Description
I need help in prescription writing(case study) due in 24hours.
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Instructions:
This is your final prescription. You must do this work on your own. I will be checking to see if
your work is similar to others. It must be your own unique work.
Jamie is 40 and a single mom of two small children. She quit smoking 1 years ago. She works in
a surgery center as a patient care worker. Both of Jamie’s parents are living but her father has
fibromyalgia, and her mother is obese and has Type II diabetes. Her maternal grandmother died
of spindle cell sarcoma at age 70. Her paternal grandmother had a stroke and died at 66. Jamie
has scoliosis which is exasperated by her long commute and sedentary job. Jamie wants to
improve her overall fitness. She needs specifically to improve her strength and power as she is
getting older and wants to maintain an active lifestyle to keep up with her children and improve
her lean mass. She would also like to improve her cardiovascular fitness and her flexibility.
Jamie has very little free time. You will need to be creative in how you fit in all the exercise. Her
last trip to the doctor produced the following results: BP 125/82, weight 120 lbs, height 5’7″,
LDL 129, HDL 51. Total cholesterol 210, FBG 87. She is on thyroxine and cyclobenzaprine.
Write a 6-month prescription for her which addresses all of her issues and moves her to a higher
level of fitness and function.
Screen
Signs/ Symptoms
Risk Factors
Medical Clearance:
Baseline measurements:
Age
No test
40
Resting Heart Rate
Pulse Oximeter
x
Blood Pressure
Sphygmomanometer
125/82 mmHg
Height
stadiometer
1.702m
Weight
Tatina Scale
54.43 kg
Waist Circum.
Measuring tape
x
Percent Fat
Skinfold Calipers
x
BMI
BMI formula
18.8
Fitness measurements
Exercise test not necessary for
obese individuals according to
the ACSM textbook
Precautions:
Limitations:
Macrocycle
Length of cycle: 6 months
Goal:
Mesocycle 1
Length of cycle: 2 months
Objective:
Microcycle 1 Microcycle 2
Length of
Length of
cycle: 4 weeks cycle: 4 weeks
Objective:
Objective:
FITTVP Table:
Mesocycle 2
Length of cycle: 2 months
Objective:
Mesocycle 3
Length of cycle: 2 months
Objective:
Microcycle
3
Length of
cycle: 4
weeks
Objective:
Microcycle
5
Length of
cycle: 4
weeks
Objective:
Microcycle
4
Length of
cycle: 4
weeks
Objective:
Microcycle
6
Length of
cycle: 4
weeks
Objective:
MACRO-CYCLE
MESO-CYCLE 1
MESO-CYCLE 2
MESO-CYCLE 3
MICRO 1
MICRO 2
MICRO 3
MICRO 4
MICRO 5
MICRO 6
Frequency:
Frequency:
Frequency:
Frequency:
Frequency:
Frequency:
Aerobic:
d*wk^-1
Aerobic:
d*wk^-1
Aerobic:
d*wk^-1
Aerobic:
d*wk^-1
Aerobic:
d*wk^-1
Aerobic: d*wk^1
Resistance:
d*wk^-1
Resistance:
d*wk^-1
Resistance:
d*wk^-1
Resistance:
d*wk^-1
Resistance:
d*wk^-1
Resistance:
d*wk^-1
Flexibility:
d*wk^-1
Flexibility:
d*wk^-1
Flexibility:
d*wk^-1
Flexibility:
d*wk^-1
Flexibility:
d*wk^-1
Flexibility:
d*wk^-1
Intensity:
Intensity:
Intensity:
Intensity:
Intensity:
Intensity:
Aerobic:
Aerobic:
Aerobic:
Aerobic:
Aerobic:
Aerobic:
HRR. bpm
HRR. bpm
HRR.bpm
HRR. bpm
HRR bpm
HRR. bpm
Resistance:
Resistance:
Resistance:
Resistance:
Resistance:
Resistance:
Flexibility:
Flexibility:
Flexibility:
Flexibility:
Flexibility:
Flexibility:
Time:
Time:
Time:
Time:
Time:
Time:
Aerobic:
Resistance:
Flexibility:
Aerobic:
Resistance:
Flexibility:
Aerobic:
Resistance:
Flexibility:
Aerobic:
Resistance:
Flexibility:
Aerobic:
Resistance:
Flexibility:
Aerobic:
Resistance:
Flexibility:
Type:
Type:
Type:
Type:
Type:
Type:
Aerobic:
Aerobic:
Aerobic:
Aerobic:
Aerobic:
Aerobic:
Resistance:
Resistance:
Resistance:
Resistance:
Resistance:
Resistance:
Flexibility:
Flexibility:
Flexibility:
Flexibility:
Flexibility:
Flexibility:
Volume:
Volume:
Volume:
Volume:
Volume:
Volume:
Aerobic:
Aerobic:
Aerobic:
Aerobic:
Aerobic:
Aerobic:
MET·min·wk1
MET·min·wk1
MET·min·wk1
MET·min·wk1
MET·min·wk1
MET·min·wk-1
Resistance:
Resistance:
Resistance:
Resistance:
Resistance:
MET·min·wk-1
MET·min·wk1
MET·min·wk1
MET·min·wk1
MET·min·wk1
MET·min·wk1
Pattern:
Pattern:
Pattern:
Pattern:
Pattern:
Pattern:
Aerobic:
Aerobic:
Aerobic:
Aerobic:
Aerobic:
Aerobic:
Resistance:
Resistance:
Resistance:
Resistance:
Resistance:
Flexibility:
Flexibility:
Flexibility:
Flexibility:
Flexibility:
Progression:
Aerobic:
Progression:
Aerobic:
Progression:
Aerobic:
Progression:
Aerobic:
Progression:
Aerobic:
Resistance:
Resistance:
Resistance:
Resistance:
Flexibility:
Flexibility:
Flexibility:
Flexibility:
Resistance:
Resistance:
Flexibility:
Progression:
Aerobic:
Resistance:
Flexibility:
Resistance:
Flexibility:
Calculations:
Max HR: 220 – 40 = 180 bpm
● Microcycle 1: weeks 1-4
○ Intensity:
■ Aerobic/CV:
■ Volume:
■ Aerobic/CV:
■ Resistance:
● Microcycle 2: weeks 5-8
○ Intensity:
■ Aerobic/CV:
■ Volume:
■ Aerobic/CV:
■ Resistance:
● Microcycle 3: weeks 9-12
○ Intensity:
■ Aerobic/CV:
Volume:
■ Aerobic/CV:
■ Resistance:
● Microcycle 4: weeks 13-15
○ Intensity:
■ Aerobic/CV:
Volume:
■ Aerobic/CV:
■ Resistance:
● Microcycle 5: weeks 17-20
○ Intensity:
■ Aerobic/CV:
Volume:
■ Aerobic/CV:
■ Resistance:
● Microcycle 6: weeks 21-24
○ Intensity:
■ Aerobic/CV:
Volume:
■ Aerobic/CV:
■ Resistance:
Micro 1:
Warm-up :
Conditioning :
Cool down:
Micro 2:
Warm-up:
Conditioning:
Cool down:
Micro 3:
Warm-up:
Conditioning:
Cool down:
Micro 4:
Warm-up:
Conditioning:
Cool down:
Micro 5:
Warm-up
Conditioning
Cool down
Micro 6:
Warm-up
Conditioning
Cool down
Rationale
.
Format for Prescription
Introduction
•
•
•
•
•
PAR-Q+ and
Exercise Preparticipation Health Screening Questionnaire for Exercise Professionals
Assess patients readiness to participate
Establish baseline measurements
Identify precautions (are things that are established as issues for the individuals health condition
as noted in ACSM Guidelines)
Identify limitations (are things that the client is unable to do, e.g., due to his recent knee injury
the client will not be able to perform knee extensions, etc.)
Rationale – Describe your rationale for your program
•
You need to explain what your angle/rationale is in creating this prescription. What is your
intent? I am looking to see if you are covering your client’s issues. This is how I know if you are
recognizing what your client needs to improve.
Goal – Set overall goal for the program (macro-cycle)
•
Each meso-cycle should have an objective that lines up with the goal of the macro. There should
be one major goal for the program and then each meso-cycle should have an objective to reach.
Warm-up and Cool-down
•
Make sure to note the warm-up and cool-down activities
Program
•
•
•
•
•
•
•
Frequency – how often is the exercise performed, address all components in the prescription
(i.e., strength, cardio, etc.)
Intensity – how hard, make sure to be specific and not use low, moderate, vigorous alone, you
must use either %HRR, %VO2, RPE, etc.
Time – how long
Type – what type of activity are you doing
Volume – this must be done accurately measured in METs, MET·Min, Kcals, steps, Kcals·min
Pattern – what is the pattern of the activities in your prescription
Progression – make sure to use a progression rate which we have discussed or has a strong basis
of results
MACRO-CYCLE
MESO-CYCLE 1
MESO-CYCLE 2
MESO-CYCLE 3
MESO-CYCLE 4
MESO-CYCLE 5
MICRO MICRO MICRO MICRO MICRO MICRO MICRO MICRO MICRO MICRO
1
2
3
4
5
6
7
8
9
10
FREQUENCY
INTENSITY
TIME
TYPE
VOLUME
PATTERN
PROGRESSION
Reassess Progress and Adjust Prescription
Remember, you need to periodize your prescription, which means systematic
variation across the prescription
Prescription Requirements
Overall, the best way to start your prescriptions is to establish where your patient is at by screening and
assessing them. You can do bullet points to streamline this process.
1. Have the client fill out a Par-Q and medical history
2. Perform a risk factor stratification
a. Identify risk factors, signs and symptoms
b. Assign a stratification (low, moderate, or high)
c. Medical clearance for exercise
i. Is there a medical exam required prior to participation
ii. Is there an exercise test required prior to participation
iii. Does the participant require medical supervision during exercise
3. Establish baseline measurements
a. Blood pressure
b. Heart rate
c. Body composition (% fat, girth, weight, BMI)
d. Muscular strength and endurance
e. Flexibility
f. Cardiovascular endurance
g. Neuromotor
4. Identify precautions
5. Identify limitations
6. Set an overall goal for the program (macro-cycle) – see # 16
a. one goal/objective for each meso-cycle which supports the overall
b. one goal/objective for each which supports the overall
7. Include warm-up and cool-down
8. Frequency – how often?
9. Intensity – how hard?
a. Must be defined within the proper terms. Please see Table 7.1 for more information on
intensity levels
10. Time – how long?
11. Type – what kind?
12. Volume – total amount per week (please see page 176 for volume measurements)?
a.
b.
c.
d.
Mets
Mets-min ˑ week
Kcalˑmin ˑ week
Steps ˑ day ˑ week
13. Pattern – how are you going to break-up the sessions?
a. Cardiovascular – 1 30 minutes or 3 10 minute sessions
b. Strength – rest interval length 2-4 minutes between sets and ≥ 48 hours between
workouts
c. Flexibility – repetitions of 2-4 times/muscle group
14. Progression – how do you change over time?
a. Cardiovascular – Initial phase increase time/duration recommended
i. Increase of 5-10 minutes of duration every first 1-2 weeks for the first 4-6 weeks
ii. Increase 10% every one to two weeks
b. Strength – (please see page 184-185)
i. When 12 reps are easy to perform, increase weight
ii. Increase sets/muscle group
iii. Increase the days a muscle group is trained
iv. 10% every 1-2 weeks
15. Plan out your prescription across the macro-cycle, meso-cycles, and micro-cycles
a. You should have a main goal for your program (macro), each meso should have an
objective, and each micro should carry-out the particulars of the meso objective.
16. Have a rationale for your program.
a. Explain your thought and direction behind the design of your program. This should keep
the particulars of your client in mind.
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