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SPOA04 Specific populations and older adultsAssignment v2.5 (2017/01/05)

SPOA04 Specific populations and older adultsName

Email address

Assignment

Assignments may include short answer questions or longer answer questions and are designed to test how you apply your knowledge to a real-world situation. All assignments are completed as a Microsoft Word document and are submitted to an assessor through my campus. Your assessor is looking for how you apply your knowledge and how you think critically about the topic area.

Case Study 1 – ThomasPlease read through the following case study. Reflect on your learning and your own research to complete this unit.

Prepare a response that addresses each of the issues presented below. Your responses must reflect your knowledge, skills, and application for this unit.

In this case study you will be required to undertake the following tasks:

• Answer specific questions relevant to case

• Complete a referral letter to a GP outlining your concerns of the results identified within the pre-exercise health screening

• Review the complete adult pre-screening tool for Thomas's case; to inform the completion of the action plan

• Complete the action plan – outline the key pre-screening findings and create a fitness program you would implement for the case scenario.

Scenario

Thomas’s LifestyleThomas Jones (preferred name Tom) and is currently the Chief Operating Officer of a non-profit organization. He currently lives at 14 Boyd street Nundah in Brisbane but travels to Sydney three time per fortnight. He is 178 cm tall and weighs 125 kg with a waist circumference of 114cm. Tom works a 60 hour week and is currently under a lot of stress and pressure at work and home. His wife and kids are worried about him as his weight is starting to increase and his energy levels are decreasing.Thomas is also becoming quite fatigued. He would be lucky to complete 20 minutes of exercise a week (this typically includes walking around the block with the kids on a Sunday afternoon). Tom was a smoker but stopped 6 months ago, and is feeling better for it. Thomas’s Medical HistoryThomas’s blood pressure has been increasing over the last six months; his GP’s last recording was 170/90 mmHg. Recent blood test results have indicated that Tom now fits the criteria of type-2 diabetes mellitus. He has had one fasting blood sugar test with the result shown below:

• Test 1: Blood sugar levels 9.5mmol/L

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The GP also sent Tom for a complete blood test that included a breakdown of his blood lipid levels. A snippet of the results have been shown below:

• Total Cholesterol: 8mmol/LInterestingly, Tom broke his leg 2 years ago, which he has been using as an excuse as to why he cannot exercise. While he is currently not taking any medication, his GP is seriously thinking about it because of his abnormal blood test results and the high proportion of fat deposited around his mid-section. Tom has convinced her to let him address his blood pressure, diabetes and poor lifestyle himself before being prescribed medications for hypertension and Type II diabetes.

Thomas’s Pre-screening:Tom completed the Adult Pre-exercise screening tool Stage 1 (results can be found in the action plan below). The results have required the personal trainer to refer Tom back to the GP to seek clearance for him to undertake physical activity and exercise.

Results from the Adult Pre-exercise screening tool are shown in a separate document to this assignment called Adult Pre-exercise Screening Tools for Case Studies.

Knowledge Questions

1. Identify 4 potential barriers (including lifestyle and social) to this client participating in exercise programs.

The four potential barriers which are noticed in this case study are the-:The client recently left smoking after which the client is experiencing good. But the barriers such asBlood pressure-: he has tremendous high blood pressure, he needs to take accurate medicines along with doing the basic exercises.High diabetes-: due to high diabetes, the client may experience the sudden jolt of high or low sugars, if the client does not keep a watch, monitor, and take necessary precautions. He needs to take proper medications and maintain an exercise routine.

Due to his leg break, two years he cannot strain his leg he should be monitored and doing the basic and routine exercises.

He has abnormal blood tests results and high proportion fat deposited around his midsection and he may experience lethargic, fatigue and needs to do moderate physical activities.

Due to his prolong working hours, continuous stress, he is suffering from the lifestyle diseases and is not able to take out time for the moderate physical activities which he should be doing.

TThe other social obligations, family pressure should also contribute towards Tom's lifestyle, by making him eat healthily and exercising.

2. Please list a minimum of three (3) health-related precautions for this client’s training and list how these might affect any training session you conduct.

The three health-related precautions for the client's training would be-:

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Continous running-: since he has high BP, diabetes, and midsection sudden and rigorous running can lead to stroke or sudden jolt of high/low blood pressure, sugar and make him more physically incapable.Rigorous weight lifting-: sudden pressure on the heart along with the continuous weight lifting can lead to jamming, jolting and muscle pullingEating rightly and proportionately-: by adequately eating the proportionate healthy eating habits, it can help the even spread of the fat, calories and proper digestion. If the client still continuously eats high caloric food items and does not concentrate on nutrient diet, it would result in the

The other precautions which need to be taken care to avoid stress, make an active routine and avoid falling into the smoking/drinking zones.

3. Briefly, outline the benefits versus risks of participation in exercise for this client. (minimum 2 for each)

Risks Benefits

Rigorous exercise without the adequate monitoring can lead to a distressing situation. It may result in the sudden decrease or increase blood sugar or blood pressure and may even cause strokes in worst cases. Fatigue, lethargic and not maintain proper regime may result in the muscles getting cramped. It is important to have a warm-up session.

By reducing the excess weight to the certain level, he would be able to control his blood pressure and diabetes, he should strategically contribute towards weight loss by exercising moderately and increasing the duration of minutes every day.By maintaining a healthy exercise routine and lifestyle, the client can feel young and active. Common fatigue and the stress can be relied upon and avoided as exercise results in the good hormones.

4. What are the anticipated structural and physiological adaptations the client is likely to expect as they undergo their training program over time?

Structural (Physical) Adaptations

He would be-be expecting a structural transformation by having a good physique and body build. He may experience physical weakness and fatigue might set in, but after 6 months of transformation he would experience good hormones and would feel better.

Physiological (Internal) adaptations

Internally, he may experience a strong breathing and a light sensation along with it he may start experiencing young and would start loving the routine. The other psychological implications would be improved immunity, digestion and flushing out of the intoxicating substances from the systems.

5. Convert this clients goal into a SMART goal:

S-> The specific would be to attain a healthy lifestyle and get free from the unhealthy regime and

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detoxifying oneself.M-> Measurable-: to measure step by step inches of the client and the duration of the work hours. Weights measurement.A-> to make a step by steps weekly and monthly goals.

R->realistic-> to experience measurable and achievable goals. Not deciding to make unrealistic and unattainable goals. Impossible goals such as losing 10 kgs within 10 days.

T-> Timely measurement and timely workouts. Checking the timeline specified of attaining a healthy lifestyle routine and regime.

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Action plan template

1. Client Information

Title: __Mr___ Given name: ____Thomas__________ Surname: ____Jones_______________

Preferred name: ___Tom________________________ Address: ___14 Boyd Street Nundah__

City: _________Brisbane________________________ Post code: _4012__________________

Age: __60______________________ Occupation: _Chief Operating Officer_

2. Medical History Information

Record all relevant medical information and test results from Thomas’s case study below. Minimum of 5 should be recorded.

(Type your answer here)

High blood pressure 170/90 mmHg

Type 2 diabetes Test 1: Blood sugar levels 9.5mmol/LMidsize tummy

abnormal blood test results and the high proportion of fat deposited around his mid-section (Lippke, 2004)Total Cholesterol: 8mmol/LLeg injury

3. Results from Stage One – Pre-screening test

The below questions exercise as part of an interview.

1. Has your doctor ever told you that you have a heart condition or have you ever suffered a stroke? Yes/ No

2. Do you ever experience unexplained pains in your chest at rest or during physical activity/exercise? Yes/ No

3. If you have diabetes (type I or type II) have you had trouble controlling your blood glucose in the last 3 months? Yes/ No

4. Is a referral required? Why/ Why not?To do certain blood tests and consult the physician.Notes: (Type your notes here)

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4. Referral Letter

You will need to prepare a referral letter for Tom's case and address your key concerns for him to participate in the exercise in the referral letter template provided.

Please write your referral letter below

RE: Thomas Jones

DOB: 1956

Address: 14 Boyd street Nundah in Brisbane;

Phone: 11-222-000

Mobile: 99-999-9999

Dear, Dr. Shephard

Thank you for seeing Mr. Thomas Jones medical condition

I, ABC XYZ have been training Mr. Thomas Jones

for past 1 months/years now with a physical activity program to achieve the following goals:

• Reduce type disproportionate fat in the midsection

• Cholesterol, diabetes, and hypertension which can be controlled with the weight control programme

• Unregulated medications and frequent episodes of stress

As per the previous tests conducted, Six months ago on date 12-04-2017

presents with the following:

• Abnormal blood test, Total Cholesterol: 8mmol/L

• High blood pressure 170/90 mmHg

Test 1: Blood sugar levels 9.5mmol/L has reported the following signs and symptoms, and I

would like your diagnosis or assessment on these:

• Cholesterol, diabetes

• Blood pressure and the heart condition

Thank you for taking the time with this referral, and any queries or feedback for program alteration

would be greatly appreciated.

Phone: 888-000-000

Email: [email protected]

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Kind regards,

XYZ Name

The GP has sent a letter back to the PT indicating that Tom can start slow with a fitness regime and that it would be beneficial for him given his current condition. The GP has told Tom to monitor his heart rate during exercise as a gauge of how he is going.

Thomas’s Fitness Test Results:

There are specific fitness tests for different populations – Thomas has previously completed the Senior Fitness Test. Older adults need to have adequate strength, flexibility, and aerobic fitness to accomplish everyday tasks. For further information on the components of the Senior Fitness test, please refer to the additional resources.

Thomas did not score too well in the following Senior Fitness tests:

• Chair Sit and Reach Test result below average -3.0

• 2 Minute Step Test result below average 80.Thomas’s Exercise Goals:

1. Wants to develop an exercise program to reduce his blood pressure2. Implement an exercise program that results in weight loss

3. Wants to lose 20 kg of weight in the next 6 months4. Wants to focus on reshaping his body.

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5. Fitness/Exercise Program for Thomas

Using Thomas’s data complete the resistance and aerobic program templates. In this program, you will need to record five (5) resistance exercise examples relevant to this case.

Client name: Thomas Jones Client age: 60 Goal: 20 kg of weight in the next 6 months & reshaping his body.

To reduce his blood pressure

Implement an exercise program that results in weight loss

Resistance Exercise ProgramWarm up

5 minutes stretching of the arms, legs and the neck rotation.5 minutes jogging5 minutes breath in and out exercise

Conditioning phase

For Thomas's case, it is important for him to include both resistance and aerobic exercise to address his weight concern and reshaping his body. Because of his elevated blood pressure, it is also critical to have a well-rounded exercise program. A focus on using weight machines for stabilization and cardio equipment to monitor heart rate is the priority starting point before introducing free weights or other advanced exercise techniques. It is best to start with a series of five (5) different exercise for this case. The program below will focus on resistance aspects for this case. The first exercise has been provided for you to show the level of detail required.

Exercise Sets Reps Rest period Comment - A comment needs to be generated focusing on each exercise prescribed and what the client's progression should be

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1. Leg Press(any variation): A body weight is an initial focus as a starting point

1-2 10-15 1-2 minutes between exercise

Set number and REPS should be started at the low end with a progression to increase the intensity as his strength increases. The set number can be increased once the client is comfortable at achieving the REPS at the low-end intensity.

Tummy exercise A needs to concentrate in the belly fat

1-2 10-15 1-2 minutes of resting in between

Needs to bend and stretch exercise. Do a bit of twisting.

Hands and arms any variation


Stretch and do rotation exercise. Can use lifts if he is working out. Bend stretch and repeat

Sit-ups


Bend the knees and repeat. Face the wall and take the support of chair and repeat.

Cool down

Massage and therapy

Notes for next session

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Practice and start with the basic exercise and gradually increase the episodes of the sets.In case of pain or swelling consult the doctor

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Aerobic Exercise Program

Warm up

Jogging and stretching

Conditioning phase

The activities are examples that should be completed in one session per day and in conjunction with the resistance training. Three days per week, increasing to 5-7 days per week.It is best to start with a series of two (2) different exercise for this case. The program below will focus on aerobic aspects for this case. The first exercise has been provided for you to show the level of detail required.

Activity Intensity/ HR Time Distance Rest period

1. Walk Moderate (60% of maxHR) 87-102 BPM.

Start 3 days per week. Increase 5 minutes per week until 30-60 minutes per session.

15 minutes 2km 1 minute every 5 minutes of exercise

2. Lunges and sit-ups

Moderately and repeating within alternate days. Maximum for 20-25 minutes 20 minutes 1 minute every 5 minutes of exercise

3. Abdominal exercise

Twisting and bending. 3 days a week. Maximum for 30minutes 30 minutes 1 minute every 5 minutes of exercise

Cool down

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Case Study 2– SoulaPlease read through the following case study. Reflect on your learning and your own research to complete this unit.





• Review the complete adult pre-screening tool for Soula's case; to inform the completion of the action plan


Scenario

Soula’s Family History and LifestyleSoula is retired and living in Melbourne with her daughter in a granny-flat. Her current address is 27 Brisbane Street Essendon Melbourne 3247. She is 158 cm tall and weighs 79 kg with a waist circumference of 105cm. Soula has worked as a thoracic surgeon for 40 years and as a result has arthritis in her wrist, fingers, and knees. Over the last five (5) years she has had reduced movement that is impacting on her quality of life. Recently she has been asked to give three (3) guest lectures at the University of Melbourne, which she is really excited about. She is worried about her fatigue and wants to get specialized fitness advice to address her specific needs. She smoked when she was younger, but quit over 50 years ago. She does enjoy a couple of drinks at night.

Soula’s Medical HistorySoula's blood pressure has been increasing over the last twelve (12) months; her GP's last recording was 160/85 mmHg. Recent blood test results are positive for Rheumatoid factor a definitive diagnosis of rheumatoid arthritis was made and she was sent to the Rheumatologist for a follow-up appointment. Father passed away from a heart attack at age 51.The GP also sent Soula for a complete blood test that included a breakdown of her blood lipid levels. A snippet of the results have been shown below:• Total Triglycerides: 4mmol/L

The Rheumatologist wants Soula to go on medication to address the disorder but she wants to try exercise to address the inflammatory nature of her disorder. Aside from this, she has perfect health she has never broken any bones or been in any serious accidents.Soula’s Pre-screening:Soula completed the Adult Pre-exercise screening tool Stage 1 (results can be found in the action plan below part 3). The results have required the personal trainer to refer Soula back to the GP to seek guidance for her to undertake physical activity and exercise. Results from Stage Two and Three – Pre-exercise screening toolData from Soula’s case study for stage 2 and 3 of the Adult Pre-screening Exercise Tool is shown below

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Knowledge Questions

1. Identify 4 potential barriers (including lifestyle and social) to this client participating in exercise programs

The potential barriers are

She is suffering from arthritis in her wrist, fingers, and knees. Has a blood pressure of 160/85 mmHg.

Total Triglycerides: 4mmol/LPositive for Rheumatoid factor and rheumatoid arthritis.

Breakdown of her blood lipid levels which shows high triglycerides 4mmol/L.

2. Please list 2 health-related precautions for Soula's training and list how these might affect any training session you conduct with her.

She is suffering from arthritis in her wrist, fingers, and knees. Has high triglycerides 4mmol/L.

This means she cannot strain herself and needs to exercise caution.

3.Briefly, outline the benefits versus risks of participation in exercise for this client. (minimum 2 for each)

Risks Benefits

Excess of participation may lead to the imbalance in the joints or dislocation of it.High rate exercises will have a pressure on the heart rate and blood flow.

By exercising she will get better flexibility and relaxing in the joints.The calcium and the blood flow will be better in the body.She would be able to reduce her triglycerides and improve her lifestyle. Blood pressure will also reduce

4. Explain the benefits of exercise and the anticipated structural and physiological adaptations as they relate to client goals and needs?

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Structural (physical) Adaptations

She would experience an intolerable pain initially, but frequent exercise would help her in restoring the lifestyle by gaining flexibility and youngness. The joint pains may get ease and can help in recovery strategy.


The triglycerides which are considered bad cholesterol would be greatly reduced due to the continuous exercise.it would also help in the arthritis improvement and the flexibility.

5. Convert this clients goal into a SMART goal:

Specific to gain flexibility and reduce the bad cholesterol by maintaining healthy weightMeasurement-: attaining a weight loss and specific inches.

Attainable-: specific attainable goals through the work out sessions and measuring it bi-weekly

Realistic-: by gaining a realistic measurable weight attainable.

Timely-: Attainable timely goals which are measurable and realistic.



Title: __Mrs__ Given name: _______Soula ________ Surname: ___Anu_________________

Preferred name: _________Soula_________________ Address: ___27 Brisbane St_________

City: __________________Melbourne____________ Post code: __3247________________

Age: ___________85___________ Occupation: _Retired Thoracic Surgeon


Record all relevant medical information and test results from Soula’s case study below. Minimum of 3 should be recorded.

(Type your answer here) Total Triglycerides: 4mmol/L

Seasonal alcoholicShe is suffering from arthritis in her wrist, fingers and knees.

Has a blood pressure of 160/85 mmHg.Positive for Rheumatoid factor and rheumatoid arthritis.

Breakdown of her blood lipid levels which shows high triglycerides 4mmol/L.


The below questions are asked as part of an interview.

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1. Has your doctor ever told you that you have a heart condition or have you ever suffered a stroke? Yes/ No

2. Do you have any diagnosed muscle, bone or joint problems that you have been told could be made worse by participating in physical activity/exercise? Yes/ No

3. Is a referral required? Why/ Why not?To take a quick note of itNotes: (Type your notes here)

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4. Referral Letter

You will need to prepare a referral letter for this clients case and address your key concerns for them to participate in the exercise in the referral letter template provided.


RE: Soula

DOB: 27-10-1960

Address: 27 Brisbane Street Essendon Melbourne 3247.

Phone: 990000000

Mobile: 1122222111

Dear, Dr. Shepherd

Thank you for seeing Ms. Soula

I, Dr. Nanny Biswas have been training MMs. Soula

for 1 months/years now with a physical activity program to achieve the following goals:

• Total Triglycerides: 4mmol/L

• Has a blood pressure of 160/85 mmHg.

• She is suffering from arthritis in her wrist, fingers, and knees. Positive for Rheumatoid factor and rheumatoid arthritis.

As per the previous tests conducted,


• Has a blood pressure of 160/85 mmHg.

• She is suffering from arthritis in her wrist, fingers, and knees.

has reported the following signs and symptoms, and I


• Total Triglycerides: 4mmol/L

• . Positive for Rheumatoid factor and rheumatoid arthritis.



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Phone: 9999919991


Kind regards,

Nancy

The GP has sent a letter back to the PT indicating that Soul can start slow with a fitness regime and that it would be beneficial for them given their current condition. The GP has told your client to monitor their heart rate during exercise as a gauge of how they are going.

Soula’s Fitness Test Results:

There are specific fitness tests for different populations – Soula has previously completed the Senior Fitness Test. Older adults need to have adequate strength, flexibility, and aerobic endurance to accomplish everyday tasks. For further information on the components of the test, please refer to the supplemental resources.

Soula did not score too well in the following Senior Fitness test:

• Arm Curl Test:<6.Soula’s Exercise Goals:1. Start an exercise program that will assist her high blood pressure and knee pain2. Start an exercise program that will improve her upper body strength3. Start an exercise program to reduce her weight.

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5. Fitness/Exercise Program for Soula

Using the data in the below case study put together a fitness/exercise program to address her key complaints. Please complete the resistance and aerobic program templates for this case.

Client name: Soula Client age: 85 Goal: 1. Start an exercise program that will assist her high blood pressure and knee pain

Resistance Exercise Program

2. Start an exercise program that will improve her upper body strength.

Warm up

Stretching and jogging for a brief period of 5 minutes

Conditioning phase

Soula has reduced movement, which is impacting on her quality of life. This is most likely due to her advanced age and knee issues. The degree of exercise exertion needs to be low to start with and take into account her movement issues.It is best to start with a series of three (3) different exercise for this case. The program below will focus on resistance aspects for this case.

Exercise Sets Reps Rest period Comments

Arms and hands rotation and stretching

10-15 2 1 minute in between

Needs to be consistent in a rotation and anti-rotational which will strengthen her joint.

Legs rotation and variation10-15 2 1 minute in

betweenA bit of jumping and stretching. Needs to be consistent in a rotation and anti-rotational which will strengthen her joint.

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Abdominal10-15 1 1 minute in

betweenModerate bending and side exercising.

Cool down

Breathing in and out

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Aerobic Exercise Program

Warm up

Stretching and jogging

Conditioning phase

The activities are examples that should be completed in one session per day and in conjunction with the resistance training. Three days per week, increasing to 5-7 days per week.

Activity Intensity/ HR Time Distance Rest period Notes

Power WalkingModerate for 30minutes. Slowing and again gaining speed

30 minutes 1 km 1 minute or when required

Timely and moderately walk-in. Need to restrain the joints

Lunges/sit-ups Slowly for thighs and buttocks flexibility 15 minutes 1-minute rest Relaxed and slowly bending and repeating

Cool down

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Case Study 3 – RogerPlease read through the following case study. Reflect on your learning and your own research to complete this unit.





• Review the complete adult pre-screening tool for Roger's case; to inform the completion of the action plan


Scenario

Roger’s Family History and SymptomsRoger is married and lives with his wife in Tasmania. His current address is 2 Katherine Street Tasmania 4237. Roger was diagnosed with gout, which is a condition where there is defective metabolism of uric acid that becomes deposited in the small joints of the feet and hands. Roger developed this five (5) months ago, and still, presents with a range of symptoms that include the following:

• Pain and swelling in his big toe• Little movement in the affected joint• The Reddish appearance of the skin around the joint. Roger has been a casual drinker and smoker for most of his life and is contemplating on giving up both habits. There is no history of heart disease or cancer in his family and both his parents passed away of natural causes; his mother was 92 and his father was 88 years old.

He has a sister named Julie who is 60 years old and has type-1 diabetes and was diagnosed at age 21. Other than that she is relatively healthy and has no signs of neuropathy or retinopathy.

Roger has tried to exercise in the past but has experienced some dizziness. Roger really wants to work on his fitness so he can enjoy the later end of his life; however, he does want to start slow. He is on a program with his GP and is on nicotine patches and chewing gum to assist his smoking habit.

Roger’s Medical HistoryRoger’s blood pressure has been stable over the last twelve (12) months; his GP’s last recording was 120/85 mmHg. Roger is 192 cm tall and currently weighs 79 kg; he has a waist circumference of 70cm.

The GP also sent Roger to complete a 24-hour urine test to examine his uric acid levels. His urine test came back with the following results:

• Uric acid levels: 1200 milligrams per 24 hours.Aside from gout, he has never experienced any other health-related issues.

Roger’s Pre-screening:Roger completed the Adult Pre-exercise screening tool Stage 1 (results can be found in the action

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plan below part 3). The results have required the personal trainer to refer Roger back to the GP to seek guidance for him to undertake physical activity and exercise.


Knowledge Questions

1. Identify 4 potential barriers (including lifestyle and social) to your client participating in exercise programs

The four potential barriers are-:defective metabolism of uric acid that becomes deposited in the small joints of the feet and hands

casual drinker and smoker Can be under the type 1 diabetes if doesn’t abstain from the bad lifestyles.

Moderate BP is not a worry sum.Controlled weight and pains and swelling in legs and arms.

2. Please list health-related precautions for Roger's training and list how these might affect any training session you conduct with him.

As he is experiencing the below problems, he needs to abstain from the rigorous workout Pain and swelling in his big toe• Little movement in the affected joint• The Reddish appearance of the skin around the joint. His uric acid is high he needs to have lots of water and needs to do moderate walking.If he doesn’t take timely actions for the improving lifestyles and the exercise, he would develop

type 1 diabetes and the chances of fatty liver diseases.He needs to avoid heavy work loads and needs to be careful with the jumping or putting

pressure on the heart valves.


Risks Benefits

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Heavy exercises can lead to the pressure on the heart and the kidney. As he has moderate BP, undue pressure on kidney may result in the liver or kidney failure. Heavy loads and high volume of exercise can strain him and he may experience fatigue.

The uric acid high, meaning liver is not about to convert the fat into the utilization of energy, the kidney has pressure to flush it out. He needs lots of water and should be sweating it out. Excercise is the best thing for him.He needs to attain flexibility and needs to exercise for this


Structural (Physical) Adaptations The anticipated structural would reduced inches, weight, detoxifying

oneself and experiencing the physical youngness

Physiological (Internal)adaptations

The internal would be flushing out of the in toxic through perspiring and sweating. Timely actionable would improve the liver condition and would help in avoiding the gout problems.

5. Convert your client’s goal into a SMART goal:

Specific to cure gout and the related health implications

Measurement to check the timely measurable goals of gaining the good health within a specific timeline

Attainable to moderately exercising and reach specific goalsRealistic to reshape the body and vigor of the body.

Time-: within a defined period of time



Title: __Mr___ Given name: _______Roger_______ Surname: __Taylor________________

Preferred name: _________Roger_______________ Address: ___2 Katherine St_________

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City: __________________Hobart_______________ Post code: __4237________________

Age: ___________70___________ Occupation: _Retired______________


Record all relevantmedical information and test results from Roger’s case study below. Minimum of 2 should be recorded

(Type your answer here) Gout problem due to which experiencing the Pain and swelling in his big toe• Little movement in the affected joint• Reddish appearance of the skin around the joint.

Alcohol and smokerChances of attaining the fatty liver disease and the type 1 diabetes


The below questions are asked as part of an interview. 1. Has your doctor ever told you that you have a heart condition or have you ever suffered a

stroke? Yes/ No 2. Do you have any diagnosed muscle, bone or joint problems that you have been told could be

made worse by participating in physical activity/exercise? Yes/ No 3. Is a referral required? Why/ Why not?

Yes to secure a good treatmentNotes: (Type your notes here)

4. Referral Letter

You will need to prepare a referral letter for your client’s case and address your key concerns for him to participate in the exercise in the referral letter template provided.


RE: Roger

DOB: 1940

Address: 2 Katherine Street Tasmania 4237

Phone: 1222-3344

Mobile: 22—22—22

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Dear, Dr. Shepherd

Thank you for seeing Mr. Roger

I, Nancy Crew have been training Mr. Roger


• Improvement in the legs flexibility and the avoiding the gout problem

• Improving the vigor of his life

• Obtaining from the bad lifestyles such as the alcohol and smoking

As per the previous tests conducted, On the date of 17th June 2017


• Chances of type 1 diabetes

• Fatty liver disease and the kidney pressure

Gout problems has reported the following signs and symptoms, and I


• Pain and swelling in his big toes

• Little movement in the affected jointThe Reddish appearance of the skin around the joint.



Phone: 1122—222


Kind regards,

Nancy Crew

The GP has sent a letter back to the indicating that your client can start a gradual fitness program that must cater for their restricted movement due to the presence of gout in their big toe. The GP also indicated light exercise to start with because of your client’s previous history with smoking and drinking.

Roger’s Fitness Test Results:There are specific fitness tests for different population groups– Your client has previously completed the Senior Fitness Test. Older adults need to have adequate strength, flexibility and endurance to accomplish everyday tasks. For further information on the components of the test, please refer to the supplemental resources.

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mailto:[email protected]


Roger did not score too well in the following Senior Fitness tests:• 8 Foot Up and Go Test - <-6.5Roger’s exercise Goals:1. Start walking around the block three days per week2. Improve his overall fitness and agility 3. Increase his overall health and well-being.

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5. Fitness/Exercise Program for Roger

Using the data in Roger’s case study put together a fitness/exercise program to address her key complaints. Please complete the resistance and aerobic program templates for this case.

Client name: Roger Taylor Client age: 70 Goal: 1. Start walking around the block three days per week

2. Improve his overall fitness and agility

3. Increase his overall health and well-being


Stretching and a bit of walking

Conditioning phase

Roger has a relatively fit physic. Roger, however, has experienced some dizziness in the past when performing an exercise, so the degree of exertion needs to be taken into account. His gout needs to be taken into account when conducting an aerobic exercise.It is best to start with a series of three (3) different exercise for this case. The program below will focus on resistance aspects for this case.

Exercise Sets Reps Rest period Comment

1. SQUATS (any variation): A bodyweight squat is an initial focus on no weight.

1 10-12 1-2 minutes between exercise

Set and REPS should be started at the low end with a progression to increase the intensity. The set number can be increased once the client is comfortable at achieving the REPS at the low-end intensity.

2 stretching of armsAny variation


Should repeat the variations of the arms stretching and rotation

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Stretching of legs any variation1 10-12 1-2 minutes between

exerciseShould repeat the variations of the legs stretching and rotation

Cool down

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Aerobic Exercise ProgramWarm up

Stretching and a twisting

Conditioning phase

Roger has a relatively fit physic. Roger, however, has experienced some dizziness in the past when performing an exercise, so the degree of exertion needs to be taken into account. His gout needs to be taken into account when conducting an aerobic exercise. Water-based exercises need to be considered because of gout. It is best to start with a series of three (3) different exercise for this case. The program below will focus on aerobic aspects for this case.


1. Swimming Moderate (50% of maxHR) 78-109 BPM. Start 3 days per week. Increase 5 minutes per week until 30-60 minutes per session (Dishman, 2015)

15 minutes 1 km After the completion of every four laps

2. power walkingModerately with 5 days a week at a pace of 102 rpm for 20-30 minutes

30 minutes 1 km Per minute rest

Cool down

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Case Study 4 – ElizabethPlease read through the following case study. Reflect on your learning and your own research to complete this unit.



• Answer specific questions relevant to case• Complete a referral letter to a GP outlining your concerns of the results identified within the

pre-exercise health screening • Review the complete adult pre-screening tool for Elizabeth's case; to inform the completion

of the action plan• Complete the action plan – outline the key pre-screening findings and create a fitness

program you would implement for the case scenario.

Scenario

Elizabeth’s Family History and SymptomsElizabeth is married and lives with her husband in Perth. Her current address is 27 George Street Broome Perth 4111. Elizabeth was diagnosed with fibromyalgia, which is a clinical condition where the patient presents with widespread pain and tenderness in the body. It has been 25 years ago since she first showed symptoms of this disorder, and still presents with a range of symptoms that include the following:1. Morning stiffness and pain (particularly in the back)2. Pain in her joints particularly the elbows, wrist and lumbar spine3. Numbness and tingling in her hands and feet.

Elizabeth has been a smoker for the last ten years and drinks occasionally. Her father died of a myocardial infarction at age 47. Her mother is still living at 90 years of age and has no history of heart disease. She has one brother named John who is 51 years old and has had three myocardial infarctions in the past but is now active and living a more healthy lifestyle. Because of her fibromyalgia, she is worried about her fitness and needs a program put together to take into account her symptoms and address her flexibility issues.Elizabeth’s Medical HistoryElizabeth’s blood pressure has been stable over the last twelve (12) months; her GP’s last recording was 130/80 mmHg. Recent blood test results are positive for inflammatory mediators (as shown below) a diagnosis, together with her pain symptoms, point towards fibromyalgia. Elizabeth is 152 cm tall and currently weighs 79 kg; she has a waist circumference of 50cm.

The GP also sent Elizabeth for a complete blood test that included a breakdown of her inflammatory markers, with results of her erythrocyte sedimentation (is a blood test that helps detect the degree of inflammation present in the body) shown below:• Erythrocyte sedimentation rate: 50

Aside from the fibromyalgia, she has never experienced any other health-related issues.Elizabeth’s Pre-screening:Elizabeth completed the Adult Pre-exercise screening tool Stage 1 (results can be found in the

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action plan below part 3). The results have required the personal trainer to refer Elizabeth back to the GP to seek guidance for her to undertake physical activity and exercise.


Knowledge Questions


4 potential barriers (including lifestyle and social) to your client participating in exercise programs

Are :

Overweight and high blood pressureDiagnosed with fibromyalgia, which is a clinical condition where the patient presents with widespread pain and tenderness in the bodyOccasional smoker and drinker

History of myocardial infarctions.Erythrocyte sedimentation rate: 50

2. Are there any precautions to exercise relevant to your client’s case?

Yes, moderate exercises and restraining from the impulsive, high-intensity high exercises. Straining and periodic massaging in the form of the physiotherapy can help her relieve the pain. She has an infection which needs to erased with high immunity which is possible through good lifestyle and exercise.


Risks Benefits

The benefits would be increased flexibility and fighting with the infection due to high immunity attained.

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High-intensity exercise can result in the more pains and strain out of the muscles.High exercises and heavy workloads can cause her restricted or limited ease of pain.

More flexibility in the wrist, arms and the body parts with the exercise regime. Increased circulation of the blood flow.


Structural (Physical) Adaptations

The physical adaptation would be increased flexibility and helping the increased circulation fo the blood flow. Gaining immunity.


The internal would be fighting with the infections and the numbness, pains as the exercise would increase more blood flow everywhere.

5. Convert your client's goal into a SMART goal:

The specific would be to attain a healthy lifestyle and get free from the unhealthy regime and detoxifying oneself.

Measurable-: to measure step by step inches of the client and the duration of the work hours. Weights measurement.

Attainable-> to make a step by steps weekly and monthly goals.Realistic-> to experience measurable and achievable goals. Not deciding to make unrealistaic and unattainable goals. Impossible goals such as losing 10 kgs within 10 days. Timely measurement and timely workouts. Checking the timeline specified of attaining a healthy lifestyle routine and regime.

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Title: __Mrs__ Given name: _______Elizabeth___ Surname: ____Lang_______________

Preferred name: ________Elizabeth____________ Address: _____2 George St_________

City: __________________Broome_____________ Post code: ____4111______________

Age: ___________60_________Occupation: ___Retired ___________


Record all pertinent medical information and test results from Elizabeth’s case study below. Minimum of 3 should be recorded

(Type your answer here)

Overweight and high blood pressureDiagnosed with fibromyalgia, which is a clinical condition where the patient presents with widespread pain and tenderness in the body (Consolvo, 2006)Occasional smoker and drinker

History of myocardial infarctions.Erythrocyte sedimentation rate: 50


The below questions are asked as part of an interview. 1. Has your doctor ever told you that you have a heart condition or have you ever suffered a

stroke? Yes/ No 2. Do you have any diagnosed muscle, bone or joint problems that you have been told could

be made worse by participating in physical activity/exercise? Yes/ No 3. Is a referral required? Why/ Why not?

To get quick insurance and proper treatmentNotes: (Type your notes here)

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4. Referral Letter

You will need to prepare a referral letter for your client’s case and address your key concerns for them to participate in the exercise in the referral letter template provided.


RE: Elizabeth

DOB: 27-10-1940

Address: 27 George Street Broome Perth 4111

Phone: 11—222--999

Mobile: 22—28822--

Dear, Dr. Shepherd

Thank you for seeing Ms. Elizabeth Jersey

I, Nancy Crew have been training Ms. Elizabeth Jersey


• Movements around and flexibility in her hands, legs, and other body parts

• Improving immunity and reducing blood pressure

• Reducing weight and improving the flexibility

As per the previous tests conducted, On the 14-June-2017


• myocardial infarctions

• High blood pressure

erythrocyte sedimentation has reported the following signs and symptoms, and I


• fibromyalgia

• myocardial infarctions



Phone: 9900011--22


Kind regards,

Nancy Crew

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mailto:[email protected]


The GP sent a letter back indicating that Elizabeth can start a gradual fitness program that must cater for her fibromyalgia with information indicating that significant weight and pressure to her lumbar region should be avoided. The GP has told Elizabeth that she needs to take it easy during each exercise and gave her pain levels.

Elizabeth’s Fitness Test Results:There are specific fitness tests for different populations – Elizabeth has previously completed the Senior Fitness Test. Older adults need to have adequate strength, flexibility and endurance to accomplish everyday tasks. For further information on the components of the test, please refer to the supplemental resources.

Elizabeth did not score too well in the following Senior Fitness tests:

• Back Scratch Test - <-5.5

Elizabeth’s Goals:1. Reduce the stiffness and pain she experiences in her back2. Start an exercise regime that includes aerobic and flexibility programs.

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5. Fitness/Exercise Program for Elizabeth

Using the data in Elizabeth’s case study put together a fitness/exercise program to address her key complaints. Please complete the resistance and aerobic program templates for this case.

Client name: Elizabeth Client age: 60 Goal: 1. Reduce the stiffness and pain she experiences in her back

2. Start an exercise regime that includes aerobic and flexibility programs.


Stretching and bit of walking

Conditioning phase

Elizabeth is relatively inactive due to her fibromyalgia. She experiences quite severe pain as a result of her medical condition.However she acknowledges the importance of exercise to help improve her health and well-being. It is best to start with a series of three (3) different exercise for this case. The program below will focus on resistance aspects for this case.


1. SQUATS (any variation): A bodyweight squat is an initial focus on no weight.


Set and REPS should be started at the low end with a progression to increase the intensity as she becomes more comfortable. The set number can be increased once the client is comfortable at achieving the REPS at the low-end intensity. Considerations for the back pain and stiffness needs to be taken into account.

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Flexibility Program

Upper Body

Hands and arms any variation


Stretch and do rotation exercise. Can use lifts if he is working out. Bend stretch and repeat

Tummy exercise A needs to concentrate in the belly fat


Needs to bend and stretch exercise. Do a bit of twisting.

Lower Body

2. Leg Press(any variation): A body weight is an initial focus as a starting point

1-2 10-15 1-2 minutes between exercise

Set number and REPS should be started at the low end with a progression to increase the intensity as his strength increases. The set number can be increased once the client is comfortable at achieving the REPS at the low-end intensity.

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Cool down

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Rotation and stretching

Conditioning phase

For this client, it is important to take the significant amount of stiffness and pain she experiences. Due to this and her overall inflammatory profile, it is important to focus on exercise that can be undertaken in water. It is best to start with a series of three (3) different exercise for this case. The program below will focus on aerobic aspect for this case.


1. Swimming Moderate (50% of maxHR) 87-102 BPM. Start 3 days per week. Increase 5 minutes per week until 30-60 minutes per session.

15 minutes 1 km After the completion of every four laps

1. Walk Moderate (60% of maxHR) 87-102 BPM.

Start 3 days per week. Increase 5 minutes per week until 30-60 minutes per session.

15 minutes 1 km 1-minute rest in between

Cool down

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Case Study 5 – AlexPlease read through the following case study. Reflect on your learning and your own research to complete this unit.



• Answer specific questions relevant to case• Complete a referral letter to a GP outlining your concerns of the results identified within the

pre-exercise health screening • Review the complete adult pre-screening tool for Alex's case; to inform the completion of the

action plan: • Complete the action plan – outline the key pre-screening findings and create a fitness

program you would implement for the case scenario.

Scenario

Alex’s Family History and SymptomsAlex Johnston is married and lives in Byron Bay. His current address is 22 Friday Hut Road Byron Bay 4215. Alex has previously injured his leg badly in a car accident 10 years ago. As a result, he experiences pain every day in his lower leg. He is concerned that he is now is experiencing some type of arthritic pain. His psychologist has indicated that it may also be psycho-somatic (defined as the presence of a physical condition caused by a mental factor, including internal conflict and stress). He is now very concerned that he is becoming more and more overweight and is now starting to experience palpitations. Alex is a casual drinker and used to smoke but gave it away five (5) years ago. There is a history of heart disease in his family with his Father passing away at age 68 years old. His mother is suffering from end-stage Alzheimer's disease; and passed away age 65.

He has a sister named Belinda who is 60 years old and is in excellent shape and exercises every day.

Alex is inspired by his older sister and would really like to start exercising so he can work out with her. However when he does try to exercise he experiences leg pain, which really deters him from doing exercise several times per week. Alex’s Medical HistoryAlex’s blood pressure has been stable over the last twelve (12) months; his GP’s last recording was 135/95 mmHg. Alex is 182 cm tall and currently weighs 110 kg; he has a waist circumference of 110 cm. The GP also sent Alex for an electromyogram and nerve conduction study; this test result measures muscle and nerve function to find out whether chronic pain is related to muscle or nerve problems. An extract from the results are outlined below:

• Alex’s test results were abnormal indicating that the pain appears to muscular in nature; and also highlighted that there may be arthritis present as well.

Alex’s Pre-screening:Alex completed the Adult Pre-exercise screening tool Stage 1 (results can be found in the action plan below part 3). The results have required the personal trainer to refer Alex back to the GP to seek guidance for him to undertake physical activity and exercise.

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Knowledge Questions


High blood pressure of 135/95 mmHg

High weight and high abdominal fatHistory of heart diseases

Experiencing psycho-somatic Arthritic pain

Abnormal indicating that the pain appears to muscular in nature; and also highlighted that there may be arthritis present as well

2. Please list health related precautions for Alex's training and list how these might affect any training session you conduct with him.

Continous running-: since he has high BP, diabetes and mid section sudden and rigorous running can lead to stroke or sudden jolt of high/low blood pressure, sugar and make him more physically incapable.Rigorous weight lifting-: sudden pressure on the heart along with the continuous weight lifting can lead to jamming, jolting and muscle pullingEating rightly and proportionately-: by adequately eating the proportionate healthy eating habits, it can help the even spread of the fat, calories and proper digestion. If the client still continuously eats high caloric food items and does not concentrate on nutrient diet, it would result in the The other precautions which need to be taken care to avoid stress, make an active routine and avoid falling into the smoking/drinking zones (Blair, 2016).


Risks Benefits

Rigorous excercise without the adequate monitoring can lead to a distressing situation. It may result in

By reducing the excess weight to the certain level, he would be able to control his blood

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the sudden decrease or increase blood sugar or blood pressure and may even cause strokes in worst cases. Fatigue, lethargic and not maintain proper regime may result in the muscles getting cramped. It is important to have a warm-up session.

pressure and psychological disorder, he should strategically contribute towards weight loss by exercising moderately and increasing the duration of minutes every day.By maintaining a healthy exercise route and lifestyle, the client can feel energetic Common fatigue and the stress can be relied upon and avoided as exercise results in the good hormones.


Structural (Physical) Adaptations The anticipated structural would reduced inches, weight, detoxifying

oneself and experiencing the physical youngness


The internal would be flushing out of the in toxic through perspiring and sweating. Timely actionable would improve the liver condition and would help in avoiding the gout problems.

5. Convert your client's goal into a SMART goal:

Specific to cure arthritis and reduced blood pressure along with loss of weight gain and the related health implications

Measurement to check the timely measurable goals of gaining the good health within a specific timeline

Attainable to moderately exercising and reach specific goalsRealistic to reshape the body and vigor of the body.

Time-: within a defined period of time



Title: __Mr___ Given name: _______Alex_________ Surname: __Johnston______________

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Preferred name: _________Alex_________________ Address: ___22 Friday Hut Rd_______

City: __________________Byron Bay_____________ Post code: __4215________________

Age: ___________55___________ Occupation: _Retired______________


Record all pertinent medical information and test results from Alex’s case study below.

Minimum of 3 need to be provided

(Type your answer here) High blood pressure of 135/95 mmHgHigh weight and high abdominal fat

History of heart diseases and arthritis pain


The below questions are asked as part of an interview. 1. Do you have any diagnosed muscle, bone or joint problems that you have been told could be made worse by participating in physical activity/exercise? Yes/ No

2. Is a referral required? Why/ Why not?

Better treatment and insurance accessNotes: (Type your notes here)

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4. Referral Letter

You will need to prepare a referral letter for your client’s case and address your key concerns for him to participate in the exercise in the referral letter template provided.


RE: Alex Johnston

DOB: 27-10-1945

Address: 22 Friday Hut Road Byron Bay 4215

Phone: 22--28882820

Mobile: 3939030-0

Dear, Dr. Shepherd

Thank you for seeing Alex Johnston

I, Nancy Crew have been training Alex Johnston


• Increased fitness for removing the arthritis pain

• Improved flexibility for the immunity and the reducing heart disease

• Reducing blood pressure and stress

As per the previous tests conducted, On the date of 14th January-2017


• Increased muscular pain and Experiencing psycho-somatic

• High weight and high abdominal fat

History of heart diseases

Arthritic pain has reported the following signs and symptoms, and I


• Arthritic pain

• Increased muscular pain



Phone: 44555000


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Kind regards,

Nancy Crew

The GP has sent a letter back to the indicating that Alex can start a gradual fitness program that must cater for his leg pain.

Alex’s Pre-Fitness Test Results:

There are specific fitness tests for different population groups– Your client has previously completed the Senior Fitness Test. Older adults need to have adequate strength, flexibility and endurance to accomplish everyday tasks. For further information on the components of the test, please refer to the supplemental resources.

Alex did not score too well in the following Senior Fitness tests:

• 8 Foot Up and Go Test - <-6.5Alex’s Exercise Goals:

1. Increase physical fitness so he can run for 5 minutes nonstop2. Reduce his body fat by 30 kilograms in the next 6 months

3. Increase overall muscle mass.

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5. Fitness/Exercise Program for Alex

Using the data in Alex’s case study put together a fitness/exercise program to address her key complaints. Please complete the resistance and aerobic program templates for this case.

Client name: Alex Client age: 55 Goal: 1. Increase physical fitness so I can run for 5 minutes non stop

2. Reduce my body fat by 30 kilograms in the next 6 months

3. Increase my muscle mass in my lower and upper body.


Stretching and walking

Conditioning phase

For Alex's case, it is important for him to include both resistant and aerobic exercise to address his weight concern and physical fitness. Because of his suspected arthritis and pain, it is also critical to have a well-rounded exercise program. A focus on using the client's own body weight is the priority starting point before introducing free weights. It is best to start with a series of three (3) different exercise for this case. The program below will focus on resistance aspects for this case.


1. SQUATS (any variation): A bodyweight squat is an initial

focus on no weight.


REP and sets should be started at the low end with a progression to increase the intensity as she becomes more comfortable. The set number can be increased once the client is comfortable at achieving the REPS at the low-end intensity. Considerations for the back pain and stiffness needs to be taken into account.

Legs any variation

2 10-15 2 minutes rest Rotation and stretching exercises. Repeat with same moderately

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Abdominal exercise of bending and stretching

2 10-15 1 minutes rest Repeat motion of twisting and bending.

Arms and hands variation2 10-15 1 minutes rest Rotation and stretching exercises. Repeat with same moderately

Cool down

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Conditioning phase

For Alex's case, it is important for him to include both resistant and aerobic exercise to address his weight concern and physical fitness. Because of his suspected arthritis and pain, it is also critical to have a well-rounded exercise program. A focus on using the client's own body weight is the priority starting point before introducing free weights. It is best to start with a series of three (3) different exercise for this case. The program below will focus on aerobic aspects for this case.

Activity Intensity/ HR Time Distance Rest period Notes

1. Walk Moderate (80% of maxHR) 83-116 BPM.Start 3 days per week. Increase 5 minutes per week until 30-60 minutes per session.

20 minutes

3km 1 minute every 5 minutes of exercise

For each of these aerobic exercises, the client will need to start 3 days per week with a day separating each activity. When the intensity, time and distance is comfortable then the aim should be to increase the activity to 5 times per week (Arora, 2006).

Power WalkingModerate for 30minutes. Slowing and again gaining speed

30 minutes

1 km 1 minute or when required

Timely and moderately walk-in. Need to restrain the joints

Lunges/sit-ups Slowly for thighs and buttocks flexibility 15 minutes

1-minute rest Relaxed and slowly bending and repeating

Cool down

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References

Arora, R., Stoner, C., & Arora, A. (2006). Using framing and credibility to incorporate exercise and fitness into individuals' lifestyle. Journal of Consumer Marketing, 23(4), 199-207.

Blair, S. N., Piserchia, P. V., Wilbur, C. S., & Crowder, J. H. (2016). A public health intervention model for worksite health promotion: impact on exercise and physical fitness in a health promotion plan after 24 months. Jama, 255(7), 921-926.

Consolvo, S., Everitt, K., Smith, I., & Landay, J. A. (2006, April). Design requirements for technologies that encourage physical activity. In Proceedings of the SIGCHI conference on Human Factors in computing systems (pp. 457-466). ACM.

Dishman, R. K., Sallis, J. F., & Orenstein, D. R. (2015). The determinants of physical activity and exercise. Public health reports, 100(2), 158.

Lippke, S., Ziegelmann, J. P., & Schwarzer, R. (2004). Behavioral intentions and action plans promote physical exercise: A longitudinal study with orthopedic rehabilitation patients. Journal of Sport and Exercise Psychology, 26(3), 470-483.

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