Unit 6 Project

EF310-02
CassandraKraft2 6/25/2011

Introduction
Being physically active throughout your lifetime is extremely important. It can help to prolong your body, health and quality of life. At every age physical activity can be beneficial as long as it is done safely and is appropriately for your body and age. As we grow older strategies for successful fitness change, it is imperative we pay attention to our bodies and use safe guidelines for physical activities to avoid bodily injuries. For this exercise will assess the health and physical level of Jane Doe, a 65 year young female of who is wondering what physical activities she can safely participate in to stay healthy and active. In order to find out we will be looking at her current health and fitness levels, any contraindications to exercise.

PAR-Q Rating
As we have learned, an important part of assessing someone for physical activity is using the PAR-Q questionnaire (Edward T. Howley, 1986). These simple questions help to assess the safety level of the participant and will assist in shaping an exercise prescription and other recommendations for better health. A PAR-Q questionnaire has seven questions related to health. Jane Doe has answered no to all questions of the PAR-Q. This means she is currently not at high risk and does not need special instruction or restrictions for exercise other than recommendations and guidelines for her age group. If a subject answers yes to any of the questions on the PAR-Q advise them to see their general practitioner or medical provider for further assessment.

Health Status
Taking a health status questionnaire can give more specific information about a persons health than simply filling out a PAR-Q form. It is still an overall assessment but gives the trainer a little more information to better tailor a fitness plan with the client. Ms. Doe seems to be in relatively good health. She has recently had a physical and has been Okayed for a fitness program. Currently she is physically active at least three days a week is a non-smoker and a non-drinker. Other questions to ask Ms. Doe to assess and plan for more physical activity are: What activities do you do when you are active? How long do you do these activities? What sort of other activities do you enjoy?

General Medical History

Ms. Doe has had knee surgery on the right knee in the past. About 30 years ago she had part of her meniscus removed. She reports no signs of arthritis and that she still has full range of motion and function in that knee. Because she has recently seen her medical provider and was given no restrictions we can safely assume she needs no restrictions. Simple tests will prove her assumptions about the range of motion of her knee correct and remove restrictions as long as Ms. Doe feels no distress to that joint (or anywhere else).

Risk Factors and Precautions

Risk factors and precautions should be taken very seriously. If a client has any risk factors they should be explored. Ms. Doe is on medication for high cholesterol and shows very early signs of osteoporosis. Ways to control high cholesterol include changing the diet and exercising (Mayo Clinic, 2011). Osteoporosis is a condition where the body starts to break down bone tissues. Exercise helps to prevent bone loss and even re-build bone structure due to repetitive and high stress motion on the bones. Ms. Does father died from a heart attack at age 60. Ms. Doe seems to be in relativity good health overall. She has passed her fathers age and still going strong. The only conce rn I would have is her high blood pressure, as long as it can be controlled and maintained without any complications increasing fitness should not be a problem. Her mother died from lung cancer at age 65, Ms. Does mother was a smoker. I do not think she has much to worry about unless she is around copious amounts of second hand smoke. I would think Ms. Doe has very low chances of developing lung cancer, especially at her current age.

Medications
Ms. Doe is on Lipitor for high cholesterol. Side effects of medications can be hazardous during normal activities and amplified during high stress activities. It is important to know of any medications a client might be on that may influence their behavior or performance. Medications could alter a persons performance or place them at risk (or higher risk) for injury. If Ms. Doe has high blood pressure along with high cholesterol issue exercise will assist in lowering both naturally. People who have lower blood pressure have lower risks of kidney disease, stroke and heart disease. Lowering cholesterol helps the body pump blood more efficiently. People who exercise regularly, maintain ideal body weight and are non-smokers tend to naturally have lower blood pressure and cholesterol (Medicine Net, 2011).

Lipitor is considered a statin medication and is one among the most commonly prescribed medications for lowering cholesterol. It works by blocking a substance your liver needs to make cholesterol. This causes your liver to remove cholesterol from your blood. It can also help reabsorb cholesterol already in your system, from built up deposits on your artery walls, potentially reversing coronary artery disease (Mayo Clinic, 2011). Lipitor seems to have no adverse side effects when coupled with exercise. In fact, exercising may help to reduce Ms. Does high cholesterol issues and possibly reducing/eliminating the need for medications. This would need to be coordinated and monitored with her medical doctor for a safe assessment/reduction if a future goal of Ms. Does is to lessen the amount of medication she may need to take.

Health and Lifestyle Behaviors

Ms. Doe is currently physically active at least three days a week. Because she is already active a few days a week adding structure and goals to her activities will be relatively easy. Using enjoyable activities as an exercise or as a reward for exercise will increase her over all fitness. Activities she enjoys are walking, gardening, crafting, and golfing. Walking can be paired with a friend and can have the intensity increased by walking faster, farther, on an incline or with weights. Gardening can be a very vigorous activity. Making sure to mix some of the heavy activity with light will ensure a good round about activity. While golfing make sure to carry your own clubs and walk from hole to hole. This will ensure plenty activity for a day. After completing physical activity for the day Ms. Doe can relax and work on her crafting.

Body Composition
According to Ms. Does weight of 164 pounds and height of 64 inches, she is considered over weight. Her body mass index is 28.2 percent. Ms. Does recommended weight is between 112 to 140 pounds (Body Mass Index Calculator). Since the ideal body fat percentage for women over 60 is 23 to 30 percent, Ms. Doe is not in too bad of shape, but would benefit from losing some weight (Lean Body Mass Calculator, 2011). Reducing her weight to the recommended 140 pounds will help to increase her health and energy. Remember these are guidelines; a physician should help her to determine the ideal weight and amount of body fat for each person depending on their structure/build (Lean Body Mass Calculator, 2011).

Assessment on testing CRF, Endurance, Flexibility, Strength

Check normal ranges for tests in seniors

The best way to assess how physically fit a person is to have them conduct a series of tests and compare them with national averages with their gender and age group. Guidelines for fitness and physical activity are set by U.S Department of Health & Human Services and the Presidents Council on Fitness, Sports and Nutrition. Using the Presidents Council on Physical Fitness and Sports standardized tests we can assess people of all ages and compare them to national minimum recommendations of for each category: preliminary, flexibility, cardiovascular, and muscle strength for physical fitness (Department of Health and Human Services, 2009). Some seniors fitness assessment test include taking resting heart rate, Walkport test, modified push-up, modified sit-ups, sit stand and walk test, and the sit and reach. Ms. Does resting heart rate was 70 beats per minute. According national standards she has a rapid heartbeat (elderly are rated closer to 50 -65 for normal heart rate). Heart rate can change when stresses occur on your body creating a change in your system. Things that can change heart rate include thoughts, emotions, sitting, standing, low blood sugar, ect. The lower the pulse the less your heart works to circulate blood, but too low is also dangerous . The Walkport test of one mile was completed in 19 minutes and 47 seconds. Heart rate taken at the end of the test was 128 beats per a minute. Ms. Doe has a poor rating for this test. To increase her ratings she may try increasing her walking by distance and intensity. Muscular strength/endurance and flexibility tests for seniors include a modified push-up and modified sit-up, sit and reach. This testes their upper body strength and core muscle strength. Core muscles are vitally important to maintain because they assist in balance and coordination. One of the most common causes of injuries in older adults is due to falls. Ms. Doe was able to complete 3 modified push-ups and 20 modified half sit-ups (YMAC sit-ups). This puts her in a classification of average for both tests. For the flexibility test/sit and reach on her first attempt Ms. Doe was shy of her toes by 2 inches. On the second and third attempts she was able reach them. Ms. Doe has excellent flexibility for her age, in order to keep her body in this good of condition she would need to continue regular exercise and possibly increase it for more flexibility.

Nutrition
Ms. Doe did not include a break-down of her diet and meals. She has showed interest in losing 20 pounds; by managing her meals she may be able to get closer to her goal without increasing much physical activity. Helpful recommendations for a simple and easy get fit quick program could be planning out meals and snacks a week or more in advance. When you know the healthy choices you have for

food you are less likely to splurge and get unhealthy junkie foods. Also eating throughout the day to maintain blood sugars will reduce the risk of over eating during meals thus controlling calorie intake in a sitting. As a treat or a snack you can reward yourself with a healthy smoothie, some fruits, maybe a small one serving bag of 100 calorie cookies. Having an idea of how many calories to consume in a day will also be beneficial.

Readiness for Change

Ms. Does readiness for change is stage four, active stage. Ms. Doe frequently exercises but not enough for it to be regular fitness or a long lasting habit. To move to stage five, maintenance stage Ms. Doe must maintain steady a steady fitness routine for a minimum of 6 months (Marcus, 2003).

Motivational Strategies and Techniques

Losing weight is a motivator for Ms. Doe; she would like to lose 20 pounds. Recommended weight for a woman Ms. Does height and weight is between 112 to 140 pounds (Lean Body Mass Calculator, 2011). This will put her right next to a healthy weight range of 144 pounds. Motivation and accountability are huge parts of success in making difficult but positive behavioral changes in life. Adding exercise to a weekly routine is a wonderful and difficult task for many. In situations where people feel more accountability for their fitness they typically follow through with regular exercise. If a person does not hold themselves accountable and follow through with their fitness or activity plan then they are fighting a losing battle with their health.

Recommendations
For an older adult who wishes to continue to be physically active or would like to become physically active there are a few recommendations to follow. After the client is medically cleared for exercise/fitness a fitness plan can be developed. Involving the client in the creation of this plan will make sure not only are their fitness goals in mind, but will give them ownership and accountability for their health plan. By following the FIT guidelines for a routine a schedule and prescription of exercise could be made for Ms. Doe. She could easily follow a simple routine for an acceptable and thorough workout. To follow FIT guidelines Ms. Doe could pick the days (frequency) she would like to do physical activity, the intensity of the activity (percent of elevating heart rate), how much time to commit and the type of exercise/physical activity. It is good to start off slowly (one day a

week for a half hour) and build into or up to your ideal work out week (five times a week or every other day for 45 minutes or more). Acceptable work outs include through stretching and warming up before and after the actual exercise. For an older adult have about 150 minutes of moderate to intense aerobic exercise a week, adding muscle strengthening twice a week is recommended to keep bone and muscle strength. Doing repetitions fast with moderate weights will encourage muscle growth and healthy bone density for older adults. Creating social networks and supports will naturally help to raise a persons motivation. Ha ving someone expect you at the gym will keep them motivated to go. Starting a regular fitness routine with a friend or taking exercise classes will help to keep a steady pace for exercise. Choosing several classes will give a variety of workouts and intensities to keep people engaged and excited about coming to classes.

Summary
In summary being physically active can increase a persons level of health. It can help to prolong healthy quality of life and body deterioration along with positive lifestyle choices and nutrition. Minimum recommendations for fitness for most older adults is being active 30 minutes a day three times a week with moderate to vigorous activity (Marcus, 2003). This break down translates to about 150 minutes of moderate intense activity a week with at least two days of muscle and strength training or 75 minutes of vigorous activity with two days of muscle and strength training (Center for Disease Control and Prevention, 2001). Make sure before starting to increase physical activity to be assessed for dangers or contraindications of physical activities. An assessment done properly will start a base line of how fit (or unfit) a person is, what health issues they may have and what level of fitness/exercise is safe to do. From there a collaborative effort can be made to create a fitness plan that is best suited to the clients wants and their fitness needs. They can help to make plans and strategies that will help to keep them motivated to stay active for a lifetime.

References Works Cited

Body Mass Index Calculator. (n.d.). Retrieved June 3, 2011, from ExRx: http://www.exrx.net/Calculators/BMI.html

Center for Disease Control and Prevention. (2001, March 30). Physical activity for everyone guidelines. Retrieved 2 2011, June, from CDC: http://www.cdc.gov/physicalactivity/everyone/guidelines/what_counts.html Demand Media. (2011). Calorie Calculator Livestrong.com. Retrieved June 9, 2011, from Livestrong.com: http://www.livestrong.com/thedailyplate/users/myinfo/myinfo.php Department of Health and Human Services. (2009, Nov 4). Physical Activity Guidelines for Americans. Retrieved June 5, 2011, from U.S Department of Health and Human Services: http://www.health.gov/paguidelines/default.aspx Edward T. Howley, &. B. (1986). Fitness Professional's Handbook. Champaign: Human Kinetics. ExRx. (n.d.). Target Heart Rate Range. Retrieved June 9, 2011, from ExRx: http://www.exrx.net/Calculators/TargetHeartRate.html Gabe Mirkin, M. (2011). Aspirin and Athletic Performance. Retrieved June 10, 2011, from DrMirkin.com: http://www.drmirkin.com/archive/6385.html Lean Body Mass Calculator. (2011). Retrieved June 10, 2011, from HealthStatus.com: http://www.healthstatus.com/cgi-bin/calc/calculator.cgi Marcus, L. F. (2003). Motivating People to be Physically Active. Champaign: Human Kinetics. Mayo Clinic. (2011, June 1). High Cholesterol: Treatments and Drugs. Retrieved June 27, 2011, from MayoClinic.com: http://www.mayoclinic.com/health/high-bloodcholesterol/DS00178/DSECTION=treatments-and-drugs Medicine Net. (2011). Low Blood Pressure Symptoms, Causes, Treatment. Retrieved June 10, 2011, from MedicineNet: http://www.medicinenet.com/low_blood_pressure/page4.htm