Unit 8 Project

EF310: Current Trends in Exercise and Fitness: Aging Well Across the Lifespan
CassandraKraft2 7/7/2011

For obesity develop a program for Marsha--a 51 year-old female whose information is on page 310 of the Howley and Franks text.

Across the nation we have become more sedentary than ever before. People sit for jobs, lectures, transportation and leisure time; how often in a day do you find yourself sitting? Obesity is a major problem for the United States. It has now become an epidemic across the country. One in every four people in the U.S is overweight or obese (Centers for Disease Control and Prevention, 2011). Several reasons for such a large percentage of the country being overweight can be due to poor lifestyle choices such as inactivity, excessive eating and poor food choices. Being overweight can cause a magnitude of health issues which leads to medications and other complications. Some medications we use to treat behavioral disorders such as depression or prevention of pregnancy can cause excess weight gain as well (American Dietetic Association, 2009). Why is obesity so prevalent; how can we become more fit as a nation? One major reason why obesity is on the rise is due to inactivity. In most cases diet and exercise alone can help cut obesity rates, as long as there are no other major complications from glands or hormones in the body (like thyroid issues or pituitary issues). The subject for this paper is a Ms. Marsha (Edward T. Howley, 1986). She has shown interest in our fitness facility and would like start a program to help her lose weight and become healthier. Ms. Marsha is 51 years old 5ft 5in and 240lbs and has a history of heart disease in her family. We will come up with a suitable plan for Ms. Marshas health goals. This assessment will reflect Ms. Marshas health, physical status and activity, lifestyle behaviors, body abilities, and motivational strategies to improve her overall health and wellness

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). Health reports and PAR-Q ratings help to assess risks for physical fitness and activity. They can help to determine a clients level of fitness and what precautions may be considered to prepare for fitness. The PAR-Q provides the fitness coordinator with a platform or starting level to make a detailed fitness prescription for each individual. A PAR-Q questionnaire has seven questions related to health. These help to determine if someone is healthy enough for activity or if a more thorough examination by a medical professional is appropriate (Edward T. Howley, 1986). If any of the answers are yes to the questions on a PAR-Q questionnaire it is best to advise them to see their general practitioner or medical provider for further assessment. Ms. Martha has answered no to all questions of the PAR-Q. This means she is not currently at risk for major medical issues (related to or contra-indicated for exercise) and does not need special instruction or restrictions for exercise other than recommendations and guidelines for her age and general health group (obese). If she had answers yes to any of the questions on the PARQ we would advise her to see her general practitioner or medical provider for further assessment to determine her safety to continue (Edward T. Howley, 1986).

Health Status
Taking a health status questionnaire can a fitness provider more specific information about a persons overall health than to simply fill out a PAR-Q form. The health status questionnaire is still an overall assessment to a persons health and fitness goals, but gives the trainer a little more information to better tailor a fitness plan with the client. Ms. Martha is obese (240 pounds on a 55 frame) and is approaching her golden years (51 years young, close to senior-ship). She has reported never exercising regularly, has a desk job and has no active leisure activities. It has been over 3 years since Ms. Martha has seen a doctor or had a physical. For risk factors Ms. Martha has a family history of heart disease on her fathers side as well as her mother developing type 2 diabetes after menopause (Edward T. Howley, 1986).

General Medical History

General medical histories help to screen further into the life of the client. It can tell us major health issues that could make exercise harmful or unsafe until further explored. Routine checkups are part of health screening and can detect issues in early onset of disorders. Ms. Martha has not seen a medical practioner for three years. Before we allow Ms. Martha to continue on her new health plan it is strongly recommended she see her medical doctor. After encouraging her to see a major medical provider, Ms. Martha happily reports besides being overweight she has only slightly high blood pressure (152/88mmHg). She has no other major contraindications to fitness and is looking forward to starting a better life with a healthier her.

Risk Factors and Precautions

Risk factors and precautions should be taken very seriously. These factors could mean the difference between happy healthy exercise and a trip to the ER is the body becomes overstressed. If necessary, clients may need to be assessed by a medical professional before continuing with any vigorous activity. Medical providers may insist on medications to help control or lessen disorders (such as high blood pressure, low blood sugar) to prevent acute episodes of distress. Risk factors for obese people include many different diseases. A few diseases/disorders that are common in obese people are coronary heart disease, congestive heart failure, stroke, type 2 diabetes, hypertension (high blood pressure), dislipidemia, gallbladder disease, osteoarthritis, cancers (including breast and colon cancer), sleep apnea/respiratory problems and some menopausal/menstrual issues in women. These issues alone can shorten a persons lifespan; imagine what they can do in conjunction with being overweight and other health issues (Edward T. Howley, 1986).

Ms. Martha has four risks factors for coronary heart disease. Her blood pressure is slightly elevated (152/88mmHg, recommended >140/90mmHg). On her fathers side of the family there is a history of heart disease, which makes any elevation in blood pressure a little more serious. She is physically inactive (gets less than 30 minutes of physical activity at least three days a week), and her waist circumference is greater than 88.9 cm (Edward T. Howley, 1986).

Medications
Excessive exercise can tucker anyone out, but it can also be dangerous adding medications to the mix can only add to a more lethal combination. Medications can affect a persons body; they can also change their performance. If a client is on medication to lower blood pressure it is important to know what type of medication they are using. Some bp medications simply do not allow the blood vessels to vasoconstrict; others can simply block adrenalin to the heart not allowing heart rate to raise higher (The Nemours Foundation, 2011). It is important to know of any medications a client might be on that may influence their behavior or performance. Also inform the client about cautions of exercising while on medications such as light headedness, dizziness, nausea, muscle pain and aches, ect. Faculty should know the medications your client is on as well. They can keep an eye on the client and be aware if an emergency situation occurs. Any medications or controlled substances can alter a persons performance or place them at risk (or higher risk) for injury in their daily lives and during physical activities. Ms. Marsha is currently not on any medications and hopes starting a regular exercise routine will lower her high blood pressure as well as make her healthier.

Health and Lifestyle Behaviors

Ms. Marsha has a desk job and has not been very active in her life time. She has avoided the doctors office for three years. Most likely she has worried about her health; she has seen both her parents suffer from hardships with health issues and does not want the same for herself. She is 51 years young and wants to take control of her life again. She wants to change her life and learn new ways to lose weight and be healthy.

Body Composition
Ms. Marsha is 55 and weighs 240 pounds. According to her body mass index calculator she is morbidly obese with a BMI of 40 percent. In order to have a healthy rating for BMI Ms. Marsha would have to weigh 149 pounds or less (that would mean losing 91 pounds just to be in the far side of the scale for healthy weight) (Body Mass Index Calculator).

Assessment Results on testing CRF, Endurance, Flexibility, Strength

When assessing someone who extremely de-conditioned (morbidly obese) care needs to be taken in the steps to assess them. Normally 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 own gender and age group. Due to Ms. Marshas current weight and physical ability the only reason to assess her would be to establish a base line to compare to as she progresses with her fitness goals. As of today Ms. Marsha is unable to complete any assessments. In the future she has already excelled if she can complete (or attempt) any of the fitness tests. Guidelines for fitness and physical activity are provided by the U.S Department of Health & Human Services and the Presidents Council on Fitness, Sports and Nutrition. When we use these standards for testing we can assess individuals and compare them to national recommendations of health/performance for each category. The test categories are preliminary (heart rate and blood pressure), flexibility, cardiovascular (aerobic activity), and muscle strength (Department of Health and Human Services, 2009).

Nutrition
The good news for Ms. Marsha is making healthy changes to her diet and portion control will make a big difference in her life along with becoming physically active. Helpful suggestions for simple and easy ways to get fit quickly could be as simple as planning meals and snacks in advance. When you have healthy choices for food you are less likely to indulge in fast, fatty or junk foods. Also eating every two hours throughout the day will maintain blood sugars and reduce the risk of over eating during meals. This will help to control calorie intake throughout the day or in one sitting. Knowing how many calories to consume in a day would be a good guide to controlling hunger and food proportions. An example of a healthy snack or treat could be a few pieces of fresh fruit and yogurt.

Readiness for Change

I would say Ms. Marsha is in stage two to three; thinking about becoming more active and starting to become more active. Because she has never been regularly active before Ms. Marsha has a greater chance of slipping back to being inactive. Fortunately, because she is joining our facility we can provide her with fun activities and social support groups that can easily integrate her into our community (more active and health aware).

Motivational Strategies and Techniques

Motivation and accountability are key elements to success in making new life changing behaviors (such as including physical activity in daily routines). Creating accountability for your

own actions and success can be infinitely rewarding and a motivating in itself. Having a social network, support group, and workout partner(s) can create a feeling of belonging and accountability for ones self. This also give support and strength to those who feel a little lost or become under-motivated. Letting others know they are not alone in their journey to become fit and healthy takes pressure off of them and increases their determination/motivation to be healthier (Marcus, 2003).

Recommendations
The ACSM recommends a specific FIT plan for those who are obese. Frequency is increased to 5 to 7 days a week. Intensity is initially moderate (40%-60% HHR) and builds as they build stamina/tolerance to progress into a higher intensity work out (50%-75% HHR). Finally the duration or amount of time to exercise starts from a slow progression of short easily tolerated work outs to 45 to 60 minutes of daily activity. In order to have minimum results against chronic heart conditions (from obese to healthy weight range) it is suggested to be physically active about 150 minutes a week. To get maximum results for long lasting weight loss and health it is recommended to have a total of 200-300 minutes of physical activity per a week (Edward T. Howley, 1986). By following the FIT guidelines and a routine a schedule for prescription exercise Ms. Marsha could be very successful in losing weight and keeping it off. To start her exercise routine she would need to work hard at building up her stamina. For extremely obese people being physically active can be very hard on joints as well as overall body structure (Edward T. Howley, 1986). She could easily follow simple routines for an acceptable and thorough workout every time. To follow FIT guidelines Ms. Marsh would have to pick several days (if not every day) to be physical active (frequency). The intensity of the activity would have to start off low (percent of elevating heart rate) she will not have the conditioning or stamina to work out continuously for an entire timed session. Ms. Marsha would have to try many small timed sessions until she can handle larger segments of time. Ms. Marshas first task would be walking (preferably inside in the air conditioning on a treadmill to control her speed), swimming, cycling and or arm cycling. These activities will help her to build up stamina as well as condition her body for the work to come. After being able to exercise for longer periods of time (up to the 45 to 60 minute mark) we can increase the intensity of these workouts (going faster, maybe a bit more resistance and adding different exercises). Finally, when we have seen more weight loss and have adopted new healthy eating habits (for good) Ms. Marsha can start using weights, changing up her routines/exercises, and add even more resistance really pushing her exercise to the intense exercises for intense rewards.

Recommendations to stay motivated would be to go to exercise classes and or to have an exercise buddy. This would help to improve Ms. Marshas attendance at the gym and give someone to connect with. Classes at fitness centers are structured they host the same type of activity at the same of time a week. The structure will give Ms. Marsha choices of different activities to do and have fun exercising.

Summary
In summary being physically active can increase a person health. It can help give you a long lasting healthy quality of life and fight off body deterioration and disease when paired with positive lifestyle choices and good nutrition. Being physically active throughout your lifetime is extremely important. At any age or any stage physical activity can be beneficial as long as it is done safely and appropriately for your body (man, woman, big or small) and age. Make sure before starting to increase physical activity to be assessed for dangers or contraindications of physical activity. Each category of people comes with its own risks and recommendations. A health assessment done properly will start a base line for 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 both the fitness personnel and the client can create a fitness plan that is best suited to the clients wants fitness needs. Together they can help to make plans and strategies to keep the client motivated to stay active for a lifetime. Like all categories of people becoming fit (men, women, young and old) exercise will benefit people who are obese as well. When taking into consideration other risks associated with obesity exercise can be a fun activity anyone can enjoy. Creating social network supports will naturally help to raise a persons motivation. Someone expecting you at the gym will help to keep you motivated to go. Starting regular fitness routines with a friend(s) or taking exercise classes will keep a steady pace for exercise as well as enough change to keep you engaged and having fun. As stated before like all groups, work out routines should include through stretching and warming up before, during and after the actual exercise. For obese adults it is recommended to have a minimum of 150 minutes of moderate to intense exercise a week. This includes aerobic training and muscle strengthening (as followed by each persons individual fitness prescription). For long term weight control and heart health for previously obese people having 200-300 minutes of exercise is preferable (Edward T. Howley, 1986). If a person has developed major medical issues contributed solely by their excessive weight gain wouldnt the best solution be to lose the excessive weight to reverse medical issues?

References Works Cited

American Dietetic Association. (2009, Feb). Weight Gain: Unintentional Medical Information. Retrieved July 8, 2011, from Drugs.com: http://www.drugs.com/enc/weight-gain-unintentional.html 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 Centers for Disease Control and Prevention. (2011, May 27). Obesity and Overweight. Retrieved July 7, 2011, from CDC: http://www.cdc.gov/obesity/defining.html 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 The Nemours Foundation. (2011). High Blood Pressure (Hypertension). Retrieved June 3, 2011, from Kids Health from Nemours: http://kidshealth.org/parent/medical/heart/hypertension.html#