Module 2 - case study EXW 420-
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Arizona State University *
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420
Subject
Health Science
Date
Feb 20, 2024
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Module 2 – Case Study (19 pts)
Mrs. Case Study-BH (Bone Health)
Instructions
Read the case of Mrs. Case Study-BH in chapter 21 of the Exercise Testing & Prescription Textbook. In addition to the info in text, assume that
o
Mrs. Case Study-BH has a relative upper body strength of 0.39
o
Mrs. Case Study-BH has a relative lower body strength of 0.87
o
Mrs. Case Study-BH’s unilateral grip strength is 15.5 kg
o
Mrs. Case Study-BH’s Timed Up and Go Test (3m distance) time is 12.2 sec
Read the rest of chapter 21 with special attention to Table 21.1
Read the exercise guidelines for people with osteoporosis in the ACSM GETP 11
th
ed., chapter 10.
Answer the following questions
1)
Classify Mrs. Case Study-BH’s resting blood pressure (1 pt)
2)
Assess Mrs. Case Study-BH’s current muscular fitness and fall risk by answering the following questions.
a.
What is the percentile ranking for her relative upper body strength? (1 pt)
b.
What is the percentile ranking for her relative lower body strength? (1 pt)
c.
What is the percentile ranking for her grip strength? (1 pt)
e. How would you interpret/classify her fall risk? (2 pt)
N/A
Mrs. Case Study’s relative upper body strength is in the 25
th
percentile, and is classified as poor. Her relative lower body strength is in the 20
th
percentile, and classified as well below average.
Mrs. Case Study’s hand grip strength is less than the 5
th
percentile. Her hand grip strength was 15.5 kg and the 5
th
percentile is 17 kg. So, she has low handgrip strength. d. How would you interpret/classify her Timed Up & Go Test time? (1 pt)
Mrs. Case Study is above the cut off score of 10 seconds for someone with osteoporosis. She is at an increased risk of falling due to her time being 12.2 seconds. Mrs. Case Study is at a high fall risk due to her very low handgrip strength and increased fall risk scoring on timed up and go test. Having a less than 16 kg handgrip strength places her at
an increased risk of falling. In addition, a low hand grip strength minimizes the ability to keep
oneself from falling.
3)
What kind of exercises, movements, and intensities should Mrs. Case Study-BH initially avoid? Come up with three examples. (3 pts)
4)
Come up with your own
1-week resistance and balance exercise program for Mr. Case-Study BP using the table below. This program should be designed to be effective in increasing the client’s bone mineral density and lowering the client’s risk of fractures and falls (
Hint:
If you feel like the
client would not yet be able to meet the exercise recommendations for osteoporosis, design the
program so as to get the client as close to the recommendations as possible). Every cell, except the blacked-out ones, has to be filled in. You have to show your work in the box below to receive credit. (9 pts)
Resistance Training
Frequency (days/wk)
Intensity*
Number of sets
Number of reps
1-3 days/wk
% of 1-RM: 40%-60%
1-2 sets for first couple of weeks 8-12 reps % of perceived intensity: 40%- 60%
List of main 4 upper body exercises. Explain any modifications to the exercises that would deviate from the way
they are traditionally executed.
Exercise #1: Seated bicep Curls -
Seated on a bench with proper back support. -
1-5 lb weight based on intensity Exercise #2: Stabilized Bent over Rows -
Place knee and hand opposite to working arm on a bench with the back forming a table top position.
-
Maintain core stabilization and flat back
-
Use light weight Exercise #3: Wall Pushups -
Slightly inclined against a wall she can start the exercise
-
As she progresses she can gradually increase the incline
Exercise #4: Shoulder Shrugs
1.
Toe Touches : due to full spinal flexion
2.
Crunches or Sit-ups : due to full spinal flexion
3.
Box Jumps: due to explosive high impact movement
Any exercises including spinal flexion should be avoided. She should avoid heavy lifting in spinal flexion positions. She should begin with body weight, partial range of motion, and supported movements. High explosive movements with an increased fall risk should be avoided and substituted with slower and more controlled low force movements.
-
Can be done in a seated position
-
Use light weight List of main 4 lower
body exercises. Explain any modifications to the exercises that would deviate from the way
they are traditionally executed.
Exercise #1: Side leg raises
-
Slow and controlled pace -
1-5 lb ankle weights -
Use a wall or bar to maintain balance Exercise #2: Sit to stands -
Slow and controlled movement -
Utilize a bar to help reduce fall risk when standing -
Utilize a chair that isn’t too deep or low, to reduce spinal flexion
Exercise #3: Step Ups
-
Done in a slow and controlled manner
-
Maintain neutral spine -
Utilize a spotter -
Low step up height difference Exercise #4: Hip Extensions -
Can be done with just body weight -
Lie in a supine position with proper back support -
Maintain a tucked pelvis and tight core through the movement -
Complete slowly and controlled *It is understood that a % of 1-RM would only apply to exercises where a (predicted) 1-RM is known. Otherwise, the % of perceived intensity applies (e.g. body weight exercises, resistance band exercises, dumbbell exercises etc.)
Balance Training
Frequency (days/wk)
Number of exercises per workout
Number of reps or duration for each exercise
2-4 days per week
2-3
10 reps or 30 seconds
List of main 4 balance exercises. Explain any modifications to the exercises that would deviate from the way they are traditionally executed (e.g., holding on, eyes open vs eyes closed, on solid ground vs foam pad, etc.).
Exercise #1: Single leg stands -
Switching between each leg -
Assist with something to hold onto while standing -
10 seconds per leg x3 with eyes open -
To increase intensity close eyes Exercise #2: Weight Shifts -
Standing hip distance apart, shift weight onto one foot and
lift the other foot onto the toes. -
Hold for 10 seconds on each leg x3
-
Monitor patient and provide a support in case balance is lost -
To increase intensity, stand on a foam pad Exercise #3: Bosu ball weight shifting
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-
Standing on a bosu ball shift the weight between each foot
almost like marching in place -
Provide some sort of bar to hold onto -
Head and eyes remain upright in neutral position looking away from the feet. Exercise #4: Swiss Ball sitting balance -
Sitting upright on a swiss ball
-
Raise one leg slightly off the floor for 5 seconds then switch to the other leg. -
Provide some sort of bar or assistance to prevent falls