1) The client is a healthy female with a clear medical record and she is currently not on any medication. The client has low-intensity aerobic exercise as part of her current workout routine and for the past 6 months, however, she has not implemented any resistance training in her routine for the past 10 years. As the patient is looking to start a more advanced exercise routine, it is indispensable to check with her doctor for medical clearance should she have any contraindications for high-intensity or high weight exercises. The patient has a history of childbirth, lactation, occasional low back pain, and the feeling of fatigue during current exercising. Though medical clearance is very important before enrolling in any exercise program, listed conditions are not considered contraindications for exercise. Cautions for exercise would be her borderline elevated blood pressure and lower back pain that could be aggravated by certain exercises. The patient would benefit from further medical investigations if symptoms with either condition worsen. For example, pelvic floor dysfunction that could be caused by birth/childbearing can lead to lower back pain and can be aggravated by running/heavy lifting exercises.
2) Dear Adi Das, the following are findings from your assessment:
In terms of body shape, your height of 175cm is directly proportional to your weight of 70kg. This gives us a body mass index (BMI) value of 23.5/m2 signifying that you are within the normal ranges of body size and you are not obese or underweight for your age and sexual category. Systolic blood pressure is the pressure in the arteries when blood is ejected out of the heart during contraction of the heart muscle. Your assessment results of the systolic blood pressure measure 118 mmHg, indicating that it is within the normal ranges. Diastolic blood pressure is the blood pressure measured when your heart muscle is between beats and blood is filling the heart chambers. Normal diastolic blood pressure should be less than 80mmHg. Your results show an elevated diastolic blood pressure of 89 mmHg for a non-sedentary young person which classifies you in the pre-hypertensive group. Resting heart rate refers to the number of hearts beats every minute at rest. The normal ranges for a healthy adult fall in between 60-100 bpm which means your heart rate of 67bpm is within the acceptable range. Though, a lower resting heart rate implies a better heart function and cardiovascular fitness.
If you need assistance with writing your essay, our professional essay writing service is here to help!
The result of your VO2max test which is the maximum rate of oxygen that is used during activity was used to assess your body’s ability to take up and use oxygen and thus your level cardiorespiratory fitness level. The ergometer showed a value of 33mL O2/kg/min, which means that your aerobic fitness is relatively low for your age.
In terms of body composition, your BIA results indicate a 27% body fat. This is the measure of the fitness level of an individual and a high value can indicate a higher risk of morbidity. In your case, it shows your level of fitness to be average.
The postural assessment indicates that you have a posterior pelvic tilt and a flat back posture. The correct posture is characterized by the ability to maintain an upright and straight position and balance with minimal effort while maintaining an appropriate lumbar, thoracic and cervical curve. A flat back posture means that your pelvic bone is pushed in and downwards, and your lower back is straight instead of lumbar lordosis, causing you to bend forward; as demonstrated in figure 1. This is likely the cause for your difficulty standing for long periods, and the leaning of your neck and head forward resulting in neck and upper back straining. Flatback posture is the result of muscle imbalances where some muscles are tight pulling on the weaker ones, thus making you adopt this posture. To correct this posture, you will have to engage in exercise that strengthens your core muscles, buttocks, neck and rear shoulder muscles, and back extensors.
Flexibility is the ability of your muscles to bend or lengthen your joints to optimal ranges. You demonstrate a good ROM in the tested joints, except for hip flexion with the leg straight which could be an indication of hamstring tightness, weak hip flexors or nerve mobility issues. The posterior pelvic tilt mentioned before could also be correlated to hamstring tightness denoting that we would want to add hamstring stretching exercises to your program. Hip flexors can be strengthened by certain types of strength training.
Manual Muscle Testing (MMT) assessment was used to analyze your muscular strength. MMT scores for your elbow and knee joints were both 4 out of 5, indicating that you have full ROM against gravity with moderate resistance and normal strength. However, there is still place for improvement mainly achieved through resistance training with an emphasis on these joints. Strength results indicate your predicted 1RM, which is the maximum load you can handle during 1 repetition in this case for a bench press is 41 kg and leg press is 91 kg. This information will be used to determine the load (intensity) for your resistance training to prevent overload injury.
Figure 1. Spine alignment in a person with flatback vs. an ideal posture
3a) 1-month timeline of exercise prescription for Mrs. Das:
Flexibility Exercises for Weeks 1 to 4:
Frequency | 2-3 times/week – to be done before resistance exercises as a warm-up |
Intensity | Each stretch is performed with a slow but steady movement without bouncing or locking of the joints which may result in injury. The client must stretch to point of slight discomfort and stop before the stretch becomes painful. |
Time | Total: 10-15 minutes
– holding each stretch for 20-30 sec before proceeding to the next. – the client may repeat 2-3 times targeting the major muscles – 15-30 sec rest before the second repetition |
Type | static or dynamic stretches are recommended (listed in the chart below) |
Exercise type | Tempo | Targeted muscles |
Bird-dog | 4 sets of 10 reps | Glutes, rectus abdominis, and erector spinae |
Upward facing dog | 4 sets of 10 breaths | No specific muscle group worked. Intervertebral discs decompressed to the opposite direction of lumbar lordosis caused by pregnancy |
Cat-cow pose | 4 sets of 10 reps | Glutes, rectus abdominis, erector spinae, rhomboids, and lower trapezius |
Assisted Hamstring Stretch | 3 sets of 10 reps | Hamstrings (requires resistace bands) |
Alternating Toe Touches | 3 sets of 10 reps | Rectus abdominis, abs, obliques, bicep femoris, hamstrings |
Elbow Stretch | 4 sets of 20 seconds | Triceps, wrist extensors |
Supine Pelvic tilts | 3 sets of 10 reps | Rectus abdominis and glutes |
*only 4 of the above exercise to be done each time (extra options in case the client loses interest)
Cardiorespiratory Exercises For 4 Weeks:
The client is encouraged to participate in activities that raises her heart rate and engages large muscle groups in a continuous and rhythmic nature e.g. cycling, walking, swimming, jogging or shoveling. Intensity recommendations are 65-90% of maximum heart rate (HRmax). Each workout starts with a warm-up session of 5 minutes or more followed by a moderate-intensity activity, which is intended to make the client sweat and increase her HR, and is completed by a cooldown exercise.
Week 1 | Saturday & Wednesday | |
Type: | Running (low intensity) | |
30 Minutes
1. 10 minutes warm-up – walk 2. 30-minute low-intensity run 3. 10-minute cool down – walk |
||
Intensity: | %VO2max 50, THR40 114bpm +/- 5bpm | |
Frequency: | 2 times per week |
Week 2 | Saturday & Wednesday | Monday | |
Type | Running | Cycling | |
35 Minutes
1. 5-minute warm-up – walk 2. 30-minute run 3. 10-minute cool down – walk |
30 Minutes
1. 5-minute warm up – walk 2. 30-minute cycling 3. 10-minute cool down – walk |
||
Intensity: | %VO2max 5, THR40 114bpm +/- 5bpm | %VO2max 50, THR40 114bpm +/- 5bpm | |
Frequency: | 2 time per week | 1 time per week |
Week 3 | Saturday and Sunday | |
Type: | Moderate to High Intensity Interval Training | |
31.5 Minutes
1. 10-Minute warm-up – Walk 2. 15-Minute moderate-intensity jog 3. 30 seconds of jump rope. 4. 1-minute rest 5. 15-minutes of cycling 6. 10-minute cool down – walk |
||
Intensity: | VO2max % 70, THR 145 bpm +/- 5bpm | |
Frequency: | 2 times per week |
Week 4 | Saturday and Sunday | |
Type: | HIIT (High Intensity Interval Training) | |
25 Minutes
|
||
Intensity: | VO2max % 75, THR 155bpm +/- 5bpm | |
Frequency: | 2 times per week |
Resistance Training For 4 Weeks: Resistance training would help with improving the client’s strength, thus her performance in soccer while elevating her resting metabolism to help her get back in shape. The following resistance program is designed so that the whole body (all muscle groups) are trained in the same session as opposed to training selected muscle groups such as lower body muscle and upper body muscles on different days (month 2 & 3). The Load assigned to each exercise set was estimated using the information provided on the predicted 1RM for bench press and leg press. ACSM guidelines recommend a 40 – 50% 1RM for beginners. The appropriate limb-specific weight load is calculated using the 1RM for chest press and bench press. The number of repetitions and sets are also adjusted according to the time restriction of the client and it is compensated by increasing the load of the resistance exercise. The client wants to increase her strength and improve her shape while increasing her cardiovascular endurance, thus a moderate load of 8-15 reps would be optimal to enable her goal. In a few exercises, a heavier load with lower reps are used to gradually build muscular force.
Week 1 | Monday, Thursday & Saturday | |
Type | Full body compound (body weight) | |
35 Minutes total | ||
Intensity | Moderate, 30% of 1RM | |
Frequency | 3 time per week |
Exercise Order | Tempo | Rest | Targeted Muscles |
|
3 sets of 10 | 60 second | chest (pectoralis major), shoulders (deltoid), and elbow extensors (triceps brachii/anconeus). |
|
3 sets of 6 | 60 second | back (latissimus dorsi, Erector spinae, trapezius, etc.), elbow flexors (biceps brachii, brachialis, brachioradialis, etc.), and scapula stabilizers (rotator cuff muscles & rhomboids). |
|
3 sets of 16 | 60 second | quadriceps, and hip extensors (gluteus maximus) |
Week 2 | Monday, Thursday & Saturday | |
Type: | Full body compound with weights | |
45 Minutes total | ||
Intensity | Moderate, 40% of 1RM | |
Frequency | 3 time per week |
Exercise Order | Load | Tempo | Rest | Targeted Muscles |
|
65 lb. | 3 sets of 12 | 90 second | Chest (pectoralis major), elbow extensors (triceps brachii/anconeus) |
|
45 lb. | 3 sets of 12 | 60 second | Shoulders (deltoid). |
|
65 lb. | 3 sets of 12 | 90 second | Back (latissimus dorsi, trapezius, erector spinae, etc.), elbow flexors (biceps brachii, brachialis, brachioradialis, etc.), and scapula stabilizers (rotator cuff muscles & rhomboids). |
|
85 lb. | 3 sets of 8 | 90 second | Muscles of the posterior chain / primarily back muscles (latissimus dorsi, trapezius, erector spinae, etc.), and hamstrings and glutes. |
|
85 lb. | 3 sets of 12 | 90 second | quadriceps, and hip extensors (gluteus maximus). |
Week 3 | Monday, Thursday & Saturday | |
Type | Full body compound with weights & accessory lifts (i.e. isolation of specific muscle groups apart from compound movement) | |
60 Minutes total | ||
Intensity | Moderate, 40% of 1RM | |
Frequency | 3 time per week |
Exercise Order | Load | Tempo | Rest | Targeted Muscles |
|
65 lb. | 3 sets of 12 | 90 second | chest (pectoralis major), elbow extensors (triceps brachii/anconeus) |
|
45 lb. | 3 sets of 12 | 60 second | shoulders (deltoid) |
|
65 lb. | 3 sets of 12 | 90 second | back (latissimus dorsi, trapezius, erector spinae, etc.), elbow flexors (biceps brachii, brachialis, brachioradialis, etc.), and scapula stabilizers (rotator cuff muscles & rhomboids). |
|
85 lb. | 3 sets of 12 | 90 second | quadriceps, and hip extensors (gluteus maximus) |
|
85 lb. | 3 sets of 8 | 90 second | muscles of the posterior chain / primarily back muscles (latissimus dorsi, trapezius, erector spinae, etc.), and hamstrings and glutes. |
|
15 lb. | 3 sets of 12 | 60 second | elbow flexors (biceps brachii, brachialis, brachioradialis, etc.) |
|
15 lb. | 3 sets of 12 | 60 second | elbow extensors (triceps brachii/anconeus). |
Week 4 | Monday, Thursday & Saturday | |
Type | Full body compound with increased weight, and accessory lifts (i.e. isolation of specific muscle groups apart from compound movement) | |
60 Minutes total | ||
Intensity | Moderate, 50% of 1RM | |
Frequency | 3 time per week |
Exercise Order | Load | Tempo | Rest | Targeted Muscles |
|
80 lb. | 3 sets of 8, 10 pushups super set | 90 second | chest (pectoralis major), shoulders (deltoid), and elbow extensors (triceps brachii/anconeus). |
|
20 lb. | 3 sets of 8 | 60 second | back (latissimus dorsi, Erector spinae, trapezius, etc.), elbow flexors (biceps brachii, brachialis, brachioradialis, etc.), and scapula stabilizers (rotator cuff muscles & rhomboids). |
|
25 lb. | 3 sets of 8 | 90 second | back (latissimus dorsi, trapezius, erector spinae, etc.), elbow flexors (biceps brachii, brachialis, brachioradialis, etc.), and scapula stabilizers (rotator cuff muscles & rhomboids). |
|
90 lb. | 3 sets of 12, followed by 10 curtsy lunges superset | 90 second | quadriceps, and hip extensors (gluteus maximus). |
|
90 lb. | 3 sets of 8 | 90 second | Muscles of the posterior chain / primarily back muscles (latissimus dorsi, trapezius, erector spinae, etc.), and hamstrings and glutes. |
|
20 lb. | 3 sets of 12 | 60 second | Elbow flexors (biceps brachii, brachialis, brachioradialis, etc.) |
|
20 lb. | 3 sets of 12 | 60 second | elbow extensors (triceps brachii/anconeus). |
3B) The cardiorespiratory exercise section includes a warm-up period, a cardiorespiratory phase and a cool-down period. Wagner (2005) argues that warm-ups prepare the body for a transition from rest to physical activity. It serves to stretch muscles, increase flexibility, increase heart rate and circulation. This, therefore, decreases the incidences of both orthopedic injury and ischemic response. The choice of exercises prescribed for this client is based on her level of fitness, the tight schedule, and interests. Most of the aerobic activities prescribed employ large muscles groups and are maintained in continuous and rhythmic motions (Griffin, 2016). Most of these exercises do not require specialized equipment or facility to perform. The client is interested in cycling which is another reason I chose cycling as part of her aerobic exercise. The exercises are also low impact activities, which then decreases the risk of injuries and increases the client’s exercise compliance. According to Farnsworth & Cannon, (2018) aerobics enhance muscular endurance, cardiorespiratory endurance, and flexibility while weight training improves the muscular strength and muscular endurance. I also incorporated HITT into her schedule as it is more effective at building endurance, than endurance training alone. In a study of healthy young and middle ages people, HIIT increased their VO2max levels (a measure of endurance) considerably more than longer, steady-state workouts. HIIT also burns fat, build muscle, improves both your aerobic fitness and your strength, lowers risk of obesity and diabetes by improving the way your body manages insulin.
Our academic experts are ready and waiting to assist with any writing project you may have. From simple essay plans, through to full dissertations, you can guarantee we have a service perfectly matched to your needs.
The flexibility exercises assigned are important in stretching her back and neck which aids in correcting her flat back posture. They are also quite relaxing and therapeutic which will help the client recover from her other activities. The strength training exercises are inexpensive, easy and are tailored to make use of her body weight hence compliance. The client has a variety of exercises to choose from unlike her normal running, which is a recipe for overtraining and may pose muscular imbalance. This helps in preventing long term repetitive strain of the involved muscles and neglect or weakening of other muscles (Acevedo & Starks, 2016)
4) 1-month schedule for Adi Das
Sunday | Monday | Tues | Wednesday | Thursday | Fri | Saturday |
Flexibility
Resistance |
REST | Cardio 35-min- running | Flexibility
Resistance |
REST | Flexibility
Resistance Cardio 30-min- running |
|
Flexibility
Resistance Cardio 30- min cycling |
Cardio 35-min- running | Flexibility
Resistance |
Flexibility
Resistance Cardio 35-min-running |
|||
Cardio 31.5-min- moderate HIIT | Flexibility
Resistance |
Flexibility
Resistance |
Flexibility
Resistance Cardio 31.5-min- moderate HIIT |
|||
Cardio 25 min HIIT | Flexibility
Resistance |
Flexibility
Resistance |
Flexibility
Resistance Cardio 25 min HIIT |
Flexibility Exercises Week 1 to 4:
#1 Alternating Toe Touches – 3 sets of 10 reps
|
#2. Bird-dogs exercise – 4 sets of 10 reps
|
#3. Elbow Stretching – 4 sets of 20 secs
|
#4. Assisted hamstring stretch – 3 sets of 30 secs
|
WEEK 1 | 3 sets of 10 + 60 sec between sets | Push-ups
|
3 sets of 10 + 60 seconds between sets | Pull-ups
|
|
3 sets of 16 + 60 seconds between sets | Squats
|
|
WEEK 2 | 3 sets of 12 with varying weights + 90 sec between sets | Barbell Bench Press
|
3 sets of 12 with 45 lb. Barbell + 60 secs between sets | Barbell Military Press
|
|
3 sets of 12 with 65 lb. Barbell + 90 secs between sets | Barbell Row
|
|
3 sets of 8 with varying weights
+ 90 secs between sets |
Barbell Deadlift
|
|
3 sets of 12 with varying weights + 90 sec between sets | Barbell Squat
|
WEEK 3 |
|
|
3 sets of 12 with varying weights + 60 seconds between sets | Dumbbell Biceps Curl
|
|
3 sets of 12 with varying weights + 60 seconds between sets | Dumbbell Triceps Extensions
|
|
3 sets of 8 with 20 lb. Dumbbells + 60 seconds between sets | Dumbbell Shoulder Press
|
|
WEEK 4 |
|
|
3 sets of 8 with 20 lb. Dumbbells + 60 seconds between sets | One-Arm Dumbbell Row
|
5) client vision is the most important factor when designing a progression exercise plan. Progression is necessary as the body adapts to the loads and exercise frequencies, and lessening the benefits associated with each exercise. Hence, the client must increase the intensity, frequency interval or the type of the exercises they have been prescribed. However, this must be done in a controlled manner while monitoring the client, should any complications arise, appropriate adjustments must be made. In the first 4 weeks the progression for aerobic exercises was achieved through increasing the duration of each exercise session by 5 to 10 minutes every 1 to 2 weeks as recommended by ACSM (eq. running time was increased from 30 to 35 minutes with no change in intensity) In week 6 and 8 the duration is furthermore increased to 50 minutes per session while the frequency increases from 2-3day/week to 4 days/week in to increase the client’s oxygen consumption capacity (VO2max) and improve her cardiorespiratory fitness. The intensity is not increased until beginning of week 10, assuming the client is well adapted to the increases in duration of the exercises. In week 10 to 12 the ACSM guidelines recommend an increase of approx. 3-5% HRR every 6th session in exercise intensity. This indicates a value of 125bpm for the THR and increase in VO2max by about 5% from 50% to 55%. The ACSM generally does not recommend progression in resistance training unless an individual has been training for at least 6 months on a regular basis. The client wishes to build endurance and increase her strength, attained through increasing load and the number of reps per each set while decreasing the rest period between sets. For endurance, the ACSM recommends a load below 70% 1RM, with a high repletion of 10-25 for 2-4 sets and 1 minute of rest between each set. In order to achieve muscular strength, it is recommended that one exercises at 60-70% 1RM, with 8-12 reps of 1-3 sets and 2-3 min rests between each set. The load was increased by 2%-10% of the client recommended 1RM after the client was able to complete two consecutive reps over the recommended reps in the last set for two successive workouts. This means that the client must increase the load by 2-5lbs for smaller muscle groups and 5-10lbs for larger muscle every month at the end of every 4-week period.
6) In terms of other measurements, waist circumference, lean body mass, as well as multiple repetition maximum testing from various joints as part of the assessment would have been helpful in designing an appropriate strength training plan. 1RM testing is not appropriate for a person with little resistance training experience, and may result in serious injury. It is important for the client to be in a stable mental state before committing to a tight regime or somewhat demanding schedule with new exercises. Psychiatric evaluation, one to one consultation with the client, and knowing more about their capacities to respond to changes may help the assessor choose a more appropriate plan for her that does not challenge her mentally, and also incorporate relaxing, and theopoetic exercises in her routine to help her with the transition. The personal fitness evaluation can be repeated every 2 weeks to monitor the progress of the client. Therefore, the assessor has a better sense of how much they need to add to the exercise time each time for the client to receive the maximum benefit from the exercise and continues improving.
7) Self and Peer Evaluation:
Your name: Donya Eslami-Rezaei
I did this project individually, so I did not have any group members.
Evaluation Criteria | SELF EVALUATION | TEAM-MATE
NAME: N/A |
Attends group meetings regularly and arrives on time. | 4 | N/A |
Contributes meaningfully to
group discussions. |
4 | N/A |
Completes group tasks on time. | 4 | N/A |
Prepares work in a quality
manner. |
4 | N/A |
Demonstrates a cooperative and supportive attitude. | 4 | N/A |
Contributes significantly to the success of the project. | 4 | N/A |
TOTALS | 24 | N/A |
Feedback on team dynamics:
- How effectively did your group work?
I partnered with a girl from the class to complete this assignment together. We had a brief meeting at the beginning of the term to spilt the work load for background research on the assignment. However, she was not able to continue being part of this assignment, and I had to finish it independently. I believe I kept up with the calendar and tasks very well and followed the instructions very closely.
- Were the behaviors of any of your team members particularly valuable or detrimental to the team? Explain.
I completed the entire assignment alone. Even though my partner dropped out midway through the term, and I do not believe that the behavior of my team member was detrimental to this assignment as I was not entirely relying on the other person. I tried to get a few hours of work done every week as planned.
- What did you learn about working in a group from this project that you will carry into your next group experiences?
In fact, I learned a lot about working in a group from this project. After hearing the news that my partner was not going to do the assignment anymore, I was very stressed out and overwhelmed. I tried to find another partner, but everyone was already working in groups. Being in this situation taught me a lot about the fact that unfortunate circumstances may happen anytime that we may not have been prepared for. Emailing/ talking to professors and asking for help early on is important in overcoming such situations.
References:
- Acevedo, E. O., & Starks, M. A. (2011). Exercise Testing and Prescription Lab Manual. Champaign, IL: Human Kinetics.
- ACSM’s Guidelines for Exercise Testing and Prescription (10th Edition). Wolters Kluwer/Lippincott Williams & Wilkins. Baltimore, Philadelphia. 2018.
- Altug, Z., & Hoffman, J. L. (2017). Manual of Clinical Exercise Testing, Prescription, and Rehabilitation. Upper Saddle River, NJ: Prentice Hall.
- Farnsworth, C. D., & Cannon, M. (2018). Exercise Prescription. The Sports Medicine Resource Manual, 497-506. doi:10.1016/b978-141603197-0.10039-4
- Griffin, J. C. (2016). Client-centered Exercise Prescription. Champaign, IL: Human Kinetics.
- Hong Kong Exercise Prescription Development Committee, & Hong Kong Department of Health. Centre for Health Protection. (2016). The Exercise Prescription Project: Professional Manual.
- KNUDSON, D et al. (2001) Acute Effects of Stretching Are Not Evident in the Kinematics of the Vertical Jump, Journal of Strength & Conditioning Research.
- Wagner, D. R. (2015). ACSMs Resource Manual for Guidelines for Exercise Testing and Prescription, 5th Edition. Medicine & Science in Sports & Exercise, 37(11), 2018. doi:10.1249/01.mss.0000189075.58666.c2