Jessica Richardson and Brittany Litchford

Advanced Strength and Conditioning

Beth Funkhouser
December 7, 2016
Final Paper
1. Introduction to your Client
Our client is a 61 year old female who is hoping to increase her overall well-being. She
used to be much more active when she was younger but maintained a good amount of physical
activity by walking a couple miles on the Creeper trail about 3 times a week. However, more
recently this physical activity has declined as well and she has started to see its repercussions
in her daily life. She discussed how she recently noticed how out of breath she would be after
walking up the hill to Wiley or how she would have to take a break in walking up flights of stairs.
Thus, her main overall goal was to return to a more active lifestyle and to improve her overall
wellness. Our client has no major health issues but does have arthritis, with the worst coming in
her fingers and knees. Thus, she requested to not have many squats in the workouts and
warned us that some days she would really struggle to hold a weight in her hands.
The goals that our client hoped to achieve during this 6 week training program were to
increase overall fitness and well-being, to increase her upper body strength, and to improve her
balancing skills. As such, we decided on more general testing measurements. We first
measured her height and body weight and discovered that she was 67.5 inches tall and weighs
152.5 pounds. Next, we measured her body fat with a Skyndex caliper and found that she had
32.5% body fat. Then we took her blood pressure and got a reading of 115/70. We also used a
tape measurer to measure the circumference of her dominant arm to use as one indicator of
arm strength and recorded 10.75 inches. We next moved on to the BESS balance test where
she was able to complete the double leg stance well, struggled on the tandem stance with the
dominant foot forward with 6 errors and then could not even complete the tandem stance with
the dominant foot in the back. Recognizing her struggle with the first stage of the BESS test we
decided to not even attempt the second stage on the foam pad. The last test we did was a
pushup test but we had her complete the pushups against a wall until failure and she was able
to complete 32 with very nice form.
2. Exercise Selections
When choosing modes for our client, there were many factors we had to consider. She
had arthritis in her wrist and hand joints, and the arthritis in her thumb made gripping activities
very difficult. She had stated to us that some days the pain was so severe she could not open a
jar, or grasp an object overhead. We chose to use cuff weights for her upper body exercises,
careful to avoid irritation of the arthritis. She also stated that she had some mild arthritis in her
knees so we opted for the elliptical and bike as a low impact aerobic training and warm up.
Improving her balance was not one of her specific goals, but as the aging process occurs it is an
essential skill that deteriorates. To improve her balance, we modified her land training to model
a BESS test and performed all the exercises on a stable surface. We also incorporated an
aquatic day in her workout program in order to incorporate neuromuscular control,
proprioception, and resistance training in one session. As a rule, we chose low impact activities,
and progressed as her strength improved.
As preferred by the client, one of us was always present at her training sessions. She
said she would be more motivated and committed if one, or both of us were present. Her
training days were Monday, Tuesdays, and Thursdays, and on the other days she rested. We
were careful not to overstress her, especially since her activity level had decreased in the
previous years. Monday and Thursdays were focused on her upper body coordination and
balance, whereas Tuesdays were a full body training since that was our aquatic day. Her goals
allowed for four days of rest since she was not training for anything specific; she just wanted to
be more active. However, on her off days and in the evenings, she would work on her balance
while talking on the phone or cooking dinner. In sequencing her workouts, we wanted to ensure
that the workouts would challenge her, but also keep her motivated. We created a specific
workout design for each workout day of the week with no repeating exercises occurring on two
workouts within a week. Our client was vocal in letting us know when an activity became too
easy or was too challenging for her. Progression was made based on her comments about the
exercises or that day's workout, but also on the changes and improvements we saw throughout
her training. We also used the mid-season testing to help us progress her workouts, noting any
areas where we could challenge her more, or specific focus was needed.
3. Results

Tests Pre-test (10/17) Mid-test (11/15) Post-test (12/6)

Height 67.5 67.5 67.5

Weight 152.5 lb 148.5 lb 149.2 lb

Body Fat 32.5% 30.09% 27.4%

Blood Pressure 115/70 120/75 115/78

Dominant Arm Size 10.75 10.75 11

Push-up Test 32 31 50

BESS balance Test:

# Of errors (Max 10) FIRM Surface FOAM Surface

Double Leg Stance (Feet Pre: 0 Pre: Did not attempt

together) Mid: 0 Mid: 0
Post: 0 Post:0

Tandem Stance Pre: 6 Pre: Did not attempt

(Non-dominant foot in back) Mid: 2 Mid: Attempted, but couldn't
Post: 4 complete
Post: Attempted, but couldn't
complete (17 sec, 5)

Tandem Stance Pre: Could not perform Pre: Did not attempt
(Dominant foot in back) Mid: 4 Mid: Did not attempt
Post: 5/ couldn't perform? Post:Attempted, but couldn't
complete (14 seconds)
 We chose to do a continuation of our workouts based on the progress we saw through
her mid-test results. While we did not see an improvement of her arm strength we did see a
great improvement in her balance as well as a decrease in both her weight and body fat. Since
strength is built over time and while we have seen no initial strength gains, neuromuscular gains
are occurring. Therefore we chose to continue with the same workouts just steadily progress in
both repetitions and weight as the client has said that the upper body exercises are challenging
for her.
4. Discussion
Our client has made a lot of progress in just these past 6 weeks. Her balance has
improved remarkably and we have seen improvements in the other categories across the board.
However, in order for our client to maintain the progress she has made and continue to make
more progress towards her health and fitness goals she must continue to remain active a couple
times a week. We have attached a fitness plan for the next 6 weeks and hope that she
continues to remain active even past this time frame. We would suggest potentially looking into
joining a water aerobics group as she enjoys the workouts in the water and this may be a fun
and different way to remain active. We also encourage our client to continue practicing her
balance at all the random times she is able to (like when talking on the phone). Encouraging our
client to return to the Creeper trail, in warmer weather, is also a suggestion we made. She used
to enjoy that and now that she has began exercising again, this would be a great way for her to
add variety to her program we created.
Overall this was a very valuable and insightful project. We not only had the chance to
design workouts but we were able to actually enact them and see what worked and didnt work.
We had to make adjustments as the training time went on due to unforeseen circumstances
(weight room changes, client having pain in the abdomen, her reaction to Trumps election,
etc.). This aspect of the project was very insightful in realizing what little control us as instructors
have on outside variables. We had to make immediate adaptations to her program, based on
physical and emotional variables we could not control. We believe that this project allowed us to
gain some real world experience in strength and conditioning and through the process we were
able to help our client reach her fitness goals and hopefully remain on the path to a healthier
lifestyle. It was also very motivating when she had told us that she had be practicing her
balance activities at home, and even challenged a friend to do the same. This go-getter and
proactive attitude really assisted her in the completion of her workout. We too believe that
beginning this program was a great step in the right direction to decreasing the health concerns
that are age related she presented to us in our initial meeting.

5. Appendix A
See attached sheet.

6. Appendix B
See attached sheet.