Case Study #1
Mary Moffet is a 59-year-old Type 2 diabetic. She is well controlled through diet,
exogenous insulin and occasional walking. Mary is 5’2”, 105 lbs. and very nervous. Her
total cholesterol is 220 mg/dl, HDL 38 mg/dl, triglycerides 170 mg/dl and blood glucose
is 120 mg/dl. She has been a secretary for more than 25 years. Leisure time activities
include frequent trips with a social group at her church, and visiting her grandchildren
frequently. Her resting heart rate is 82 bpm and blood pressure 110/88 mmHg. Her
father died at the age of 60 of a myocardial infarction, her mother is an active Type 2
diabetic at the age of 81. Mary is here at the request of her physician who recommended
that she exercise regularly. Mary has already completed a graded exercise test that
revealed no symptoms or signs suggestive of heart disease. She had a predicted VO2 max
of 27 ml/kg/min. Her measured MHR is 168 bpm, and her RHR 78 bpm.
1.
Risk stratification level ________________________________
2.
Discuss fitness testing options.
Case Study #2
This is a 63-year-old white male, who is a security guard. He is 5’7”, 190 lbs. with a
triglyceride level of 300 mg/dl, total cholesterol of 300 mg/dl and blood pressure 155/90
mmHg. He is a chronic television viewer who has never been “athletic.” He suffers from
asthma, which is controlled by Ventolin. He avoids walking due to mild arthritis in his
left knee. He smoked for twenty years before the asthma forced him to quit. He typically
drinks two to three glasses of scotch a couple of evenings per week. Recently a graded
exercise test was administered (Bruce Protocol) for complaints of chest pain. The test
was terminated at stage two at a heart rate of 150 bpm due to volitional exhaustion,
however results were negative. Additional testing revealed a hiatal hernia as the cause
for the chest pain that is being treated by his physician. He is at your facility because his
physician suggests that he should exercise. Baseline evaluation revealed:
RHR: 82bpm
Sit and Reach: 12 inch (15 inch footline)
Waist circumference: 42 inch
Hip circumference: 45 inch
1.
Risk stratification level ________________________________
2.
Discuss fitness testing options.
Case Study #3
This is a 40-year-old administrative assistant with two small children, who suffers from
chronic fatigue. She is 5’3”, 125 lbs and is recently recovered from childbirth by
cesarean section five months ago. She does not smoke and ingests alcohol infrequently.
Her resting pulse is 60 b/min with a resting blood pressure of 100/70 mmHg. She has
engaged in exercise sporadically over the past ten years, but complains of
lightheadedness upon intense exertion. She also reports low back pain after performing
Jane Fonda aerobics. Her cholesterol is 220 mg/dl and triglycerides are 100 mg/dl. Her
mother was a Type 2 diabetic at the age of 48 and her father suffers from osteoarthritis of
the knee and low back. This client is interested in initiating an exercise program to
increase her energy level. Baseline evaluation revealed the following:
RHR: 72 bpm
Predicted VO2 max: 32 ml/kg/min. (YMCA bike test)
Sit and Reach: 16 inch (15 inch footline)
Push ups: 23 reps
1RM 40 lb. (Bench press)
Waist: 29 inch
Hips: 36 inch
1.
Risk stratification level ________________________________
2.
Discuss fitness testing options.
Case Study #4
This is a 30-year-old runner, height 5’10”, weight 165 lbs. who participates in road races
bimonthly. He works as a consultant with unusual hours and high stress. His resting
heart rate is 45 bpm, and resting blood pressure 130/85 mmHg. Although he exercises
regularly, his dietary intake consists of simple carbohydrates and at least a six pack of
beer daily. His total cholesterol is 245 mg/dl, triglycerides 450 mg/dl and blood glucose
170 mg/dl. Both of his parents were medicated for hypertension by age 50 and his father
suffers from occasional gout. He suffers occasional shin splints and recurrent knee pain
as a result of chondromalacia.
1.
Risk stratification level ________________________________
2.
Discuss fitness testing options.
Case Study #5
Mr. Z is a 69-year-old male, who is retired from the New City Police Department. He is
5’9”, 210 lbs. With a resting blood pressure of 140/80 mmHg. Mr. Z’s family history
reveals his mother died of a myocardial infarction at age 70 and his father developed
hypertension at age 70. At the present time Mr. Z smokes approximately a pack of
cigarettes a day and drinks small to moderate amounts of beer and vodka daily. A recent
blood test showed his cholesterol to be 260 mg/dl and HDL is 40 mg/dl. Mr. Z does not
complain of any orthopedic problems or chest pain. He had a MI 6 years ago.
Mr. Z’s recent treadmill test was terminated at the 2nd stage of a Bruce protocol due to leg
fatigue. His peak heart rate was 130 bpm at 7 METS, and peak blood pressure was
170/100 mmHg. PVC’s were noticed. His current medication is Nitropatch 7.5 daily.
Mr. Z had the following results on baseline testing:
Sit and Reach: 10 (15 inch footline)
Body fat: 28.2%
Waist circumference: 42 inch
Hip circumference: 36 inch
1.
Risk stratification level ________________________________
2.
Discuss fitness testing options.
Case Study #6
Mr. S is 48-year-old male, who is a sales representative for a large electronics firm who
travels quite a lot. He is 6’, 190 lbs. with a blood pressure of 100/70 mmHg. Five years
ago he was diagnosed with Type 2 diabetes. He blames his 2 and half pack a day
smoking habit on the stress of his job. Family history reveals his brother had a MI at the
age of 40. His cholesterol level is 250 mg/dl and HDL is 30 mg/dl. Mr. S complains of
chest pain upon exertion. His last exercise stress test was terminated due to shortness of
breath and leg fatigue. He achieved 13 METS with a peak heart rate of 170 bpm and
blood pressure of 160/90 mmHg.
1.
Risk stratification level ________________________________
2.
Discuss fitness testing options.
Case Study #7
This is a 40-year-old male, height 5’7”, weight 160 lbs. He is a grammar school teacher
who is not particularly active due to pain in his knee, which occurs due to an injury over
10 years ago. His blood pressure is 150/98 mmHg and cholesterol is 200 mg/dL with
HDL of 40 mg/dL. He does not smoke or drink and does not have any physical
complaints other than his knee problem. Family history shows father developed coronary
artery disease at age 60.
A previous Bruce Protocol test was administered. He completed 6 minutes and achieved
a peak heart rate of 183 bpm and blood pressure of 220/100 mmHg. The test was
terminated due to claudication. The results of testing revealed the following:
Push up test: 28 reps
Curl ups: 48 reps
Sit and Reach: 13 inch (15 inch footline)
Body fat: 18%
Waist: 30 inch
Hips: 32 inch
1.
Risk stratification level ________________________________
2.
Discuss fitness testing options.
Case Study #8
This is a 32-year-old Caucasian female, height 63”, weight 130 lbs. She is employed as a
telephone operator and is sedentary.
Her mother underwent bypass surgery at age 73, her father is hypertensive. Her appetite
fluctuates readily and she has some abdominal problems. Present blood pressure is
130/86 mmHg and RHR is 70 bpm. The purpose of today’s test is to establish a workout
routine for entry into a supervised exercise program. Baseline testing revealed the
following:
B.P.: 110/68
Total Cholesterol: 188 mg/dL
LDL: 112 mg/dL
Triglycerides: 122 mg/dL
HDL: 68 mg/dL
Glucose: 98 mg/dL
Body fat: 26%
Waist: 30 inch
Hips: 37 inch
VO2 max: 32 ml/kg/min (YMCA bike test)
Modified Push ups: 21 reps
Curl ups: 26 reps
Sit and Reach: 23 inch (15 inch footline)
1 RM bench press: 80 lb.
1 RM leg press: 152 lb.
1.
Risk stratification level ________________________________
2.
Discuss fitness testing options.
KIN 430 Exercise Prescription
Class Assignment – September 15, 2005
Instructions: To be completed during class time with one partner. You may use the
text as well as the ACSM Guidelines for Exercise Testing and Prescription. Upon
completion of the assignment please turn in all work.
Name: __________________________________________
__________________________________________