PHR 101

SP 23: CASE STUDY 3

Ryan is a 42-year-old owner of a website design company. Before starting his company eight years ago, he
used to be very active lifting weights twice a week and running on the weekends. He now finds that he only
has time to play rugby twice a week after work because he typically works 8-10 hours per day. Lately he has
been noticing that he feels a dull ache in the center of his right knee after rugby. His doctor said his knee pain
will be resolved with strengthening and balancing his vastus medialis and vastus lateralis to improve patella
tracking. Ryan started to notice that his once in-shape, toned body is starting to feel flabby. He would also like
to run a 10km race in the next year. He is available after 8pm, 3 times/week. He reports that he is single, eats
out a lot at fast food places, sits at a computer for most of the day and talks on the phone with clients, has
some low back stiffness at the end of the day and sleeps 6-7 hours a night but often has a hard time falling
asleep at night. He also states he has a hard time sticking to his exercise programs. He would like you to set
him up on a program that he can do a few times a week and provide nutrition counseling. You notice forward
head posture and forward shoulders as well as tightness in his hamstrings, IT band and gastrocnemius

The assessment provided you with the following information:

Age HT WT RHR RBP
42 5’7” 200 lbs 85 bpm 120/80 mmHg

Body Composition:
Hip Waist Skinfold – Skinfold – Skinfold –
Circumference Circumference Chest Abdomen Thigh
36 in 38 in 32 mm 49 mm 42 mm

Blood Chemistry Profile:

Total cholesterol HDL LDL Triglycerides Fasting Blood Glucose
225 mg/dL 45 mg/dL 115 mg/dL 325 mg/dL 83 mg/dL

Ryan’s goals
• Start working out in the weight room again and manage his knee pain
• 1 month: Decrease knee pain
• 4 months: Lose 20 lbs.
• 1 year: Run the 10km. Sun Run Race
 a. Use the Cardiovascular Disease (CVD) Risk Factors and Defining Criteria Table below to identify
all your client’s modifiable and non-modifiable risk factors for cardiovascular disease. Explain to your
client which of their risk factors that are in their control.
MODIFIABLE:
Physical Inactivity
Body Mass Index (Obese)
Blood Pressure (Diastolic = 80)

NON-MODIFIABLE:
None

b. Calculate and interpret Body Mass Index (BMI; kg/m2), Waist to Hip Ratio (WHR) and % Body Fat
using the sum of skinfold method (%BF) (show your work).
• 1kg = 2.2 lbs; 1lb = .4535 kg; 1 inch = 2.54 cm; 1m = 100 cm

BMI = kg/m2 Waist to Hip Ratio = Sum of Skinfolds for % Body Fat
Waist measure/hip
measure Site 1 + Site 2 + Site 3 = Sum of
Skinfolds → then use Table to
determine % Body Fat

BMI = 90.7/2.9 = 31.3

Waist-Hip = 36/38 = 1.06
Body Fat % = 32 + 49 + 42 = 123

c. Identify your client’s health categories for BMI, WHR, and %BF using the tables at the end of this
case study.
Measurement Score Health Risk Category
Body Mass Index (BMI) 31.3 Kg/m2 Obese
Body Fat % (%BF) 34.5 % BF Obese
 Waist to Hip Ratio (WHR) 1.06 At risk

d. Using complete sentences, explain one advantage and one disadvantage of each measurement:
body mass index, body fat percentage using skinfold calipers, and waist to hip ratio. HINT: “Cheap”,
“Expensive/Inexpensive”, “Quick” are not acceptable answers.
Measurement Advantage Disadvantage
Body Mass Simple, Noninvasive, can be done by yourself Doesn’t account for muscle, only looks at height and
Index weight

Body Fat % The test is done in fatty spots of the body, so Requires someone skilled to do it
(using skinfold it is more accurate
calipers)
Waist to Hip Tests fat distribution Need someone skilled to complete it
Ratio

e. Calculate your client’s estimated target heart ranges for low (40%), moderate (60%), & high
intensity (80%) exercise using the Karvonen Method (show your work).
220 – 42 = 178 178 – 85 = 93
40% (Low) = 93 x .4 = 37.2 + 85 = 122.2
60% (Moderate) = 93 x .6 = 55.8 + 85 = 140.8
80% (High) = 93 x .8 = 74.4 + 85 = 159.4

f. In your own word and using complete sentences, explain to your client the general physical
activity guidelines for health.
For adults, it is recommended that they get at least 150 minutes of moderate-intensity exercise or at least
75 minutes of high-intensity exercise per week. You could do this by working out in the gym for 30
minutes a day, 5 days a week. You could also play rudgy for a total of 75 minutes per week or go on a
moderate intensity run 5 days a week for 30 minutes each day.
Use this table to answer question “a”.

** HDL ≥ 60 mg/dl negates another cardiovascular risk factor (ex. If HDL is 60, it could negate the age
risk factor for a female who is 55yo).

BMI