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Client Information

My client is a 20 year old female. She is 5 feet 2 inches tall and weighs 111 pounds. At
this time, she has no physical injuries; however, her past physical limitations include a dislocated
rib, knee pain from Osgood-schlatter disease, and minor Achilles tendon pain. Currently, she is
recovering from two ear infections and a sinus infection; thus, exercise has been restricted since
August 20th, 2014 excluding light to moderate intensity walking. The client has received medical
clearance to participant in physical activity after September 22nd, 2014. She satisfies all other
aspects of the PAR-Q assessment.
The client is a full time university student attending classes 4 days a week. Her schooling
consists of 580 minutes sitting in lectures and 360 minutes sitting or engaging in light physical
activity during laboratory settings each week. She also spends 1-2 hours studying (sitting) each
day. As well, she regularly attends moderate to vigorous intensity dance lessons for 1 hour twice
a week on Monday and Wednesday in the evening. She also teaches dance lessons for 4 hours a
week on Thursday and Saturday at moderate intensity. Furthermore, the client tries to include
moderate intensity jogging or moderate intensity swimming for 30 minutes once a week on
Thursdays. Previous exercise history includes attending moderate to vigorous intensity dance
lessons for a total of 525 minutes a week. Past and present exercise occurs in the evenings
around 7-10 at night. Her mode of transportation includes busing or driving. The client believes
she eats a relatively healthy and well-rounded diet with low to zero caffeine intake. She has low
alcohol intake and does not smoke. Also, the client notes that she has difficulty falling asleep and
often feels restless during the day. Her average sleep each night is 7 to 7 hours.
Besides dance lessons, the client finds it difficult to commit and find time to exercise
when the school term gets busy in October and November. She wants to develop better sleeping

patterns through a structured exercise routine. The client likes to exercise to maintain a healthy
weight and increase energy during the day. In addition, the client would like to incorporate more
exercise into her weeks; however, she feels limited by time and finances. She is available to
exercise immediately afterschool from 4pm-8pm on Tuesdays, 4-7:30pm on Wednesdays, and
11:30-1pm on Thursdays. Also, she is available to exercise Friday from 1-5, Mondays before
9pm, or anytime on Sundays. If possible, the client prefers to exercise during the weekdays
rather than Sunday. She has access to a dance studio, gym, and pool. The client enjoys exercise
that involves participation in groups, music, full body coordination, and set time frames. Also,
the client enjoys exercising with friends and family. She receives support to exercise and eat
healthy by her friends and family. Lastly, the client is willing to engage various exercise as long
as she feels comfortable and confident with the activity.

Test Results & Smart Goals


The client completed two tests to measure cardiorespiratory fitness: the 20m shuttle run
and 2400m run. The client completed stage 8 of the 20m shuttle run test; therefore, her metabolic
equivalent task score was 12.7 and her predicted VO2max was 44.5ml/kg/min. According to
Cooper Institute for Aerobics Research (2005), the clients cardiorespiratory fitness is classified
as Excellent. Using the shuttle run score, this VO2max was calculated as follows:
Stage 8 = 12.7 METs
V02max= 12.7 METs x 3.5ml/kg/min
= 44.5ml/kg/min

The client finished the 2400m run in 13.67 minutes. As a result, the client ranks good
cardiorespiratory fitness with a predicted VO2max of 41.9ml/kg/min (Copper Institute for
Aerobics Research). This V02 max was calculated by the following equation:
BW= 50.62 kg, time= 13.67, gender= 0 female
VO2max= 88.02 - (0.1656 x 50.62kg) (2.76 x 13.67) + (3.716 x 0)
= 41.9 ml/kg/min
Furthermore, the client performed five musculoskeletal tests: Push-ups, partial curl ups,
vertical jump, back endurance, and the sit and reach. All tests followed CPAFLA protocol, except
the partial curl ups which followed the ACSM protocol. The client completed 25 repetitions of
push ups; thus, the client ranked very good (Canadian Society for Exercise Physiology
(CSEP), 2003). During the partial curl ups, the client finished 35 repetitions. According to the
Canadian Association of Sports Science (1986), the clients percentile ranking for partial curlups was between 65-70%. The clients vertical jump score was 43.2cm and their sit and reach
score was 47cm. As a result, the client ranked excellent for both the vertical jump and sit and
reach test (CSEP). Lastly, the clients completion time for back endurance was 2 minutes 30
seconds, which ranked the client as very good (CSEP).
For the course of 4 weeks, the clients goal is to improve her 20-m shuttle run test from stage 8 to
stage 8.5 by November 17th, 2014; therefore, the client aims to increase her VO2max from 44.5
ml/kg/min to 46 ml/kg/min. As well, the client would like to attend and work above an intensity
of 70% HRR (156bpm) at a 1 hour DanceFix class once a week over the next 7 weeks.
Attending class once a week and improving her shuttle run score by half a stage are both
attainable and realistic goals for a short period of 4 weeks. The client has also made note that she
would like to maintain a healthy weight and enjoys exercise with groups of people and music;
thus, both of these goals satisfy the clients exercise preferences. Also, both goals are specific

and measureable because her shuttle run score can be measured by retaking the shuttle run test
on November 17th, as well as she can measure the number of DanceFix classes she attends and
the intensity she is working at by monitoring her heart rate during the class. Lastly, these goals
are set in a distinct time frame (4 weeks and 7 weeks) and they are action oriented. In addition to
these goals, the client has set an 8 week goal of maintaining her shuttle-run score at stage 8
and VO2max around 46ml/kg/min by continuing prescribed exercise each week. This goal is
rational as the client will be going into exam period and will have difficulty increasing exercise
frequency or duration during the weeks. Similarly, this goal is measureable by retesting her
shuttle-run test at the end of the 8 week period. It is also realistic and attainable considering the
circumstances of busy school during these weeks. As well, this goal is specific and time oriented
in a period of 8 weeks. Furthermore, the goal of attending Dancefix class and working at an
intensity above 70% HHR (156bpm) will be continued as the class runs for 7 weeks.

Exercise Prescription
In order to achieve the clients goals, prescribed exercise will focus on adding
cardiovascular exercise in addition to her regular dance lessons. Furthermore, this training
program aims to create a structured exercise routine to improve the clients sleeping patterns and
add variety to her weekly activity.
In this program, the exercise intensities are prescribed as heart rate instead of VO 2
because the client has her own heart rate monitor; thus, heart rate is a quick and convenient
method for tracking intensity during her exercise sessions. In addition, a range of treadmill
speeds are prescribed as a secondary method for tracking exercise intensity. However, the client
will not be able to use a speed or target heart rate to monitor intensity during the DanceFix class

because she does not have control over the types of exercises that will be performed. Therefore,
intensity during DanceFix is prescribed using the 0-10 Borg RPE scale because it allows the
client to subjectively monitor intensity without fixating on meeting a target heart rate and being
distracted from the class (Heyward & Gibson, 2014).

Week 1
During week one, the client will engage in a 30 minute treadmill run between 5.2mph and
6mph while sustaining a heart rate between 163-171bpm twice a week at 4pm on Monday and
Tuesday. The client will also attend a DanceFix class for 1 hour working at a 7-8 RPE according
to the 0-10 Borg rating of perceived exertion (RPE) scale at 6:30pm on Wednesday. Lastly, the
client will do a 5 minute brisk walk at 111-126bpm on the treadmill to increase skeletal blood
flow for warmup, as well as she will end her run with a 5 minute brisk walk at 111-126 to allow
blood pressure and heart rate to decrease back to baseline (Heyward & Gibson, 2014).
In order to see improvements in cardiorespiratory fitness, the American College of Sports
Medicine (ACSM) (2014) recommends exercising 3 times a week at moderate to vigorous
intensity; therefore, exercise is prescribed for three days during week 1. When picking a starting
frequency, the weekend warrior style of consecutive exercise days is chosen because Monday,
Tuesday, and Wednesday works best with the clients schedule. While ACSM recommends
exercising on alternating days, consecutive exercise days show similar increase in
cardiorespiratory fitness as alternating training days (Auracher, Heeg, Urhausen, & Kindermann,
2006). As well, sleeping patterns play an important role in determining when exercise should be
performed as the client wants to get better sleep during the night. According to Buman & King
(2012), exercise close to sleeping times promotes acute benefits on sleep by causing a

thermoregulatory response which correlates with a deeper sleep. Conversely, an alerting effect
occurs when an individual performs exercise too close to sleep; therefore, exercise should be
performed in the late afternoon 3-6 hours prior to sleep (Taylor, 2001). Based on this rationale,
exercise is prescribed for Monday, Tuesday, and Wednesday because the client is available to
exercise during the late afternoon these days.
For starting intensity, calculations are based on the clients predicted VO 2max from her
20m-shuttle run score. A lower predicted VO2max was also measured during a 2400m run;
however, the 20m-shuttle run results are used because the shuttle run is a maximal test making its
VO2max prediction more accurate than the submaximal 2400m run test (Heyward & Gibson,
2014). Nonetheless, the lower predicted VO2max is considered by picking a starting intensity at
the lower end of her recommended intensity range. According to Canadian Society for Exercise
Physiology (CSEP) (2003), the clients starting intensity should be between 70-90% of her heart
rate reserve (%HHR) as her cardiorespiratory fitness ranked excellent on the 20-m shuttle run
test (Cooper Institute of Aerobic Research, 2005). As a result, the clients prescribed starting
intensity is 75-80% of her %HRR; therefore, her starting intensity is a heart rate value between
163bpm and 171bpm. Also, this target heart rate range correlates with a 7-8 RPE on the Borg 010 RPE scale based on the clients results during her jog and fast jog in laboratory testing;
therefore, a 7-8 RPE is also prescribed for monitoring intensity. The heart rate reserve method
(%HRR) is used to calculate target heart rates for exercise intensity because it produces a more
individualized target heart rate by including the clients resting heart rate and maximal heart rate
(Heyward & Gibson). Especially since the client has a low resting heart rate of 52bpm, it is
better to use a more personalized calculation rather than the maximum heart rate method that
uses a standardized resting heart rate value (Heyward & Gibson).

Furthermore, ACSM (2014) recommends exercise duration of 30-60 minutes at a


moderate intensity to improve cardiovascular fitness; thus, two 30 minute sessions and a 1 hour
session is prescribed for first week as the clients 4 week goal is to improve her VO 2max. Since
the client is already active, she should be able to maintain her target intensity of 75-80% of her
%HRR and 7-8 RPE for all three sessions (ACSM).
Lastly, the type of exercise selected for week 1 is based on the clients exercise
preferences and initial fitness level. The client is already physically active and at a good fitness
level; therefore, type B (jogging) and type C (DanceFix) exercises are selected (Heyward &
Gibson, 2014). DanceFix is an aerobic dance class that involves group participant and
coordinating body movements to music which fits the clients preferences. Conversely, treadmill
running does not satisfy all aspects of the clients preferences; however, it is chosen because it is
convenient for the client to access, as well as she is able to listen to music or talk with a friend
during her exercise.

Week 2
In order to improve cardiovascular fitness, exercise overload should be increased
throughout the program by increasing frequency, intensity, or duration independently of each
other (Heyward & Gibson, 2014). According to Heyward & Gibson, frequency or duration
should be increased before intensity increases; therefore, only duration will be increased for
week 2 and intensity, type, and frequency will remain the same as week 1. Additionally, duration
should only been increased a maximum of 10 minutes per session every1-2 weeks of the first
month (ACSM, 2014). Based this rationale, the client will engage in a 35 minute treadmill run
between 5.2mph and 6mph while sustaining a heart rate between 163-171bpm twice a week at

4pm on Monday and Tuesday. Frequency, duration, and intensity for warm up, cool down, and
DanceFix will remain the same as week 1.

Week 3
For week three, frequency will be increased as the client will have more free time due to
reading break. Since the client can maintain moderate to vigorous intensity for at least 20
minutes, frequency should gradually be increased from 3 days to 5 days per week (Heyward &
Gibson, 2014). Therefore, the clients will swim 50m lengths for 20 minutes at 11:30 on Thursday
working at 7-8 RPE. Intensity was prescribed as RPE so the client does not have to stop and
manually measure heart rate while in the pool. In addition to swimming, the client will maintain
the same exercise prescribed for week 2. Swimming was chosen because it is a skill the client
already can perform, as well as it involves full body coordination and it can be done with other
people.

Week 4
Exercise prescription will remain the same as week 3, except training will be moved from
Thursday to Sunday and it will increase in duration by 5 minutes. Fitness testing will be
occurring at the end of week 4 which is marked as the Thursday according to the laboratory
schedule. Exercise should not be performed 6 hours prior to testing; therefore, the client will not
swim on Thursday as her swimming time is 3 hours before her testing time. Nevertheless, the
client will keep the same exercise intensity, frequency, and duration for the treadmill runs, cool
down, warm up, and DanceFix as week 3. She will also swim for 25 minutes at 10am Sunday

working at 7-8 RPE. Duration was increased only by 5 minutes because the client will still be in
her first month of her program (ACSM, 2014).

Week 5- Week 7
The clients goal for the last 4 weeks of her program is to maintain her VO 2max as she
will be starting exams. According to Heyward & Gibson (2014), frequency can be reduced from
3days to 5days without decreasing cardiovascular fitness as long as exercise intensity remains
the same. Subsequently, the clients exercise frequency will reduce back down to 3 days a week
during week 5. Therefore, the client will treadmill run between 5.2mph and 6mph for 35 minutes
while sustaining a heart rate between 163-171bpm at 4pm on Monday and Tuesday. The client
will also attend a DanceFix class for 1 hour working at a 7-8 RPE according to the 0-10 Borg
RPE scale at 6:30pm on Wednesday. Warm up and cool down will remain the same as the prior
weeks. If the client has time between study sessions, she will play squash for 30 minutes working
at RPE 7-8 to add variety into her weekly exercise.

Week 8
During week 8, the clients DanceFix class ends; therefore, the client will attend a 1hr drop-in
jazzercise class at 9:15am on Thursday working at a RPE between 7 and 8. The client will
continue the same intensity, duration, and frequency for treadmill runs, warm up, and cool down
from week 7.

References
American College for Sports Medicine. (2014). ACSMs guidelines for exercise testing and
prescription (9th ed.). Philadelphia: Lippincott Williams & Wilkins.
Buman, M. P. & King, A. C. (2010). Exercise as a treatment to enhance sleep. American Journal
of Lifestyle Medicine, 4(6), 500; 500-514; 514.
Canadian Association of Sports Sciences. (1986). Canadian standardized test of fitness (CSTF):
Operations manual (3rd ed.). Ottawa, ON: Health Canada
Canadian Society for Exercise Physiology. (2003).The Canadian Physical Activity, Fitness
and Lifestyle Approach (CPAFLA) (3rd ed.).Ottawa, ON: Canadian Society for
Exercise Physiology.
Cooper Institute for Aerobic Research. (2005). The fitness specialists certification
manual. Dallas, TX: The Cooper Institute.
Heyward, V. & Gibson, A. (2014). Advance Fitness Assessment and Exercise Prescription
(7th ed.). Champaign, IL: Human Kinetics.
Taylor, S. R. (2001). The influence of exercise on sleep quality. International SportMed
Journal, 2(3), 1.

Appendix
Summary for 8 week training program
WEEK 1

Proposed Activity

Date

Intensity

Time

Type

Oct.
27

4550%HHR
111126bpm

5min

Brisk walk

30min

Treadmill running
(5.2mph and 6mph)

5min

Brisk walk

5min

Brisk walk

30min

Treadmill running
(5.2mph and 6mph)

5min

Brisk walk

60min

DanceFix Class

75-80%
HHR
163171bpm

Oct.28

4550%HHR
111126bpm
4550%HHR
111126bpm
75-80%
HHR
163171bpm

Oct.29

4550%HHR
111126bpm
7-8 RPE

Actual Activity
Date

Intensity

Time

Comments for week 1: See reverse side of this sheet.

Proposed Activity

WEEK 2
Date

Intensity

Time

Type

Nov.3

45-50%HHR
111-126bpm

5min

Brisk walk

Actual Activity
Intensity

Time

Type

Type

Nov.4

Nov.5

75-80% HHR
163-171bpm

35min

Treadmill running
(5.2mph and 6mph)

45-50%HHR
111-126bpm
45-50%HHR
111-126bpm

5min

Brisk walk

5min

Brisk walk

75-80% HHR
163-171bpm

35min

Treadmill running
(5.2mph and 6mph)

45-50%HHR
111-126bpm
7-8 RPE

5min

Brisk walk

60min

DanceFix Class

Comments for week 2: See reverse side of this sheet.

Proposed Activity

WEEK 3
Date

Intensity

Time

Type

Nov.10

45-50%HHR
111-126bpm

5min

Brisk walk

75-80% HHR
163-171bpm

35min

Treadmill running
(5.2mph and 6mph)

45-50%HHR
111-126bpm
45-50%HHR
111-126bpm

5min

Brisk walk

5min

Brisk walk

75-80% HHR
163-171bpm

35min

Treadmill running (5.2mph and


6mph)

45-50%HHR
111-126bpm
7-8 RPE
7-8 RPE

5min

Brisk walk

60min
20min

DanceFix Class
Swimming lengths

Nov.11

Nov.12
Nov.13

Actual Activity
Intensity

Time

Type

Comments for week 3: See reverse side of this sheet.

WEEK 4

Proposed Activity

Date

Intensity

Time

Type

Nov.16
Nov.17

7-8 RPE
45-50%HHR
111-126bpm

25min
5min

Swimming lengths
Brisk walk

75-80% HHR
163-171bpm

35min

Treadmill running
(5.2mph and 6mph)

Actual Activity
Intensity

Time

Type

Nov.18

Nov.19

45-50%HHR
111-126bpm
45-50%HHR
111-126bpm

5min

Brisk walk

5min

Brisk walk

75-80% HHR
163-171bpm

35min

Treadmill running (5.2mph and


6mph)

45-50%HHR
111-126bpm
7-8 RPE

5min

Brisk walk

60min

DanceFix Class

Comments for week 4: See reverse side of this sheet.

WEEK 5

Proposed Activity

Date

Intensity

Time

Type

Nov.24

45-50%HHR
111-126bpm

5min

Brisk walk

75-80% HHR
163-171bpm

35min

Treadmill running
(5.2mph and 6mph)

45-50%HHR
111-126bpm
45-50%HHR
111-126bpm

5min

Brisk walk

5min

Brisk walk

75-80% HHR
163-171bpm

35min

Treadmill running
(5.2mph and 6mph)

45-50%HHR
111-126bpm
7-8 RPE

5min

Brisk walk

60min

DanceFix Class

Nov.25

Nov.26

Actual Activity
Intensity

Time

Type

Comments for week 5: See reverse side of this sheet.

WEEK 6

Proposed Activity

Date

Intensity

Time

Type

Dec.1

45-50%HHR
111-126bpm

5min

Brisk walk

75-80% HHR
163-171bpm

35min

Treadmill running
(5.2mph and 6mph)

45-50%HHR

5min

Brisk walk

Actual Activity
Intensity

Time

Type

Dec.2

Dec.3

111-126bpm
45-50%HHR
111-126bpm

5min

Brisk walk

75-80% HHR
163-171bpm

35min

Treadmill running
(5.2mph and 6mph)

45-50%HHR
111-126bpm
7-8 RPE

5min

Brisk walk

60min

DanceFix Class

Comments for week 6: See reverse side of this sheet.

WEEK 7

Proposed Activity

Date

Intensity

Time

Type

Dec.8

45-50%HHR
111-126bpm

5min

Brisk walk

75-80% HHR
163-171bpm

35min

Treadmill running
(5.2mph and 6mph)

45-50%HHR
111-126bpm
45-50%HHR
111-126bpm

5min
5min

Brisk walk

75-80% HHR
163-171bpm

35min

Treadmill running
(5.2mph and 6mph)

45-50%HHR
111-126bpm
7-8 RPE

5min

Actual Activity
Intensity

Time

Type

Brisk walk

Dec.9

Brisk walk

Dec.10

60min

DanceFix Class

Comments for week 7: See reverse side of this sheet.

WEEK 8

Proposed Activity

Date

Intensity

Time

Type

Dec.15

45-50%HHR
111-126bpm

5min

Brisk walk

75-80% HHR
163-171bpm

35min

Treadmill running
(5.2mph and 6mph)

45-50%HHR
111-126bpm

5min

Brisk walk

Actual Activity
Intensity

Time

Type

Dec.16

45-50%HHR
111-126bpm

5min

Brisk walk

75-80% HHR
163-171bpm

35min

Treadmill running
(5.2mph and 6mph)

45-50%HHR
111-126bpm
7-8 RPE

5min

Brisk walk

Dec.18

60min

Jazzercise Class

Comments for week 8: See reverse side of this sheet.