Individual Exercise Prescription Project

Our client is a 48-year-old male with the initials BS. He is 5 feet 10 inches tall and

weighs 205 pounds. He is a full-time fire medic at the local fire department that runs on

average 10 calls a day. These calls can vary in activity, some can be very light such as

taking care of a patient in the back of a squad car. Other calls can be vigorous activities

such as fighting fires with 45lb gear for over 5 hours. When he is not running calls,

occasionally he has to partake in training activities which is typically a moderate form of

exercise. His schedule consists of working 24 hours on and 48 hours off. He typically

picks up an overtime shift of 12-24 hours every week or two weeks. His job is a very

active job. On his days following a shift, he hits the gym focusing on weights for an hour

then followed by a 45-minute cardio workout on the Arc machine. He tries to walk 45

minutes at least 3 times a week. His father had a heart attack at 60 and his mother has

never had any medical issues. He is a non-smoker and is not on any medications. His

fasting blood glucose levels are 80 mg/dL and his blood pressure at 125 mm Hg systolic

with a diastolic of 78 mm Hg. In terms of dyslipidemia, his LDL levels are 120mg/dL,

HDL levels 52 mg/dL, and total cholesterol 194 mg/dL. He has a BMI of 29. He eats a

relatively healthy diet but tends to overeat.

Looking at the risk factors for cardiovascular disease he has 0. He is cleared to

perform any exercise and should proceed as needed. Most likely we will start him off

with a combination of strength training and moderate aerobic exercise, then work

towards more vigorous.

Client’s Current Aerobic Exercise

 Frequency Intensity Type Time Location

3 days a week RPE=16 Arc Machine 45 minutes YMCA

(aerobic)

3 days a week RPE=8 2-3 mi Outdoor 1 hour Neighborhood

walk

For the finding of his current predicted VO2 max we used a treadmill jog test. We

walked him through the whole process prior to taking the test. As he took the test we

walked him through step by step again to make sure the test was conducted properly.

He wore an Apple watch to keep track of his heart rate and we told him to adjust the

speed at the warmup and following the warmup. At each minute, we asked him to read

off the heart rate on his watch.

Treadmill Jog Test

Minute % grade Speed (mph) Hr (bpm)

1 (warmup 0 4.5 116

2 (warmup) 0 4.5 120

3 0 5.5 134

4 0 5.5 145

5 0 5.5 148
TM jog VO2 Max: 43mL/kg/min

He prefers muscular strength exercises due to being a former collegiate athlete

and having a job that requires strength. He typically lifts 3 times a week at a high

intensity. In the gym, he uses machines and free weights.

 Weightlifting Exercise Schedule
Push day
Exercise Frequency Intensity Sets Reps Additional
Information

Bench 2-3 days a 225lbs 3 3-4

Press week

Incline 2-3 days a 80lbs 3 8

Dumbbell week
Press

Shoulder 2-3 days a 40lbs 3 12

Press week

Chest Flys 2-3 days a 15lbs 3 12

week

Pull day
Exercise Frequency Intensity Sets Reps Additional
Information

Seated Row 2-3 days a 150 lbs 3 3-4

week

Lat Pull- 2-3 days a 120 lbs 3 10

down week

Incline 2-3 days a 60lbs 3 8

Dumbbell week
Row

Pull-Ups 2-3 days a Body Weight 3 8 Last set is to

week fail

Legs
Exercise Frequency Intensity Sets Reps Additional
Information

Back Squat 2-3 days a 300 lbs 3 3-4

 week

Goblet 2-3 days a 80 lbs 3 12

Squats week

Hamstring 2-3 days a 60 lbs 3 12

Curls week

Single Leg 2-3 days a 40 lbs 3 12

Lunges week

His exercise preference is one that will keep him healthy. He is not looking to be

big and bulky just lean and strong. He enjoys doing activities that push him and feels

that fitness is a big part of his life. Typically he has 3 days a week with 2-3 hours set

aside each day for exercise. For motivation, he uses self-health and job performance.

He also wants to look “like he is in shape”. In regard to barriers, the only thing is that his

work schedule can vary depending on if he picks up extra shifts or not.

Components of Fitness:

There are five components of Fitness that are important for a healthy lifestyle.

These include Muscular Strength, Muscular Endurance, Cardiovascular Endurance,

Flexibility, and Body Composition. Muscular Strength is the amount of force your

muscles can put out and it is important to have muscular strength for your daily living to

be able to lift things up without a struggle. This is important for our client because they

need to be able to move heavy objects and or even people in an emergency. Muscular

Endurance is the ability to lift certain objects multiple times, this is important so that our

client does not get tired as quickly and allows him to move for longer periods of time.

Cardiovascular Endurance is the ability to perform an everyday activity like walking

around the house or grocery store and not being out of breath. This is important
because being able to walk around and/or run without having breathing problems is

important for everyday life. Flexibility is defined as the ability of the muscles to lengthen

and increase the range of motion. This is important because if the muscles are tight

then that increases the chance of straining and/or tearing the muscles. Body

composition is best described as the percentage of fat, muscle, and bone in the body.

This is important because body composition can help find the fat% in the body and a

high fat% can lead to cardiac problems and other diseases, as well as obesity which

could make it harder to live everyday life.

Intended Outcomes and Behavioral Goals

Short term intended outcomes:

● Client wants to be prepared to run a Tough Mudder race in 2 weeks at a

competitive pace. This because a him and a few of his workmates are running it

and he wants to beat them.

● Client wants to loose 10 pounds by summer beach vaction in first week of July.

He would like to look better with his shirt off in his abdominal area.

Behavorial goals:

● In the first week of the program, the client will run 2 miles under a 17 min pace 3

times a week and get atleast 3, 45 minute lifting sessions in.

● In the first week of the program, the client will cut out desserts and beer after

dinner 6 of 7 days with a goal of losing 1-2 pounds.

 During the workout with the client we will focus on muscular strength and

endurance to limit risk of injury by him lifting on his own. We will make sure to teach him

proper technique so that we are confident in his ability to lift on his own time without

injury. When focusing on muscular strength, we will work with heavier weight and lower

reps. For muscular endurance we will focus on higher reps and lower weight. We will

begin the lift with compound movements such as a bench press. Then work our way

into accessory movements such as a cable tricep push down. On his own time, we will

instruct the client to run 2 miles a day under a 17 minute pace 3 times a week. Before

each run we will have the client to do 3-4 sets of push-ups, sit-ups, and pull-ups to

failure. This will help the client perform tasks needed to complete tough mudder.

The muscular strength and endurance session focusing on push movements will

begin with a 5-minute warm up on the bike at a light-medium intensity with little to no

resistance. The RPE should be low with a number around 7-9 on the borg rpe scale.

After warmed up, we will work through some shoulder mobility exercises before working

into heavier pushing exercises. Once mobility is complete, we will start on the flat

barbell bench press warming up with 2 sets of light weight and reps around 6-8. Then

perform 3 working sets with moderate to heavy weight with a rep range around 4-6. This

will be focusing on muscular strength. In between sets, you will have 2-3 minutes of

rest. After flat bench press, we will move into dumbbell shoulder press, the same

procedure as the bench press. Continuing through the workout, you will use the pec dec

machine working muscular endurance. To focus on muscular endurance, the rep ranges

will be 10-12 reps with 1 warm up set and 3 working sets. There will be 2-3 minutes of

rest inbetween. The weight will be moderate but not too heavy and you should feel that
you have 1-2 reps left in the tank. After finishing pec flies, you will move into more

muscular endurance performing push-ups. For pushups, you will perform 3 sets to

failure and have 2 minutes of rest between sets. To end the weight training portion of

the session, you will have 2 sets of body weight dips to failure then 3 sets of cable tricep

extensions. For the cable tricep extensions, rep range will be at 10-12 with moderate

weight. After the weight training is over you will then walk on the treadmill at a grade of

8% at 3.5 mph for 10 minutes. This will help cardiovascular endurance and body

composition. Finally, you will perform a 5 minute cool down exercise on the treadmill

with no grade at a speed of 2 mph. After the workout is complete, it is normal to feel

sore due to delayed onset muscle soreness (doms)!

Tracking progress example