When Patti Kiernan found out she had osteoporosis, she decided it was time to find a more focused workout.

The 61-year-old signed up for a fitness program at her Dallas gym that's geared specifically for women with health problems. Kiernan liked the four-week Female Focus program so much she's still in after two years.

"I just felt that this was the right way to go," said Kiernan, who also began taking medication and saw her bone density improve after a year. "Plus, there were other women in the program who had the same problem."

More and more clubs are offering exercise programs fine-tuned for people coping with a variety of ailments, said Joe Moore, head of the International Health, Racquet and Sportsclub Association. He said the number of programs has grown along with the number of studies showing the health benefits of exercise.

Medical and fitness experts say that exercise not only elevates the mood and energy levels, but helps control weight _ a contributing factor for many diseases.

For breast cancer patients, "being overweight or gaining weight post diagnosis is a huge risk factor" for recurrence, said Colleen Doyle, director of nutrition and physical activity for the American Cancer Society.

Her group and the American College of Sports Medicine are devising a special certification for people who work with cancer patients on exercise programs.

Julie Main developed such a program after she was diagnosed with breast cancer at the age of 36 in 1993. She was inspired after her doctor mentioned that she seemed to be going through treatment better than other patients.

She told him one thing she was doing was continuing to exercise.

"He said, 'Most of my other patients don't do that.' I said, 'Well, maybe they should,'" Main said.

Now president of West Coast Athletic Clubs with five gyms in California, Main teaches other health clubs how to set up programs similar to her twice-a-week, 10-week program. Her free programs are done in collaboration with the Cancer Center of Santa Barbara and focus on strength-training.

"With cancer, people feel too tired to exercise, but if they exercise the fatigue is less," said Christine Brown, the Cancer Center's wellness manager.

In suburban Boston, patients are referred to the Dedham Health and Athletic Complex after they've been diagnosed with anything from heart disease to arthritis to diabetes, said Lloyd Gainsboro, co-owner and director of business development.

Sixty-day programs that cost $60 emphasize strength and cardiovascular training and are taught in an area of the gym with more carpet and sofas and fewer "spandex and beautiful bodies," Gainsboro said.

Participants in the Female Focus program at Dallas' Cooper Fitness Center pay $580 for an evaluation, eight training sessions, two lectures _ one on exercise and another on nutrition _ and a workout booklet to help them continue their routine.

Program founder Colette Cole said the evaluation helps her tailor the workouts to each participant and their capabilities.

The program appealed to 47-year-old Gretchen Montgomery, who was feeling some trepidation about resuming exercise after a bout with food poisoning and an emergency hysterectomy in the spring.

"I loved that it wasn't a room of workout babes," Montgomery said.

Ellen Orzel did two sessions of the program last spring, about a year after a double mastectomy. After the surgery and treatment, the 49-year-old said she was weaker and carrying 20 extra pounds.

"I was comfortable going in there, knowing I could tell her I had a mastectomy," she said. Continued...