Mrs. J is a sedentary 48 year old (62 in, 165lb) administrative secretary and ma
ID: 3510790 • Letter: M
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
Please write out an exercise prescription for Mrs. J below:
Frequency
Intensity %HRR
Intensity RPE
Time
Type
Aerobic Exercise
Why did you chose this FITT design for her aerobic exercise?
Resistance Exercise: Exercise selection
Reps
Sets
rest
Frequency
% 1-RM
Intensity RPE
Why did you choose this FITT design for her resistance exercise during weeks 1-2?
What would you need to monitor during exercise? Why?
Why other questions or considerations should you consistently ask or check in with Mrs J as you see her for sessions?
If you could answer these questions I will give you the best review and rating possible!
Frequency
Intensity %HRR
Intensity RPE
Time
Type
Aerobic Exercise
Explanation / Answer
Aerobic exercise:-
Frequency- on non consecutive days 3 or 4 resistance training sessions per week.
Intensity% hrr- 50 to 70% of maximum heart rate.
Intensity RPE- 3 sets of 8 to 10 reps and when body tolerate this load you can increase it upto 12 reps each set.
Time- 45 to 60 minutes Max.
Type- weight lifting body weight exercises such as push ups squats lunges and planks
I chose this f i t t design for her exercise as she wants to improve her strength and that can be achieved by resistance training and according to experts resistance training sessions should be between 45 to 60 minutes and for body to recover and relax it should be in a gap of 1 day and not daily. Cardiovascular exercises leads to losing weight whereas weight lifting bodyweight exercises leads to increasing strength.
Exercise- bicep curl
Repetition- 1 performance of an exercise
Sets- 1 set of 10 bicep curl
Rest- 30 seconds rest between set.
Frequency- 2-3 times per week
Intensity RPE- 11
I chose this exercise as it leads to increase in strength. The repetition of an exercise can be increased by time. in a set there must be 10 bicep curl or they can be increased as much tolerated by the women. They must be rest between sets for body to recover and relax and it should not be performed daily as it would not allow body from the pain and energy lost. At last intensity rpe must be measured and it must be between 11 to 16 as 11 count says having enough energy to continue exercise and the patient will not feel exhausted.
We need to observe that whether the body can handle the load of 8 to 10 sets and as we observe that it can handle we can increase it upto 12.
We should check for her exercise tolerance as it will allow us to decide the exercise choosen is right or wrong and the intensity is in limit or not.
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