Mr. JRC should be educated about the signs and symptoms of exercise intolerance (e.g.,
light-headedness, shortness of breath, atypical pain) as well as the importance of managing his
cardiometabolic risk profile. Blood pressure should be monitored initially during resistance
training, and proper breathing during the performance of resistance training needs to be
demonstrated to prevent the Valsalva maneuver. Additionally, the patient should be taught how
to self-monitor exercise intensity by checking his heart rate and using the Borg rating of
perceived exertion scale.
In addition to continued fitness improvements, decreases in abdominal obesity will
significantly help with reduction of metabolic risk. Therefore, a decrease in total caloric
consumption combined with PA and structured exercise should be used to achieve a reduction in
total body weight of 7% to 10% from baseline over the next 12 mo. Regular or daily PA should
continue to supplement all structured exercise and will assist in attaining and maintaining a
desirable body weight and help in attenuating and managing cardiometabolic risk factors.
Examples of daily PA include walking, taking the stairs instead of the elevator, and yard work.
Discussion Questions
a. Based on the information provided, what might you consider when determining whether
this patient should perform exercise training, and what benefits would you expect to
observe?
b. Are there any signs, symptoms, medications, or other items listed that would need to be
considered when assessing this patient for an exercise training program?
c. Develop a 12 wk exercise prescription for cardiorespiratory, resistance, range of motion,
and HIIT training if applicable. Use the FITT principle when developing your
prescription.
d. Discuss issues that might affect this individual’s ability to begin and adhere to exercise
training.
e. What considerations might affect decisions for exercise workload or intensity
progression?
f. Based on the subject’s medical history and test results, identify areas for which the
patient should be further educated (e.g., weight control, diet modification). Are there
other resources that you might use?