Fitness Assessment, Health Goals, and Exercise

Prescription of Amy Loench

Stephanie Norman
V00482420
EPHE 360, A01
October 20, 2014

PART 1
Client Background Information
Today I was my initial meeting with the client, and I gathered some of their personal and
exercise background information. They filled out CSEP-PATH and PAR-Q forms, which are
attached in the Appendix, and briefly summarized here.
Physical Characteristics:
Client Name: Amy Loench

Gender: Female

Age: 25

Birth date: May 8, 1989

Weight: 130 lbs

Height: 54

BMI (mass/height 2): 22.3

Resting heart rate: 70 bpm

Resting blood pressure: 118/84 mmHg

Current exercise/activity and lifestyle behaviours:

After completing the Toronto half marathon in May, 2014, Amy admits to being
relatively lazy over the summer. She biked to work (a 15-20 min ride each way), and worked
as a summer camp counselor at a gym, which involved going swimming and playing gym games
with the kids, but when she finished work and arrived back home she felt too tired to exercise on
most days. However, she did go hiking for a few days over the summer, and did a 3-day
canoe/portage trip, and a 2 day kayak trip. She also occasionally went for a run, a bike, or to a
fitness class.

However, she feels that she was fit last spring when training for her half marathon (running
4x/week and cross training (yoga, biking, or hiking) 1x/week), and looks forward to regaining
her fitness this school year. Currently, she is running occasionally, and participates in some
group fitness classes.
Amy gets a good amount of sleep on most nights (generally 6 8 hours of sleep), does
not smoke, drinks only occasionally (1-3 drinks not more than 1x/week), and reports to eat
plenty of fruits, vegetables, dairy, and whole grains. She notes that she has a weakness for sugar,
however, and admits to often over-indulging in cookies, candies, and other baked goods.
Exercise/activity and lifestyle history:
Amy was active throughout High School, taking many dance classes including ballet,
jazz, lyrical, musical theatre, etc. After leaving High School, her parents no longer funded her
dance classes and they were too expensive for her to continue. Therefore she quit dance and took
up more recreational sports. She admits to going through very active cycles followed by lazy
cycles the lazy cycles can last 2 6 months at a time. She feels driven to exercise while
training for events, and therefore signs up for half-marathons and runs to keep her active.
She used to rock climb 3x/week a few years ago, and has completed three half-marathons
(one in 2011, one in 2012, and one in May, 2014), and a Tough Mudder (in 2013).
Her weight has remained reasonably steady (within 10 lbs) over the past 5+ years.
According to the CSEP-PATH: Stages of change questionnaire, Amy rates herself as
physically active once in a while, but not regularly. However, she was physically active in the
past (see Appendix 1).

Exercise preferences:
Amy enjoys running, but does not liking running on treadmills. She prefers running
outdoors, but feels limited in the winter when the weather is too cold (she will not run or bike
below 4C) or too wet. Amy also enjoys group fitness classes that focus on aerobics and
strength, such as cross-fit classes, HIIT classes, TRX classes, etc. She frequently bikes to school,
but does not like indoor cycling or spin classes.
Amy mentions that she loves the outdoors and enjoys hiking, surfing, kayaking,
canoeing, and snowboarding, but notes that the time commitment, cost, and weather
requirements of these activities limits her participation in them.
Barriers to exercise/activity:
The CSEP-PATH: Barriers to Physical Activity was used to determine some of Amys
barriers to exercise (see Appendix 1). They are summarized here.
Amy perceives the biggest barrier to her participating in more exercise is time. Amy is a fulltime university student who is writing her Honours Thesis this year. She also volunteers every
Monday night and some weekends. Therefore, she would prefer not to exercise more than
5x/week due to these other time commitments. She also prefers not to exercise in between
classes due the fact that she frequently bikes to school and does not want to bike with a towel,
change of clothes, and make-up.

Another barrier for Amy is money. She is not willing to pay more than $7 / exercise
session, which is a strong consideration since she prefers group fitness.
Lastly, Amy notes she feels lost in gyms she feels uncomfortable exercising in the
gym without someone guiding her through the equipment because she does not know how to use
all of the equipment. However, with a trainer or friend, she is willing to work out in the gym, but
she says she is having difficulty finding a friend who wants to go to the gym with her when she
is available. Therefore, since she lacks a friend group for exercising, she prefers either running
(which she is comfortable doing alone), or participating in fitness classes.
According to the PAR-Q (see Appendix 1), there are no health barriers to Amy
participating in an exercise regime. A doctors prior approval is not necessary.
Time availability:
Table 1 outlines her time availability.
Table 1
Time Availability of Amy Loench (A Indicates Time Available to Exercise)
Availability Monday

Tuesday

Wednesday Thursday

Friday

Saturday

Sunday

Morning

Afternoon

Evening

What she hopes to gain from this fitness program:

Through this fitness regime, Amy hopes to feel more energized, feel healthier, feel
stronger and more confident, and reduce her BMI. She reports that her main reason for
exercising is to feel stronger, healthier, and more confident.

Fitness Test Results

Fitness Testing
For the pre-training fitness measurements, numerous exercise tests were employed to gather both
cardiorespiratory and musculoskeletal fitness baseline measurements.
Pre-screening health measures were taken to ensure the client was safe to participate in the
fitness tests. A PAR-Q and Consent Form were signed (See Pre-training summary part 1), and
resting heart rate and blood pressure was taken. The PAR-Q was clear (no yes answers
indicated), the resting heart rate was 76 bpm (considered adequate for exercise if resting is below
100 bpm), and resting blood pressure was 112/60 mmHg (considered adequate for exercise if
systolic is below 145 mmHg, and diastolic is below 95 mmHg) (Heyward & Gibson, 2014).
Therefore, Amy is clear to participate in the pre-training fitness testing. The baseline resting
heart rate and blood pressure results will also be used to refer back to post-training, to note any
improvements in these physiological measures.
Prior to the fitness testing, the client was informed of the following pre-exercise guidelines:
Dress in loose, comfortable clothing, walking or running shoes;
No eating for 2 hours prior to the training/testing session;

 No caffeine for 2 hours prior to the training/testing session;

No alcohol for 6 hours prior to the training/testing session;
No smoking for 2 hours prior to the training/testing session;
Allow at least 6 hours between exercise bouts.
Amy claims to have followed these guidelines, and is therefore prepared to participate in these
pre-fitness tests.
To test her cardiorespiratory fitness and gather baseline predicted VO 2max data, a 20 m
shuttle run was performed. Amy reached the 8th stage of the test, which is equivalent to 12.7
METS (Leger, 1989). This corresponds to a predicted VO2max of 44.45 mLkg -1min-1, and a
Norm rating of Excellent (Leger).
Another test that was performed to measure Amys cardiorespiratory fitness and gather
VO2 max baseline data was the 2400 m Run. Amys time to complete the 2400 m run was 12:28,
or 12.48 minutes. This corresponds to a Norm Rating of Superior, and a predicted VO 2 max of
41 mLkg-1min-1 (Adams, 1994; Cooper, 1982).
To test upper body muscular endurance, the Canadian Physical Activity, Fitness and
Lifestyle Approach (CPAFLA) push-up protocol was followed. Amy completed 25 push-ups
from her knees, for a Norm Rating of Very good (Canadian Society for Exercise Physiology
[CSEP], 2003).
To test abdominal muscular endurance, Amy performed the American College of Sports
Medicine (ACSM) Partial Curl-up test, and did 60 reps. This gives her a Norm Rating of
excellent according to CPAFLA standards, and places her in the 80 th percentile of Women

aged 20-29 (Minister of Public Works and Government Services Canada [MPWGSC], 1986;
CSEP, 2003).
Next, Amy performed the Back Extension protocol to assess her back extensor muscular
endurance. Amy remained in back extension for 3 minutes, at which time the test was stopped
due to her achieving the highest level of performance for this test (CSEP, 2003). Therefore, her
Norm Rating was excellent (CSEP).
To assess leg power, Amy performed the Vertical Jump Test, and scored 30.48 cm on
Trial 1, and 32.0 cm on Trial 2. This gives her a Norm Rating of Good according to CPAFLA
standards, and places her in the 70th percentile of Women aged 18 34 years (CSEP, 2003;
Friermood, 1967).
Lastly, the Sit and Reach procedure was followed to assess the flexibility of Amys lower
back and hamstrings. Amy scored 47.5 cm on Trial 1, and 50.0 cm on Trial 2, giving her a Norm
Rating of Excellent (CSEP, 2003).
SMART Goals
First Four Weeks of Training Program
After completing the first four weeks of the training program, the client has developed a few
goals that she would like to have accomplished by this time. Firstly, Amy hopes to adhere to the
training program the best she can. She is concerned that time restrictions during mid-terms will
detract from her commitment to the training program, and therefore has set a goal to participate
in at least 85% of the training program over the course of the first 4 weeks. Secondly, she would
like to reach a level of 8.5 on the shuttle run after week 4, which would still classify her as

having a VO2max of 44.45 mLkg -1min-1 due to limitations in the predicted score tables, but
would suggest overall improvement in her maximal oxygen consumption (Leger, 1989). She will
accomplish this by adhering to her training program, which will contain much aerobic exercise to
improve her cardiovascular system. Lastly, Amy hopes to increase her running abilities and
endurance. By the end of 4 weeks, she aims to increase her running distance to 10 km without
having to stop and walk. She will accomplish this again by adhering to her aerobic training
program, which will include runs that will work up to a distance of 10 km.
Second Four Weeks of Training Program
After the second 4 weeks of the training program, or after 8 weeks in total, the client has
outlined a new set of goals that she can work toward. The first is that she would like to increase
her cardiorespiratory fitness, which would be indicated by reaching a level of 9 on the shuttle
run, suggesting that her VO2 max will have increased to 47.6 mLkg -1min-1 (Leger, 1989). Amy
also hopes to further improve her running by the end of 8 weeks, which will be indicated by
reducing the time it takes her to run 10 km. The client aims to be able to complete the 10 km
distance in 55 minutes or less by the end of the 8 week training program. She will accomplish
both of these goals by improving her cardiovascular fitness through sticking to her training
program, and taking the runs seriously working to improve her speed and taking less walking
breaks each week. Lastly, the client aims to lose some weight after participating in this training
program. She is aiming to lose 5 lbs by the end of the 8 week program. She will accomplish this
by not only adhering to her exercise program, but also consuming less sugar in the form of
cookies, desserts, and fruit juices which she currently indulges in.

PART 3
Proposed Exercise Prescription & Rationale
Prior to the onset of this fitness program, the client had already been working out. This is
reflected in her predicted VO2max scores (see Pre-training summary part 2). For Amys
predicted VO2max score, the shuttle run test predicted VO2max results will be used as Amys
VO2 max score, since the shuttle run is the most representative maximal exercise test of all that
were performed in the initial fitness testing (Heyward & Gibson, 2014). Therefore, for the
exercise prescription, Amy has a predicted VO2 max of 44.45 mL/(kgmin), which corresponds to
an initial fitness rating of excellent (Leger, 1989). Therefore, she will not need an initial
conditioning phase of the program, and can instead begin the program at the improvement stage.
For individuals with excellent initial fitness scores, it is recommended that they are prescribed
a starting target intensity in the range of 70-<90 %heart rate reserve (HRR), 84-96% heart rate
max (HRmax), or Somewhat hard-hard for rate of perceived exertion (RPE) (Table 5.1,
Heyward & Gibson).
Amys age-predicted max heart rate is 195 bpm, but a heart rate of 210 bpm was
measured during her all out run (Appendix 1, HR monitoring data sheet). Therefore, 210 bpm
will be used as Amys HR max for this exercise prescription, since it is her own physiological
data as opposed to a predicted maximum. For this exercise prescription, the intensity monitoring
will be done through %HRR because Amy has mentioned that she already measures her heart
rate after she goes for a run, so she is already aware of how to take heart rate measurements.
Furthermore, the client has noted that she prefers physiological numbers that she can easily track
over perceived ratings, which she believes are a little too abstract for her personal use.

Taking the clients preferences into consideration, %HRR was chosen over %HRmax for
intensity monitoring because it takes into account the clients resting values, and is therefore
more tailored to the client than %HR (Heyward & Gibson, 2014). ACSM recommends using
%VO2 reserve over other options, and %VO2 reserve equates 1:1 with %HRR, therefore, this is a
preferred measurement of intensity (Heyward & Gibson). The client will therefore begin at a
target range of 70-75% HRR, since she is at the lower-end of the excellent norm rating, and
the slightly lower intensity will allow her to get used to the new fitness program, and the new
techniques associated with it. This is especially important for the kickboxing classes, since the
client is new to kickboxing, and, as a Type C Mode of exercise, it may require more technique
building before the client is able to focus on intensity (Heyward & Gibson).
Through this fitness regime, Amy hopes to feel more energized, feel healthier, feel
stronger and more confident, and reduce her BMI. She reports that her main reason for
exercising is to feel stronger, healthier, and more confident. Furthermore, her goals are to
improve her cardiovascular fitness, as measured by both the shuttle run test scores and her ability
to run 10km in 55 minutes or less (See pre-training summaries, Part 1 & 2). However, after
running 3 half-marathons previously, Amy reports to feel bored with running when she does it
too often, and also notes that frequent running aggravates her left knee. Therefore, a multi-modal
program that will introduce a new sport, kickboxing, to the client should keep the client
interested in the program while improving her cardiovascular fitness. The kickboxing classes are
also currently offered at a great price that fits within the costs limits of the client ($2.50/class),
which she previously mentioned are a barrier to her ability to participate in exercise classes. The
high-intensity interval training (HIIT) class is also fairly new to the client she has only started
them in September, so this is another way to add diversity to her fitness program while pushing

her anaerobic threshold by participating in the supra-threshold HIIT class (McArdle, Katch, &
Katch, 2014). HIIT classes consist of Tabata-style intervals, with a 20 s supra-threshold, all-out
exercise followed by a 10 s active recovery period. This is repeated 8 times for a total of 4
minutes per exercise. Tabata-style exercises have been shown to not only increase the anaerobic
threshold, but also improve aerobic fitness and increase VO2 max (Tabata, 1996). The weekly 10
km run will allow the client to clearly view the progress of the fitness program, as the increases
in her cardiovascular fitness and increased anaerobic threshold should be evident in her ability to
run with less walking breaks and decrease her time to complete the 10 km (McArdle et al.). It is
hoped this noticeable progress will keep the client motivated to stay on-track with her program.
Further into the program, a second, shorter run will be incorporated to ensure the client is still
improving her cardiovascular fitness.
The volume of the program will be increased by increasing intensity and frequency,
rather than duration. Since the client has a high level of initial fitness, it is acceptable to start
with increasing intensity, rather than increasing duration, because she already exercises for long
periods of time, therefore duration does not need to be further increased (Heyward & Gibson).
The first week that kickboxing is introduced, there will be no 10 km run, because it is believed
that the kickboxing class will be higher-intensity than the run, and increasing both frequency and
intensity in the same week should be avoided (Heyward & Gibson, 2014). Then, when the 10km
run is re-introduced, duration should decrease as Amys cardiovascular fitness increases,
reducing the time required to run her 10km loop. It has been decided that the client will start with
a 10km run, rather than progressing to it, because she already runs a 10km loop around the lakes
near her house, and so there is no point decreasing the distance she currently runs, especially
since it is her goal to decrease her time to complete the loop, and decrease the number of times

she stops and walks. Therefore, she will continue to run 10km since she enjoys this particular
run, and, as mentioned earlier, it is a way to notice improvement in her fitness levels. Since the
run is a constant level of activity (except for the few walking periods), and it is a long duration, it
will start at a lower intensity than the recommended training intensity for the clients initial
fitness, but this is because intensity is inversely related to duration (Heyward & Gibson, 2014).
Intensity will be increased by walking less frequently during her run, and increasing her
running speed. Also, as the client gets more used to the techniques involved in kickboxing, her
ability to focus more on intensity rather than technique will allow her to reach a higher %HRR.
Duration is difficult to change for this fitness program, since she runs a set distance (and, if
anything, this will decrease in duration as she gets more fit), and she participates in many fitness
classes, all of which are of a set duration. Therefore, volume will be increased through increasing
frequency after the introduction of the kickboxing classes, and through increasing intensity, as
mentioned above. The frequency will be increased to 5 days/week, and the activities are
scheduled for times the client mentioned she was available (See pre-training summary, Part 1).
This is within the time constraints of Amy, which was mentioned as a primary barrier to her
exercise commitment.
Sample Calculations:
Target HR for 70% HRR:
= (target intensity x (max HR - resting HR)) + resting HR
= (0.7 x (210 68)) + 68
= 167 bpm
HR for 10 s count:
= 167/6
= 28 beats/10s

References
Adams, G. M. (1994). Exercise Physiology Laboratory Manual (p. 91). Dubuque, IA: Wm. C.
Brown.
Canadian Society for Exercise Physiology. (2003). The Canadian physical activity, fitness and
lifestyle approach (CPAFLA) (3rd ed.). Ottawa, Canada: Canadian Society for Exercise
Physiology.
Cooper, K. H. (1982). The aerobics program for total well-being (p. 141). New York, NY:
Bantam Books.
Friermood, H. T. (1967). Volleyball Skills Contest for Olympic Development (pg. 134-135).
Annual Official Volleyball Rules and Reference Guide of the U. S. Volleyball
Association.
Heyward, V. H., & Gibson, A. L. (2014). Advanced fitness assessment and exercise prescription
(7th ed.). Human Kinetics: Champaign, IL.
Leger, L. (1989). Fit Test (pp. 16-19). Canada: Thought Technology.
McArdle, W. D., Katch, V. L., & Katch, F. I. (2014). Exercise physiology: Energy, nutrition, and
human performance (8th ed.). Baltimore, MD: Lippincott Williams & Wilkins.
Minister of Public Works and Government Services Canada. (1986). Canadian standardized test
of fitness operations manual (3rd ed.). Ottawa, Canada: Health Canada.
Tabata, I., Nishimura, K., Kouzaki, M., Hirai, Y., Ogita, F., Miyachi, M., & Yamamoto, K.
(1996). Effects of moderate-intensity endurance and high-intensity intermittent training
on anaerobic capacity and VO2max. Medicine and Science in Sports and
Exercise, 28(10), 1327-1330. doi: 10.1097/00005768-199610000-00018