Mrs. J is a sedentary 48 year old (62 in, 165lb) administrative secretary and ma

Question

Mrs. J is a sedentary 48 year old (62 in, 165lb) administrative secretary and married mother of two college age boys. Her physician has cleared her to work with you to develop a comprehensive exercise program. She was diagnosed 2 years ago with hypertension and has dyslipidemia and impaired fasting glucose (MetS). She states wanting to take her 6 month old Labrador retriever puppy Bailey on long walks at her beach but, "I cannot last for more than 10 minutes without stopping because I get so tired and my muscles feel weak." During her fitness test, she achieved eight metabolic equivalents (8 METS) during a maximal treadmill stress test (Bruce protocol), a maximal heart rate of 155 beats/minute (90% of age-predicted max HR) and a rating of perceived exertion (RPE) of 18 out of 20 on the Borg scale. Her peak blood pressure was 180/80 and the treadmill stress test was stopped because of general fatigue. She reported no signs or symptoms of exercise intolerance or physical discomfort and displayed no electrocardiographic abnormalities. Her physician considered her test to be "normal" and "unremarkable".

Medications: Atenolol, Lisinopril, Metformin, and Atorvastatin, Fosamax

Waist Circumference: 36 in

Total cholesterol: 260 mg/dL, HDL-C: 45 mg/dL, LDL-C: 181 mg/dL, Triglycerides: 170 mg/dL

Fasting Blood Glucose: 96 mg/dL

Resting Blood pressure: 118/70 mmHg

One Repetition Max (1-RM) Bench Press, calculated from 10-RM: 90 lbs (40th percentile)

One Repetition Max (1-RM) Leg press, calculated from 10-RM: 180 lbs ( 30th percentile)

Her latest DEXA scan indicated she is < 2.2 Standard deviations below the mean for normal young women

1.What are some modifications to her exercise prescription would you make because of her history?

Explanation / Answer

I would like to modify her exercise prescription as follows:-

1).as her tests are normal or unremarkable as reported by her physician so she can continue his daily routine exercise by decreasing the time duration of her exercise and slowly increasing it day by day.

2). She can also continue her exercise by decreasing exertion and increase it day by day.

3) She has to watch her diet very carefully.She can include fresh fruits and juices to control cholesterol and blood pressure.

I would like to suggest that she must not to do heavy exercise. She can start with light exercise and increase the intensity very slowly.

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