulmonary disorder, chronic restrictive pulmonary disorder, pulmonary hypertension, and/or asthma. 

  • Metabolic – Diabetes (Type I and II), overweight/obesity, pre-diabetes, metabolic syndrome, thyroid disorders, and/or end-stage renal disease. 

  • Immunological – AIDS/HIV, fibromyalgia, chronic fatigue syndrome, anemia, autoimmune disorders (e.g., lupus, rheumatoid arthritis), and/or blood clotting disorders. 

  • Musculoskeletal – Osteoporosis, limb amputations, osteoarthritis, lower back conditions, frailty, joint disorders, joint replacements, sarcopenia, posture disorders, and cystic fibrosis. 

  • Neuromuscular – Stroke, brain injury, spinal cord disorders, multiple sclerosis, cerebral palsy, Down’s syndrome, Parkinson’s disease, epilepsy, balance disorders, and muscular dystrophy. 

  • Cancer – Multiple body systems affected. 

  • Psychological/behavioral – Disordered eating, body image disorders, depression, and chemical dependency. Special populations also include those groups of people with unique traits that are not necessarily afflicted by a chronic or temporary health condition. 

  • Females that are pregnant, postpartum and menopausal. 

  • Older adults. 

  • Children and adolescents. 

The Certified Special Population Specialist (CSPS) exam is comprised of 100 scored and 10 non-scored* multiple-choice questions that tests candidate’s knowledge in the following four domains:

  • Basic Pathophysiology and Science of Health Status, Condition, Disorder or Disease

  • Client Consultation

  • Program Planning

  • Safety, Emergency Procedures and Legal Issues

The prerequisites for the certification are the biggest challenge for most people to complete this certification. Certification is not granted until ALL of the eligibility requirements have been met.

The CSPS candidate must have at least one of the following: 

A Bachelor’s degree or higher degree granted by an accredited institution in Exercise Science or a related field (e.g., physical therapy, chiropractic medicine). (refer to Certification Handbook for a list of acceptable accredited institutions)

A current license as a physical therapist, physical therapist assistant, athletic trainer, or registered dietitian.

A current NSCA certification (CSCS, NSCA-CPT, TSAC-F).

A NCCA-accredited personal trainer certification

Hand on, adult CPR/AED certification

Have a minimum 250 hours of related practical experience.

Candidates must submit a completed CSPS Practical Experience Form (available on their website). 

Hours must be consistent with the CSPS Scope of Practice (see below) and describe a candidate’s principle or supporting role in managing clients with unique needs.

Candidates must be able to perform the following:

Educate a client on the basic pathophysiology and science of health status, condition, disorder, or disease.

Perform health appraisals, fitness evaluations, SMART goal development, program design, motivational/coaching techniques, and client outcome monitoring.

The study material involves, the main CSPS course book (Essentials of Training Special Populations), and other supportive material for exam preparation. To check the prices and registration, visit the NSCA website. 


The ACE Medical Exercise Specialist study program was created to help individuals gain valuable expertise in creating programs for clients with a range of medical conditions.


Acc. to ACE, Medical Exercise Specialists guide those suffering from injuries and chronic disease towards a healthier life by designing programs that not only help alleviate the symptoms of chronic health conditions, but prevent them from occurring altogether.

As an ACE Certified Medical Exercise Specialist, you will represent a critical link between clinic and community, serving as valued member of the patient healthcare team and working alongside healthcare providers and other allied health professionals.

Just like the NSCA CSPS, ACE too has a long and challenging list of pre-requisites:

To sit for the ACE Medical Exercise Specialist certification you must:

  • Be at least 18 years of age

  • Hold a current hands-on CPR and AED certification

  • Present a current government-issued photo ID with signature (driver’s license, passport, military ID)

You must also submit BOTH of the following documents:

  • Proof of a four-year (bachelor’s) degree in exercise science or a related field (upload unofficial transcript below).

  • Proof of 500 hours of work experience designing and implementing exercise programs for apparently healthy individuals and/or high-risk individuals, as documented by a qualified professional.

The study material involves a single detailed study manual and lot of supportive material for exam. To check the prices and registration, visit the ACE website.

When planning to do Special Population Medical Exercise courses / certifications , the main challenge you may face with NSCA CSPS & ACE Medical Exercise Specialist certifications is the prerequisites needed in order to complete the certification. This may actually keep a lot of fitness professionals away from these two certifications.
However, ISSA & AFPA are the next best medical exercise courses , with excellent course content and no major challenge in terms of prerequisites. Please visit their respective websites to register and check other formalities.

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