Background: Based on the assessments you have conducted in previous units, you will now create a personalized exercise prescription for each of the four sample clients: Justin, Sally, Carl, and Jennifer
Instructions: Your prescriptions will include all three health-related fitness components: cardiovascular activity, muscular strength/endurance, and flexibility. You will use the FITT/PROS principles for all three components to design a comprehensive program. Prescriptions must be based on the client’s precautions (if applicable) and their current levels of fitness
Part 1: FITT Principles
Create an exercise prescription for each client for aerobic, muscular strength/endurance, and flexibility using the FITT principles. This prescription should be based on the client’s current level of fitness and be appropriate for their current lifestyle. Be detailed in all areas. Your prescription should contain enough details so that the client could follow your program as written.
For reference here are the biographies for each client:
Justin Age 13, 7th grade
Height 5’ 5”, Weight 180 lbs. (BMI=30, grade 1 obesity)
Fitness Test Results (PCPFS):
Justin completes testing at school each semester and the results of his last test are listed below:
1 mile run – 12:39 (below 50th percentile)
Push-ups – 9 (below 50th percentile)
Pull-ups – 0 (below 50th percentile)
Sit-ups – 15 (below 50th percentile)
Sit & Reach – 14 cm (below 50th percentile)
Skin Fold Results:
Triceps – 17 mm, Calf – 15 mm (24.5% Fat, 135 lbs LBW, 44 lbs Fat Weight, Moderately High rating, 10%-19.9% is optimal)
Barriers to Activity: Justin struggles with his studies and has been spending extra time with a tutor and doing homework. The extra time has paid off, and his grades are up to a B average. Justin’s parents value education, and they will continue to pay for the tutoring time. The extra study time cuts into Justin’s recreation time. Justin’s parents do not encourage Justin to get outside to play with his friends. Because of their busy schedules, they aren’t around much to encourage Justin to be more active. When they come home from work, they eat fast food, and then plop down in front of the TV to watch reruns of their favorite show, Man vs. Food.
Current lifestyle and activity habits
Justin loves playing video games. He and his friends will spend hours in front of their TV’s playing any sports related video game they can get their hands on. Justin’s parents both work full time jobs to help make ends meet. Because of their busy schedule, they tend to bring home a lot of fast food. Nobody in Justin’s house eats very healthy. He has two older brothers in high school who are both in grade 2 obesity. Justin’s parents are both obese as well. Justin just started a home economics class and he is learning how to cook simple healthy meals. He likes this class and is excited to do more cooking at home.
He loves sports, especially football. He played football on his 7th grade team, but didn’t see a lot of playing time because he was slower and weaker than most of the other students on his team. He would like to improve his body composition and weight to a normal level, and improve his strength so he can start at offensive line on his school’s 8th grade football team next year. He definitely wants to excel at football through high school, and knows it will take a lot of hard work. Justin sees how his older brothers have gotten because of their inactivity, and he’s decided that he wants to be healthier. He just hasn’t done anything yet, and he’s not sure how to get started.
Parents marked no to all 7 questions on the PAR-Q.
Justin passed his sports physical to play football in 7th grade, but his doctors did admit that they would like to see Justin improve his health, weight, and activity.
Sally Age 65, full-time administrative assistant
Height 5’ 8”, Weight 218 lbs. (BMI=33.1)
Fitness Test Results:
Rockport Walk Test (1 mile): 21.30 min
Chair Stand (9 reps): below average
Chair sit and reach (1 inch): average
Arm curl (13): average
Barriers to activity: Sally works full time as an administrative assistant at a local college. She spends the majority of her day sitting at a desk, answering phones, greeting students and doing tasks for the professors in her department. Her husband is disabled and cannot work. To make ends meet, she works part time (15-20 hours per week) working at a local chain retail store. She often works late shifts and weekends and spends most of the shift on her feet. She and her husband are also the primary caregivers of their 9 year old grandson as his mother is in the Army and is overseas. Between her two jobs and grandson, when she has “free time” all she wants to do is relax with her knitting projects or attend church functions.
Current lifestyle and activity habits: Sally is sedentary much of the day except when she works her retail job which involves stocking shelves or working the cash register. Sally has never consistently exercised. When she was growing-up, sports were seen as masculine pursuits except for cheerleading and dance, which never interested her because she was so much taller than the other girls. She does not like to get sweaty or out of breath. She doesn’t understand how people can enjoy these things! Why get all out of breath when sitting and relaxing is so much better? She has tried exercise programs in the past, but has quit after a few weeks because they were not enjoyable and took so much time out of her day. She does not look forward to beginning a new program but she knows “she’ll hate it.”
Goals: Her doctor has advised her for years to lose weight. She gains 2-5 lbs. every year, including the most recent visit. She has type II diabetes and her blood sugar levels are not well controlled. Her doctor informed her that if she does not take immediate steps to lose weight and improve her diet and exercise, she will need to begin insulin therapy to control her sugar. Sally is trying to avoid that fate – she is scared of needles and the expense associated with testing and daily injections would be a financial burden to her family. In addition, her last blood pressure reading was 130/85. While not hypertensive, the doctor warned her he would put her on blood pressure medication at her next visit if her numbers remain elevated due to her additional risk of diabetes.
Medications: Metformin for diabetes
Risks: Type 2 diabetes puts Sally at higher risk for CVD and associated conditions. She is also at risk due to her age and obesity.
Carl Age 21 Junior in college
Carl underwent fitness testing when he got his campus recreation center membership last semester. His results are listed below:
Height 5’11” Weight 180lbs.
1.75 miles in the 12 minute run test for a rating of “good”
VO2max estimated at 51.66 ml/kg/min
15 reps for the YMCA bench press test with a rating of fair
Sit and reach of 15 inches for a rating of average
Skin folds: 15 Triceps, 12 Pectoral, 15 midaxilla, 18 Subscapula, 25 abdomen, 20 suprailliac, 22 quads. Lean weight: 149lbs, Fat weight 30.9 lbs, 17 % BF, Average rating
Barriers: Carl isn’t too worried about his physical health at this point in time. Both of his parents are overweight, but not obese, and Carl feels that he can make changes to his PA and exercise habits at any time if he so desires. Carl has a membership to the campus rec center, but since it is located across campus he usually only frequents it on the weekends for his intramural games.
Lifestyle and physical activity habits
Carl is a college student who has never had to worry about his weight because of his height, metabolism, and “good genes.” Carl is largely sedentary during the week, as he spends most of his time studying or gaming with his friends. He also spends much time on the computer surfing social sites. He walks to all of his classes, some of which are across campus, and walks an average of 50 minutes per day to and from classes. He does occasionally (1-2 days for 30-45 minutes) frequent the campus rec center during the week, but not on a regular basis and he does not have a specific program or plan that he follows when he works out. He plays rec sports, like his 45 minute flag football game on Saturdays, and likes to stay up late partying the night before. He drinks energy drinks to get through his day during the week and drinks Red Steer and eats Cocoa Crunchies on Saturday to get him through his scrimmage game. Carl lives in an apartment with friends, eats out a lot, and lives on the typical college food diet of ramen noodles, macaroni and cheese from a box, and whatever else he can scrounge up.
Carl likes playing intramural sports, and would like to maintain his fitness for these types of endeavors. He is not concerned about his weight or fitness level at this point. Carl is mainly concerned about his physical appearance and would like to add some bulk to his upper body.
Carl does have EIA. He has been prescribed an albuterol inhaler.
Carl answered yes to the second question on the PAR-Q, but his doctor has told him that as long as he uses his inhaler, he can be physically active.
Working mom of 3 kids
Jennifer recently received a free fitness assessment at a local gym as part of a marketing promotion.
Height 5’6” Weight 175 lbs
1.2 miles in the 12 minute run test for a rating of ‘Borderline’
VO2max estimated to be 25 ml/kg/min
16 reps for the YMCA bench press test (35 lb. weight) with a rating of “Average”
20 curl-ups completed for a rating of “Marginal”
Sit and reach of 14 inches for a rating of “Good”
Sum of skinfolds measurements for triceps, suprailliac and thigh = 101mm (Use Table 6.5 to complete calculations)
Barriers and Lifestyle
Jennifer is a very busy woman! She is a single mother with 3 children (ages 10, 8 and 5). She works as an office manager and sits behind a desk for 8 hours each day. She struggles to find time to keep the household running, shop for and prepare meals and work. As a result, she often puts herself last and rarely makes time to be physically active. Her favorite physical activity is walking, but unfortunately she was only able to go for a walk two times in the last month. All three of her children are also overweight and she worries that if she doesn’t change their lifestyle, they will all develop diseases prematurely and their quality of life will decrease. Finally, their finances are limited so Jennifer cannot afford expensive equipment or gym memberships.
Jennifer takes medication daily for high blood pressure.
Jennifer answered “Yes” to #6 on the PAR-Q since she has high blood pressure. Her doctor has cleared her for exercise since she keeps it under control with her medication.
Jennifer wants to incorporate more physical activity into her life. She wants to improve her cardiovascular endurance and also lose weight. She would love to find a way to involve her children as well so that she can set a great example for her family. Finally, her long-term goal is to reduce her dependence on her blood pressure medications and instead control it by achieving a healthy weight and active lifestyle.