Case Study = Arnold 45 year old male Does strength and aerobic training 3x/week Is just starting hockey again, and is a goalie on two recreational teams Often complains about tightness in his quads and hips Stretches before hockey and that’s about it Prescribe a flexibility program for this client (FITT)
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A 48-year-old, sedentary, overweight male with low back and knee pain inquires about your personal training services. What steps would you take to convert the individual into a client? Next, assume the individual becomes a client. What's a 4-week training program for the client accounting for all training variables, for example? Why is the training program appropriate for the client?
Qudsiya A.
A 48-year-old, sedentary, overweight male with low back and knee pain inquires about your personal training services. What steps would you take to convert the individual into a client? Next, assume the individual becomes a client. Design a 4-week training program for client accounting for all training variables. Be sure to provide an explanation as to why your training program is appropriate for the client
Supreeta N.
Chapter 28 Case Study Subjective Medical History Mr. AT, now 28 years old, suffered a series of seizures at age 7. After a physical exam, lab tests, and electroencephalography, he was diagnosed with epilepsy and put on epileptic medication. He has gained 25 pounds (11 kilograms) over the last 2 years. He complains about excessive postural sway and loss of balance while walking and therefore uses his father's cane. He also complains of being increasingly tired when going out in the community. He has no history of smoking or alcohol consumption, but he has a familial history of diabetes. At a recent physical exam, his low-density lipoprotein cholesterol (LDL-C) was 178 mg/dL, high-density lipoprotein (HDL) was 61 mg/dL, fasting glucose was 88 mg/dL, and waist circumference was 42 inches (107 centimeters). He is currently on Carbatrol (carbamazepine) and baclofen. Diagnosis Mr. AT was born prematurely along with his twin sister at 34 weeks. His mother experienced a severe infection early in her pregnancy and was hospitalized for several days; upon birth, he had an Apgar score of 4. At age 1, he was diagnosed with left-side spastic hemiplegic cerebral palsy. Objective and Laboratory Data Exercise Test Results Because Mr. AT is ambulatory but has balance difficulties, leg cycle ergometry was chosen as the method of aerobic exercise testing. His resting blood pressure and heart rate in a seated position were 134/80 mmHg and 82 beats per minute, respectively. A small face mask was used to provide an adequate seal. A toe clip on his right side was used to maintain proper foot positioning on the pedals, and an adaptive glove was used to help his right hand grip the handlebar throughout the test. Mr. AT performed a 2-minute warm-up without resistance. The leg cycle ergometry test began at 25 W at a cadence of 50 to 60 rpm. The protocol consisted of 2-minute stages with an increase of 15 W per stage. The following data were collected during the exercise test. The exercise test was terminated at 5:15 because of increased hip adductor spasticity and inability to maintain speed of 50 rpm, and by request of the participant because of shortness of breath. No signs of electrocardiogram abnormalities were present during the test. His oxygen uptake at 5:00 was 16 mL/kg/min. The RER was less than 1.00 and the heart rate and oxygen uptake failed to reach peak. This was not a valid test of cardiorespiratory endurance. Because of the termination of the clinical leg cycle ergometry test, a more functional approach was chosen. The Timed Up and Go test was used as a baseline measure as it is a strong predictor of walking capacity (6-minute walk test distances) for this group. This test used the following protocol. Test Instructions Starting position: Sit upright against the chair. Stand up from the chair (time start). Move quickly along the line toward the opposite end. Touch the end and pivot back toward the chair. Move quickly all the way back to the chair. Pivot. Sit back down (time end). The total distance was 10 feet (3.05 meters). The test was performed three times. Mr. AT's scores were 42 seconds, 38 seconds, and 40 seconds. (A score over 30 seconds suggests a higher risk of falls.) Mr. AT used his assistive device during all testing. Assessment and Plan Exercise Prescription Using the information presented in the medical history and exercise testing sections and in table 28.5, develop an exercise prescription that encompasses aerobic, strength, flexibility, and neuromuscular training. Consider the different modes for each of the exercise training domains and the frequency, duration, intensity, and progression of each. Case Study Discussion Questions How would the clinical exercise physiologist best determine the appropriate resistance levels to prescribe for this person? What factors should the clinical exercise physiologist take into consideration to increase the adherence level and success of this client? What fall prevention strategies should be incorporated into the exercise prescription for an individual who is at increased risk for falls? Is the assistive device described in this case study appropriate for use by Mr. AT? How should the clinical exercise physiologist incorporate weight loss strategies into the goals for this client?
Adi S.
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