SPOA04 Specific populations and older adults
Name
Email address
Assignment
Assignments may include short answer questions or longer answer questions and are designed to test how you apply your knowledge into a real-world situation. All assignments are completed as a Microsoft Word document and are submitted to an assessor through MyeCampus. Your assessor is looking for how you apply your knowledge and how you think critically about the topic area.
Case Study 1 – Thomas
Please 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 completed 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 Lifestyle
Thomas Jones (preferred name Tom) and is currently the Chief Operating Officer of a non-profit organisation. 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 History
Thomas’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
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/L
Interestingly, 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 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 medicaitons 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.
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.
3. Briefly outline the benefits versus risks for participation in exercise for this client. (minimum 2 for each)
Risks Benefits
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
Physiological (Internal) adaptations
5. Convert this clients goal in to a SMART goal:
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)
3. Results from Stage One – Pre-screening test
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 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?
Notes:
(Type your notes here)
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 exercise in the referral letter template provided.
Please write your referral letter below
RE:
DOB:
Address:
Phone:
Mobile:
Dear,
Thank you for seeing
I, have been training
for months/years now with a physical activity program to achieve the following goals:
•
•
•
As per the previous tests conducted,
presents with the following:
•
•
has reported the following signs and symptoms, and I
would like your diagnosis or assessment on these:
•
•
Thank you for taking the time with this referral, and any queries or feedback for program alteration
would be greatly appreciated.
Phone:
Email:
Kind regards,
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 a 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 pressure
2. Implement an exercise program that results in weight loss
3. Wants to lose 20 kg of weight in the next 6 months
4. Wants to focus on reshaping his body.
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:
Resistance Exercise Program
Warm up
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 stabilisation 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 clients progression should be
1. Leg Press (any variation): A body weight is the 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 increasing the intensity as his strength increases. Set number can be increased once the client is comfortable at achieving the REPS at the low end intensity.
Cool down
Notes for next session
Aerobic Exercise Program
Warm up
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
Cool down
Case Study 2– Soula
Please 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 completed adult pre-screening tool for Soula’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
Soula’s Family History and Lifestyle
Soula 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 specialised 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 History
Soula’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 tool
Data from Soula’s case study for stage 2 and 3 of the Adult Pre-screening Exercise Tool is shown below
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
2. Please list 2 health related precautions for Soula’s training and list how these might affect any training session you conduct with her.
3. Briefly outline the benefits versus risks for participation in exercise for this client. (minimum 2 for each)
Risks Benefits
4. Explain the benefits of exercise and the anticipated structural and physiological adaptations as they relate to client goals and needs?
Structural (physical) Adaptations
Physiological (Internal) adaptations
5. Convert this client’s goal in to a SMART goal:
Action plan template
1. Client Information
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
2. Medical History Information
Record all relevant medical information and test results from Soula’s case study below. Minimum of 3 should be recorded.
(Type your answer here)
3. Results from Stage One – Pre-screening test
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?
Notes:
(Type your notes here)
4. Referral Letter
You will need to prepare a referral letter for this client’s case and address your key concerns for them to participate in exercise in the referral letter template provided.
Please write your referral letter below
RE:
DOB:
Address:
Phone:
Mobile:
Dear,
Thank you for seeing
I, have been training
for months/years now with a physical activity program to achieve the following goals:
•
•
•
As per the previous tests conducted,
presents with the following:
•
•
has reported the following signs and symptoms, and I
would like your diagnosis or assessment on these:
•
•
Thank you for taking the time with this referral, and any queries or feedback for program alteration
would be greatly appreciated.
Phone:
Email:
Kind regards,
The GP has sent a letter back to the PT indicating that Soula can start slow with a fitness regime and that it would be a 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 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 pain
2. Start an exercise program that will improve her upper body strength
3. Start an exercise program to reduce her weight.
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
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
Cool down
Aerobic Exercise Program
Warm up
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
Cool down
Case Study 3 – Roger
Please 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 completed adult pre-screening tool for Roger’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
Roger’s Family History and Symptoms
Roger 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
• 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 History
Roger’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 the 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 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.
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 your client participating in exercise programs
2. Please list a health related precautions for Roger’s training and list how these might affect any training session you conduct with him.
3. Briefly outline the benefits versus risks for participation in exercise for this client. (minimum 2 for each)
Risks Benefits
4. Explain the benefits of exercise and the anticipated structural and physiological adaptations as they relate to client goals and needs?
Structural (Physcial) Adaptations
Physiological (Internal)adaptations
5. Convert your client’s goal in to a SMART goal:
Action plan template
1. Client Information
Title: __Mr___ Given name: _______Roger_______ Surname: __Taylor________________
Preferred name: _________Roger_______________ Address: ___2 Katherine St_________
City: __________________Hobart_______________ Post code: __4237________________
Age: ___________70___________ Occupation: _Retired______________
2. Medical History Information
Record all relevantmedical information and test results from Roger’s case study below. Minimum of 2 should be recorded
(Type your answer here)
3. Results from Stage One – Pre-screening test
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?
Notes:
(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 exercise in the referral letter template provided.
Please write your referral letter below
RE:
DOB:
Address:
Phone:
Mobile:
Dear,
Thank you for seeing
I, have been training
for months/years now with a physical activity program to achieve the following goals:
•
•
•
As per the previous tests conducted,
presents with the following:
•
•
has reported the following signs and symptoms, and I
would like your diagnosis or assessment on these:
•
•
Thank you for taking the time with this referral, and any queries or feedback for program alteration
would be greatly appreciated.
Phone:
Email:
Kind regards,
The GP has sent a letter back to the PT 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 test, please refer to the supplemental resources.
Roger did not score too well in the following Senior Fitness tests:
• 8 Foot Up and Go Test - <-6.5
Roger’s exercise Goals:
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.
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
Resistance Exercise Program
Warm up
Conditioning phase
Roger has a relatively fit physic. Roger however has experienced some dizziness in the past when performing exercise, so the degree of exertion needs to be taken into account. His gout needs to be taken into account when conducting 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 body weight squat is the initial focus with no weight. 1 10-12 1-2 minutes between exercise Set and REPS should be started at the low end with a progression to increasing the intensity. Set number can be increased once the client is comfortable at achieving the REPS at the low end intensity.
Cool down
Aerobic Exercise Program
Warm up
Conditioning phase
Roger has a relatively fit physic. Roger however has experienced some dizziness in the past when performing exercise, so the degree of exertion needs to be taken into account. His gout needs to be taken into account when conducting aerobic exercise. Water based exercises need to be considered because of the 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.
Activity
Intensity/ HR Time Distance Rest period
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. 15 minutes 1 km After the completion of every four laps
Cool down
Case Study 4 – Elizabeth
Please 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 completed 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 Symptoms
Elizabeth 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 spine
3. 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 fibromyagia 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 History
Elizabeth’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 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.
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 your client participating in exercise programs
2. Are there any precautions to exercise relevant to your client’s case?
3. Briefly outline the benefits versus risks for participation in exercise for this client. (minimum 2 for each)
Risks Benefits
4. Explain the benefits of exercise and the anticipated structural and physiological adaptations as they relate to client goals and needs?
Structural (Physical) Adaptations
Physiological (Internal) adaptations
5. Convert your client’s goal in to a SMART goal:
Action plan template
1. Client Information
Title: __Mrs__ Given name: _______Elizabeth___ Surname: ____Lang_______________
Preferred name: ________Elizabeth____________ Address: _____2 George St_________
City: __________________Broome_____________ Post code: ____4111______________
Age: ___________60_________ Occupation: ___Retired ___________
2. Medical History Information
Record all pertinent medical information and test results from Elizabeth’s case study below. Minimum of 3 should be recorded
(Type your answer here)
3. Results from Stage One – Pre-screening test
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?
Notes:
(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 them to participate in exercise in the referral letter template provided.
Please write your referral letter below
RE:
DOB:
Address:
Phone:
Mobile:
Dear,
Thank you for seeing
I, have been training
for months/years now with a physical activity program to achieve the following goals:
•
•
•
As per the previous tests conducted,
presents with the following:
•
•
has reported the following signs and symptoms, and I
would like your diagnosis or assessment on these:
•
•
Thank you for taking the time with this referral, and any queries or feedback for program alteration
would be greatly appreciated.
Phone:
Email:
Kind regards,
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 gage 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 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 back
2. Start an exercise regime that includes aerobic and flexibility programs.
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.
Resistance Exercise Program
Warm up
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.
Exercise
Sets Reps Rest period Comments
1. SQUATS (any variation): A body weight squat is the initial focus with no weight. 1 5-8 1-2 minutes between exercise
Set and REPS should be started at the low end with a progression to increasing the intensity as she becomes more comfortable. 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.
Flexibility Program
Upper Body
Lower Body
Cool down
Aerobic Exercise Program
Warm up
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.
Activity
Intensity/ HR Time Distance Rest period
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
Cool down
Case Study 5 – Alex
Please 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 completed 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 Symptoms
Alex 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 History
Alex’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.
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 your client participating in exercise programs
2. Please list a health related precautions for Alex’s training and list how these might affect any training session you conduct with him.
3. Briefly outline the benefits versus risks for participation in exercise for this client. (minimum 2 for each)
Risks Benefits
4. Explain the benefits of exercise and the anticipated structural and physiological adaptations as they relate to client goals and needs?
Structural (Physical) Adaptations
Physiological (Internal) adaptations
5. Convert your client’s goal in to a SMART goal:
Action plan template
1. Client Information
Title: __Mr___ Given name: _______Alex_________ Surname: __Johnston______________
Preferred name: _________Alex_________________ Address: ___22 Friday Hut Rd_______
City: __________________Byron Bay_____________ Post code: __4215__________¬______
Age: ___________55___________ Occupation: _Retired______________
2. Medical History Information
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)
3. Results from Stage One – Pre-screening test
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?
Notes:
(Type your noteshere)
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 exercise in the referral letter template provided.
Please write your referral letter below
RE:
DOB:
Address:
Phone:
Mobile:
Dear,
Thank you for seeing
I, have been training
for months/years now with a physical activity program to achieve the following goals:
•
•
•
As per the previous tests conducted,
presents with the following:
•
•
has reported the following signs and symptoms, and I
would like your diagnosis or assessment on these:
•
•
Thank you for taking the time with this referral, and any queries or feedback for program alteration
would be greatly appreciated.
Phone:
Email:
Kind regards,
The GP has sent a letter back to the PT 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 test, please refer to the supplemental resources.
Alex did not score to well in the following Senior Fitness tests:
• 8 Foot Up and Go Test - <-6.5
Alex’s Exercise Goals:
1. Increase physical fitness so he can run for 5 minutes non stop
2. Reduce his body fat by 30 kilograms in the next 6 months
3. Increase overall muscle mass.
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.
Resistance Exercise Program
Warm up
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 clients 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.
Exercise
Sets Reps Rest period Comments
1. SQUATS (any variation): A body weight squat is the initial focus with no weight. 1 5-8 1-2 minutes between exercise REP and sets should be started at the low end with a progression to increasing the intensity as she becomes more comfortable. 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.
Cool down
Aerobic Exercise Program
Warm up
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 clients 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.
Cool down
