Exercise Prescription for a Person - Assignment Example

EXERCISE PRESCRIPTION NEEDS ANALYSIS Case Study This is the case of a 32-year-old male weighing 80 kg, height 82 m. He has no history of any illness, and from the familial point of view, there is no significant history of any illness either. He is in a stressful job of sales spanning in the inner city involving considerable movement. However, currently, he leads mostly a sedentary life. His blood pressure has been recorded to be 140/95 mmHg, which is definitely in the hypertensive range. Thus, he demonstrates indication for future hypertensive heart disease (Jensen et al., 2000, 898-903). Although he is unaware of any injury or any other illness, this is a matter of concern, and this assignment explores the possibility of this risk modification through lifestyle measures such as exercise (Grandi, 2004, 617-625). Currently, he is not involved in any planned exercise. However, analyzing his lifestyles, few interesting facts emanate that can be utilized to plan the exercise that is needed for his health. His hobby includes meeting people, and he likes group activities. Therefore, he does not prefer exercising alone, and if offered, he would prefer exercising in a group. This cannot be a regular daily activity for him since he hardly has spare time during the day since he works long hours, sometimes until 8 pm. He gets an hour for lunch, and after works, he is too exhausted to do anything. In the weekends, he is free. He lives close to a gym; he can afford joining there, and he can drive himself to go there. He is a smoker, and this also aggravates his risk. The findings and goals have been tabulated below Current Status Desired Status (Goals) Action Prescribed Adherence Factors Body Composition: BMI 24.2 Client has normal BMI, but given his sedentary lifestyle and hypertension, exercise is indicated without any diet modification Increased activity in the form of exercise. No diet modification necessary. Abstinence from smoking. Client has no spare time. Only weekends are free. Does not like to exercise alone. Likes group activities. Currently sedentary. No current exercise programme. Drives. Although mentioned, given the nature of the drivers, perhaps would not walk and drive everywhere. At least 3 to 5 days of exercise every week including weekends. To start with moderate then going into regular exercise pattern of vigorous activities. To plan appropriate activities to lead to a target blood pressure of at least a diastolic blood pressure of below 90 mmHg. No time for activities on a normal work day. Does not like exercising alone. Free weekends may be utilized for exercising. A group exercise programme may be beneficial. The local gym may be the venue of his exercise with his affordability and driving being used for a regular exercise programme Smoking Abstinence from smoking To seek help from physicians who can help him quit. None known. Outdoor stressful life may make it difficult. High blood pressure Normal blood pressure with a diastolic below 90 mmHg Exercise and abstinence from smoking. Stress management. Stressful job till 8 pm in the night every day. Stress and meeting with people in the sales profession may be causative. Driving, group activities, and affordability may help an exercise programme. Analysis Hypertension is a well-known risk factor for CAD (Barrios et al., 2008, 400-404). Endothelial dysfunction occurs as a consequence of high blood pressure, probably mediated by reduction of NO, phenomenon that has been demonstrated in most forms of experimental hypertension models. High blood pressure (BP) is the most common risk factor for cardiovascular disease. A sedentary lifestyle is one of the risk factors for hypertension (Phillips et al., 2007, 229-230). Studies of the effect of physical activity on hypertension concluded that aerobic training does reduce BP. Physical fitness training has a graded influence on BP, from a small influence on normotensive people to a larger impact on those with hypertension (Chase et al., 2009). The respective decreases in systolic and diastolic pressures have been reported to be 3/3 mm Hg for normotensive people, 6/7 mm Hg for those with borderline hypertension, and 10/8 mm Hg for people with hypertension. Analyses of research data indicate that people who are physically active experience reduced cardiovascular and all-cause mortality rates (Centers for Disease Control and Prevention, 1993, 576-579). Physical activity is known to have a variety of metabolic and other effects that may partially explain its beneficial effects on BP (Hernelahti, Kujala, and Kaprio, 2004, 303-309). Physical activity may be associated with weight loss. It is suggested that each person perform a moderate amount of activity daily, with the amount of activity emphasized rather than the intensity (Parker et al., 2007, 703-709). The idea is that this offers people more opportunities for activities that fit into their daily lives. It is suggested that people perform this moderate amount of activity for 30 minutes or more on most, and preferably all, days of the week. These activities can take the form of brisk walking, yardwork or other household chores, jogging, or a wide variety of recreational activities. All children and adults should set a long-term goal to accumulate at least 30 minutes or more of moderate-intensity physical activity on most days of the week. Repeated intermittent or shorter bouts of activity spanning less than 10 minutes, including occupational, nonoccupational, or tasks of daily living, have similar cardiovascular and health benefits if performed at a level of moderate intensity (Hu et al., 2004, 25-30). These activities include brisk walking, cycling, swimming, home repair, and yardwork with an accumulated duration of at least 30 minutes per day. People who already meet these standards receive additional benefits from increasing this to more vigorous activity. For this subject, his profession involves quite a bit of activity, but mostly his lifestyle is sedentary. Since he likes group activity, he can be inducted in a programme involving a group in the nearby gym, where he can drive in and perform the activities at least 3 times a week (Stewart, 2002, 1622-1631). During the last few years, the philosophy on exercise recommendations as a means has changed significantly. It is now appreciated that substantial health benefits can be achieved through minimal amounts of regular exercise, regardless of whether exercise results in a measurable improvement in exercise capacity. Epidemiologic studies have shown that death rates from cardiovascular causes are considerably lower even among people who engage in modest amounts of exercise, less than the threshold that was generally thought necessary to increase exercise capacity (Hagberg, Park, and Brown, 2000, 193-206). Smoking and stress are two other problems in this subject. The person must be educated about the adverse effects of these two factors in order to demonstrate how eventually his lack of exercise may combine with smoking and stress to lead to established hypertension and then to hypertensive heart disease. Therefore the intervention in this person would include education, a group exercise programme specially in the weekends, abstinence from smoking, and techniques to alleviate stress (Greenwood et al., 1995, 583-587). Conclusion As demonstrated in this scenario, in this young hypertensive individual, the secondary prevention methods would be an exercise programme, health education, abstinence from smoking, and stress management. Reference Barrios, V., Escobar, C., Bertomeu, V., Murga, N., de Pablo, C., and Calderon, A., (2008). Risk factor control in the hypertensive patients with chronic ischemic heart disease attended in cardiologic outpatient clinics. The CINHTIA study. Rev Clin Esp; 208(8): 400-4. Centers for Disease Control and Prevention, (1993). Prevalence of sedentary lifestyle-behavioral risk factor surveillance system, United States: 1991. MMWR 42: 576-579. Chase, NL., Sui, X., Lee, D., and Blair, SN., (2009). The Association of Cardiorespiratory Fitness and Physical Activity With Incidence of Hypertension in Men. Am J Hypertens; . Grandi, AM., (2004). Hypertensive heart disease: effects of lifestyle modifications and antihypertensive drug treatment. Expert Rev Cardiovasc Ther; 2(4): 617-25. Greenwood, DC., Muir, KR., Packham, CJ., and Madeley, RJ., (1995). Stress, social support, and stopping smoking after myocardial infarction in England. J Epidemiol Community Health; 49: 583 - 587. Hagberg, JM., Park, JJ., and Brown, MD., (2000). The role of exercise training in the treatment of hypertension: an update. Sports Med; 30(3): 193-206. Hernelahti, M., Kujala, UM., and Kaprio, J., (2004). Stability and change of volume and intensity of physical activity as predictors of hypertension. Scand J Public Health; 32: 303 - 309. Hu, G., Barengo, NC., Tuomilehto, J., Lakka, TA., Nissinen, A., and Jousilahti, P., (2004). Relationship of Physical Activity and Body Mass Index to the Risk of Hypertension: A Prospective Study in Finland. Hypertension; 43: 25 - 30. Jensen, JS., Feldt-Rasmussen, B., Strandgaard, S., Schroll, M., and Borch-Johnsen, K., (2000). Arterial Hypertension, Microalbuminuria, and Risk of Ischemic Heart Disease. Hypertension; 35: 898 - 903. Parker, ED., Schmitz, KH., Jacobs, Jr, DR., Dengel, DR., and Schreiner, PJ., (2007). Physical Activity in Young Adults and Incident Hypertension Over 15 Years of Follow-Up: The CARDIA Study. Am J Public Health; 97: 703 - 709. Phillips, SA., Somberg, LB., Perme, A., Das, EK., and Gutterman, DD., (2007). Abstract 1140: Chronic Exercise Protects against Macro- and Micro- vascular Endothelial Dysfunction Induced by Acute Hypertension during Exertion. Circulation; 116: II_229 - II_230. Stewart, KJ., (2002). Exercise Training and the Cardiovascular Consequences of Type 2 Diabetes and Hypertension: Plausible Mechanisms for Improving Cardiovascular Health. 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