Ed is a 63-year-old man who is beginning to think about retirement. He gets limited physical activity because he sits at a desk most of the day and has no regular exercise program. Despite his sedentary lifestyle he is generally healthy. He has no known chronic diseases and has no signs or symptoms of chronic disease but is concerned about his balance, as he stumbles frequently and is afraid of falling. Knowing that he is going to have more free time in retirement, he wants to begin an exercise program
now to make his transition easier. He goes to the local fitness center where you work
and inquires about membership options. Per club policy all new members are required
to complete the PAR-Q+. You give him the first page of the PAR-Q+ and he answers
«no" to all seven questions.
One of the reasons Ed wants to start exercising is because his father had a fatal
heart attack at the age of 62 years before he was able to retire. His father had previous
heart attacks at 54 and 60 years of age. His mother is still living at 86 years of age. His
two siblings are currently healthy. As part of his physical exam it was found that Ed is
6 feet tall and weighs 209 pounds. His resting heart rate is 70 beats per minute and
his resting blood pressure is 132/80 mm Hg. His blood test showed his LDL-C=
108 mg/dL, HDL-C = 29 mg/dL, and fasting plasma glucose = 90 mg/dL.
Ed completes a fitness assessment that includes a submax modified YMCA cycle
ergometer test. The test results were: chest skinfolds = 12 mm
triceps skinfold = 18 mm
thigh skinfold = 11 mm
subscapular skinfold = 20 mm
midaxillary skinfold = 15 mm
abdomen subscapular skinfold = 36 mm
suprailiac skinfold = 38 mm
right hand grip strength = 49 kg
left hand grip strength = 46 kg
leg press 1-RM = 410 pounds
bench press 1-RM = 165 pounds
push-ups = 19
sit-and-reach test = 18 cm
Submax modified YMCA cycle ergometer test results using a Monark ergometer were:
Stage
== - -
".
Ill
Minute of Heart Rate Blood Pressure Resistance Workload
Test
Beats/min
mm Hg
8A
kg-m/minOther
0.5
96
150
0.5
150
96
142/80
0.5
150
108
1.5
450
112
1.5
450
6
114
122
150/82
1.5
450
2.0
600
8
128
2.0
600
9
130
158/82
2.0
600
2 heart rates > 110 bpm
Does he need to complete pages 2 and 3 of the PAR-Q+, and why or why not?
Does he need to complete the ePARmed-X+, and why or why not?
3.
Based on the PAR-Q+, can he begin the exercise program? Why or why not?
Based on the PAR-Q+, can he perform moderate or vigorous exercise to start?
Why?
Based on the American College of Sports Medicine (ACSM) Pre-participation
Screening Algorithm, should he get medical clearance before beginning? Why
or why not?
6.
Based on the ACSM Pre-participation Screening Algorithm, can he perform
moderate or vigorous exercise? Why or why not?
Based on the ACSM Pre-participation Screening Algorithm, should he get
medical clearance before progressing to higher intensities? Why or why not?
8.
What are the positive risk factors for cardiovascular disease (CVD)?
9.
What are the negative risk factors for CVD?
10.
Which risk factors does the client not have?
11.
How many risk factors does the client have?
12.
What lifestyle changes would you recommend? Why?
13.
Determine his pre-test likelihood of ischemic heart disease.
14.
Determine the exercise heart rate at which the test should be stopped if
reached.
15.
Calculate his percent body fat and fitness category.
16. Determine his estimated maximum oxygen consumption (VO, max) by
extrapolating the test data and determine his percentile classification.
17. Evaluate his hand grip strength score and fitness category.
18. Determine his fitness category for the bench press and leg press.
19.
Find his fitness category for the push-up test.
20.
Get his fitness category for the sit-and-reach test.
21. Calculate a heart rate prescription using the heart rate reserve method.
22.
Calculate the prescription using the VO, reserve method.
23.
Compute the resistance he should use when riding a Monark cycle ergometer
at 50 rpm using the midpoint of the VO, reserve method.
24. Figure out how many calories he would burn on the cycle ergometer if he
cycled for 30 minutes.
25. Indicate which exercise group should be used for the type of exercise as well
as the frequency and time of exercise.
26.
Verify if the prescription is the appropriate volume and comment on the pat-
tern and progression.
27. Design the make-up of the entire aerobic exercise session.
28.
Develop his resistance training prescription considering which exercises he
should do, initial intensity, frequency, sets, reps, and pattern.
29. Design the nonconditioning components of the exercise resistance
training session.
30.
Using the FITT-VP for flexibility exercise design his stretching program.