Client Demographics/Information
Sex: M Age: 21 Height: 71” Weight: 168 lbs BMI: 23.5 kg/m2 Ethnicity: Caucasian
Resting BP: 126/84 mm/Hg Resting HR: 80 BPM Target HR: 129-164 BPM Max HR: 199 BPM
This client is a former high school soccer player who still considers himself to be a healthy individual. He has no history of or current major health issues and visits his physician on a regular basis. The only family history concerns is high cholesterol from his mother. He does not follow a particular diet and does admit to eating out an average of one time per week along with late night high-fat eating/snacking. A personal goal of this client is to develop a healthier diet. He still participates in physical activities, including playing basketball and running a minimum of sixty minutes per week. His main goal is to eliminate his junk food consumption and improve his overall eating habits.
Patient Questionnaires:
Fitness Findings
General ACSM Recommendations:
Maintain a minimum of 3-5 days per week of moderate to vigorous aerobic exercise. Each session should be 30-60 minutes of either one continuous session or multiple sessions > 10 minutes. These exercises should be regular and purposeful that include major muscle groups and is continuous and rhythmic in nature. To progress, adjust exercise duration, frequency, and/or intensity gradually until desired goal is obtained.
Rockport Fitness Walking Test:
Mile time: 9:00 minutes
Steady state HR: 160 BPM
VO2: 57.395
Rating: Excellent
Percentile: 90%
Patient Recommendations:
Increase cardio activities from 15 minutes per session to a minimum of 30 minutes. Less than this amount has been proven to have no lasting benefits to a healthy individual looking to improve their fitness level. Maintain playing basketball a minimum of 60 minutes per week.
Resistance Findings
General ACSM Recommendations:
Each major muscle group should be trained 2-3 days per week. 60%-70% of 1 RM (Moderate/Hard intensity) for novice to intermediate exercisers attempting to improve strength. >80% of 1 RM (Hard/Very Hard intensity) for experienced strength trainers to improve strength. >50% of 1 RM (Light/Moderate intensity) to improve muscular endurance. No specific duration of training is required. Resistance exercises involving each major muscle group are recommended. A variety of exercise equipment and/or body weight can be used to perform these exercises. 8-12 reps is recommended to increase strength, 15-20 reps is recommended to increase muscular endurance. 2-4 sets are recommended to improve strength/power, >2 sets are beneficial for improving muscular endurance. Rest intervals of 2-3 minutes between each set and rest of > 48 hours between sessions for any single muscle group. Progress by adding greater resistance, and/or more repetitions per set, and/or increasing frequency.
Curl Up Test:
Total Score: 4
Ranking: Well Below Average
Push Up Test:
Total Score: 24
Ranking: Good
Patient Recommendations:
Implement resistive exercises that focus on improving core strength. These exercises do not have to be solely targeting the abdominals but can be full body exercises in which the core is engaged. These exercises should performed 2-3 times per with roughly 48 hours in between each session. Based on this patients skinfold assessment he is classified as good, but based off of his waist to hip ratio he is under a moderate risk classification. Based on these findings, implanting these resistive exercises may help improve these classifications.
Flexibility
General ACSM Recommendations:
>2-3 days of flexibility work is effective in improving joint range of motion. Stretch to the point of feeling tightness or slight discomfort. Holding a static stretch for 10-30 seconds is recommended. A reasonable target is to perform 60 seconds of total stretching for each flexibility exercise with a repetition of 2-4 times for each exercise. A series of flexibility exercises for each major muscle-tendon unit is recommended. Static flexibility (active or passive), dynamic flexibility, ballistic flexibility, and PNF are all effective in improving overall flexibility. Flexibility exercises are most effective when the muscles are warmed through light/moderate aerobic activity or passively through external methods such as heat packs or warm baths.
Neuromotor Exercise
General ACSM Recommendations:
These exercises should be performed >2-3 times per week with the possibility of 20-30 minutes of activities needed for each session. Exercises involving motor skills (balance, agility, motor skills, and gait), proprioceptive exercise training, and multifaceted activities (tai ji and yoga) are recommended.
Stork-Stand Balance Test:
Time: 22 seconds
Rating: Fair
Patient Recommendations:
Agility exercises should be implemented into his workout routine. These activities could include line drills or ladder exercises and could be used towards cardiovascular fitness as well. Yoga could also be used for improving neoromotor fitness but should not be counted towards cardiovascular fitness.
Nutrition
General ACSM Recommendations:
http://www.cnpp.usda.gov/DGAs2010-PolicyDocument.htm
Patient Findings:
Patient Recommendations:
Eating habits for this patient seem to be decently structured. There were some time slots though where meals were skipped. This can have a negative effect on ones body so this should be avoided as much as possible. To avoid this, try to have some healthy snacks available so in the event that there isn’t enough time to eat a whole meal a snack can be consumed for some form of nutrition/energy for your body. Snacking can also have a positive effect on a person. These can give your body steady energy and prevent binge eating later on due to extreme hunger. These snacks though should not be high fat, and should not be nutrient dense foods. For this patient eliminating chips or pop-tarts for a fresh piece of fruit or vegetable could be an effective change. The amount of grains this patient consumes could be increased slightly but is currently at an acceptable amount. The key with grains is to attempt to eat as many whole grains as possible and limit the amount of refined grains. The consumption of fruits and vegetables needs to be increased and this could be done by the snacking substitutions previously suggested. Fruits and vegetables should account for roughly half of the food consumed by an individual. The amount of protein consumed by this individual is at an adequate level, however I would encourage lean meats (chicken and fish) to be consumed as much as possible rather than red meats. The amount of dairy products consumed is at a decent level. My suggestion would be to increase the intake slightly or implement a fortified juice into the diet to maintain a good level of calcium. This patient’s water intake is good but could definitely be improved. Water should be attempted to be consumed at every meal and also in between meals. My final recommendation would be to monitor how