Individual Cardiovascular Program

 

A. Summary of client objectives/goals:

1. Client wants to begin a program that will increase his current level of physical activity to help reduce his likelihood of contracting colon cancer

2. He would like to incorporate a variety of enjoyable activities to keep from getting bored

3. These activities should increase general overall fitness

 

B. Summary of client safety and health concerns: Include the clients ACSM risk classification in line 1:

1. Moderate Risk classification

2. Currently sedentary

3. High blood pressure: 145/95

4. Administer Par-Q at initial consultation, no physician precertification exam required

 

 

NARRATIVE GUIDELINES FOR THE INITIAL 4 WEEKS

 

A. Explain the frequency – how many times per week your client will exercise and explain your rationale for this.

 

In order to achieve his goal of increasing overall fitness and decreasing health risks, ACSM recommends at least 30 minutes of moderate intensity cardiovascular exercise 5 days a week or equivalent to 150 minutes per week. For the first four weeks Client will train in the gym 3 days a week, with a rest day between each session, as he will not be able to tolerate the recommended frequency initially.

 

B. Explain the intensity – (% of maximum heart rate or target heart rate) of the warm-up, main workout and the cool-down and explain your rationale for these.

 

Since Client has been sedentary, he is likely deconditioned. Intensity will be measured relatively to his current level of fitness and maximal capacity using the BORG RPE scale of 1-20, and intermittently administered “talk test”. For the first 2 weeks, the main workout section should increase his heart rate to no more than 50-65% (93-121 BPM) of his Max HR (187 BPM)for the first two weeks. His Borg RPE should be 10-12, and able to talk but a little winded with “talk test”.

The warm up and cool down should be performed at 45-50% Max HR (84-93 BPM).

If tolerated, he will continue same level of intensity for weeks 3-4, but increase duration each week by 5 minutes.

 

 

C. Explain the time – how many minutes per exercise session the client will exercise and explain your rationale for this.

 

ACSM recommends at least 500-1000 MET minutes of cardiovascular exercise per week. Initially, Client, who is sedentary, may not be able to tolerate that quantity of exercise. In order to promote a positive exercise experience and likelihood of permanent adherence, he should ease in to the program starting with a duration appropriate to his fitness level. For an individual as young as Client, it is reasonable to prescribe 20 minutes of main cardio exercise for the first 2 weeks. If tolerated, weeks 3-4 he will increase main cardio session by 5 minutes each week, totaling 30 minutes. Once he is able to sustain 30 minutes of moderate intensity exercise, increasing the duration will improve cardiovascular endurance and tolerance. An increase of 5-10 minutes every 1-2 weeks is recommended to be a safe progression.

 

D. Explain the type of cardiovascular exercise the client will do (cycling, running, etc…). Also include any group fitness classes they will attend. Will it be the same the entire 4 weeks? Why or why not?

 

Initially, it would be most appropriate for Client, who is untrained, to perform exercises requiring little skill while incorporating large muscle groups in order to maintain moderate level of intensity throughout, and avoid frustration. He can begin with low resistance on the stationary bike and treadmill walking at the YMCA for the first two weeks. After 2 weeks of training, Client should be able to progress to activities requiring a little bit more skill like the elliptical and stair mill at the same levels of intensity, and possibly a water aerobics class for weeks 3-4.

 

E. Describe any other guidelines or considerations involved in the initial 4 weeks. This can include medical conditions, limitations, or additional types of training (e.g. stretching or strength training). PLEASE NOTE THAT IF YOU DISCUSS EITHER STRETCHING OR STRENGTH TRAINING, BE VERY BRIEF IN YOUR DESCRIPTIONS OF THESE ACTIVITIES. (For example, the client would stretch statically for 10 minutes after the cardiovascular session).

 

Client is concerned about his risk for colon cancer, although it is not considered a risk factor, as his father did not have any cardiovascular conditions. He works 40 hours a week, so he may have to do his workout before or after work. The program should be stimulating enough to motivate him to show up consistently.

 

He will warm up for 5-10 minutes with low to moderate intensity activity before each session. A 5 minute cool down, gradually decreasing to low intensity, will be performed immediately following each exercise session, followed by 5-10 minutes of static stretching of major muscle groups.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

F. Guidelines for client progression during the first 4 weeks:

 

1. Progression/changes in the frequency of exercise.

 

For the first four weeks Client will train in the gym 3 days a week, with at least one rest day between each day of exercise. His training days will be Monday, Wednesday, and Saturday. His resting days will be Tuesday, Thursday, Friday and Sunday.

 

2. Progression/changes in the intensity of exercise.

 

	Warm-up	Main Workout	Cool Down	Stretch
% Max HR (187 BPM)	45-50% (84-93 BPM)	50-65% (93-121 BPM)	45-50% (84-93 BPM)	resting
BORG scale 1-20	6-10	10-12	6-10

 

 

 

For the first 4 weeks continue same level of intensity

able to talk but a little winded with “talk test”.

 

3. Progression/changes in the time of each exercise session.

 

Week	Warm-up (minutes)	Main Workout (minutes)	Cool Down (minutes)	Stretch (minutes)
1	10	20	5	5
2	10	20	5	5
3	10	25	5	5
4	10	30	5	5

 

 

 

4. Progression/changes in the type of exercise performed.

 

Week	Number of Sessions	Type of exercise	Warm-up	Main Workout	Cool Down	Stretch
1	3	Recumbent bike, Treadmill walking	Easy pace, no resistance or incline	Moderate pace, light resistance no incline	Slower pace, no resistance or incline	Static, floor
2	3
3	3	Elliptical Stair Mill
4	3

 

 

 

 

 

 

 

5. What if any group fitness classes would you have your client participate in and how often would they attend these classes?

 

water aerobics

 

 

 

 

 

 

 

 

 

 

NARRATIVE GUIDELINES FOR WEEK 4 AND BEYOND

 

 

A. Explain the frequency – how many times per week your client will exercise and explain your rationale for this.

 

As he increases his exercise tolerance, he can expand his routine to include an additional day of exercise (4 days per week total) performed at home or on his own for the next four weeks. By week 6 he should be exercising enough to meet weekly MIE minutes recommendation.

 

B. Explain the intensity – (% of maximum heart rate or target heart rate) of the warm-up, main workout and the cool-down and explain your rationale for these.

 

By weeks 5, the main workout intensity will increase to 60-75% (112-140 BPM) or 12-14 RPE, with warm up/cool down at 50% Max HR (93 BPM). Increasing the duration of exercise allows his heart, lungs and muscles to adapt gradually at a maintainable level of intensity first before increasing the amount of exertion. Intensity can be increased by introducing interval training, resistance or higher level activities to program.

 

 

C. Explain the time – how many minutes per exercise session the client will exercise and explain your rationale for this.

 

If an additional day per week of exercise is added to his program, by week 6-8 he should be exercising for approximately 600-700 MET minutes. In weeks 5-8 his main workout session times will increase by 5 minutes per week from 35-50 minutes. This amount of time would help him achieve his goals of increasing fitness and decreasing health risks.

 

 

D. Explain the type of cardiovascular exercise the client will do (cycling, running, etc…). Include any group fitness classes they will attend. Will it be the same the entire 4 weeks? Why or why not?

 

In the next 4 weeks, Client can begin to exercise on his own an additional day of the week incorporating activities outside of the gym like walking, riding his bike or shooting hoops on the basketball court. He can also participate in low impact aerobics, step or cardio kickboxing classes with modifications. In order to keep him engaged he can begin to incorporate more enjoyable activities that will challenge him with slightly higher levels of skill and intensity like boxing routines (shuffles, punching and kicking a boxing bag if available at YMCA), swimming, and dribbling and shooting the soccer ball. In weeks 7-8, Client may be able to participate in a moderate level spin class, and possibly begin to play pick-up basketball games at the gym. Since the main goal is to keep him active, Client does not require any sport-specific training skills. Introducing him to a wide variety of activities will increase his overall enjoyment and adherence to continued healthy lifestyle changes.

 

 

 

 

 

 

 

 

 

 

E. Describe any other guidelines or considerations involved in the second 4 weeks. This can include medical conditions, limitations, or additional types of training (e.g. stretching or strength training). PLEASE NOTE THAT IF YOU DISCUSS EITHER STRETCHING OR STRENGTH TRAINING, BE VERY BRIEF IN YOUR DESCRIPTIONS OF THESE ACTIVITIES. (For example, the client would stretch statically for 10 minutes after the cardiovascular session).

 

He will warm up for 5-10 minutes with low to moderate intensity activity before each session. A 5 minute cool down, gradually decreasing to low intensity, will be performed immediately following each exercise session, followed by 5 minutes of various stretching of major muscle groups. He will add another day of exercise to his weekly routine, incorporating some of the activities he likes to do like biking and walking near his house, playing basketball, and group classes.

 

Guidelines for client progression during the second 4 weeks:

 

1. Progression/changes in the frequency of exercise.

 

During the next 4 weeks, Client will increase exercise frequency to 4 days a week with a day of rest between most exercise days. His exercise days will be Monday, Wednesday, Thursday and Saturday. His rest days will be Tuesday, Friday and Sunday.

 

2. Progression/changes in the intensity of exercise.

 

	Warm-up	Main Workout	Cool Down	Stretch
% Max HR (187 BPM)	50% (93 BPM).	60-75% (112-140 BPM)	50% (93 BPM).	resting
BORG scale 1-20	8-12	12-14	8-12

 

 

For weeks 5-8, same level of intensity

able to talk but a little winded with “talk test”.

 

4. Progression/changes in the time of each exercise session.

 

Week	Warm-up (minutes)	Main Workout (minutes)	Cool Down (minutes)	Stretch (minutes)
5	10	35	5	5
6	10	40	5	5
7	10	45	5	5
8	10	50	5	5

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5. Progression/changes in the type of exercise performed.

 

 

Week	Number of Sessions	Type of exercise	Warm-up	Main Workout	Cool Down	Stretch
5	4	Boxing, Outdoor cycling, Soccer dribbling and shooting, basketball	Easy to moderate pace, dynamic warm-ups	Moderate pace, light to mod. Resistance, more skill and coordination required	Slower to mod. pace, light resistance	Static, floor and standing, foam roller
6	4
7	4	Step routines, outdoor brisk walking, swimming, boxing,	Easy to moderate pace, dynamic warm-ups	Moderate pace, moderate resistance, introduce intervals	Slower to mod pace, with continued activity	Static, floor, standing, with movement, in pool, foam roller
8	4

 

 

 

 

 

5. What if any group fitness classes would you have your client participate in and how often would they attend these classes?

 

Moderate level spin class

Basketball pick-up games

Low impact aerobics

Cardio kickboxing

 

 

 

 

 

 

 

 

 

 

 

 

References:

 

American College of Sports Medicine. (2009). ACSM’s Guidelines for Exercise Testing and Prescription (9th Edition). Lippincott Williams & Wilkins. (ISBN:9780781769037)

 

Coburn, J. & Malek, M. (Eds.). (2012). NSCA’s Essentials of Personal Training – 2nd Edition. Champaign, IL: Human Kinetics. (ISBN 0-7360-8415-0)

 

https://sites.google.com/site/compendiumofphysicalactivities/Activity-Categories

 

 

 

 

 

 

 

 

EXW 218 – Cardiovascular

 

 

 

 

10

 

Individual Cardiovascular Program Week One

 

 

Day of the Week	Exercise	Frequency	Intensity	Time	Type
Monday	Recumbent bike     Floor stretches	2x/ week	Low 45-50% Moderate 50-65% Low 45-50% Low 45%-rest	10 min 20 min 5 min 5 min	Warm-up Main Session Cool down stretch
Tuesday	Rest day
Wednesday	Treadmill walking     Floor Stretches	1x/week	Low 45-50% Moderate 50-65% Low 45-50% Low 45%-rest	10 min 20 min 5 min 5 min	Warm-up Main Session Cool down stretch
Thursday	Rest day
Friday	Rest day
Saturday	Recumbent bike     Floor stretches	2x/ week	Low 45-50% Moderate 50-65% Low 45-50% Low 45%-rest	10 min 20 min 5 min 5 min	Warm-up Main Session Cool down stretch
Sunday	Rest day

 

 

 

 

 

 

 

Individual Cardiovascular Program Week Eight

 

 

Day of the Week	Exercise	Frequency	Intensity	Time	Type
Monday	Shuffle step boxing bag Air kicks Dynamic stretches	1x/ week	Low-mod 50% Moderate 60-75% Mod-Low 50% Low 45%-rest	10 min 50 min 5 min 5 min	Warm-up Main Session Cool down stretch
Tuesday	Rest day
Wednesday	Stationary bicycle spin class	1x/ week	Moderate intensity intervals 60-75% MHR	50 min	Group Class spin
Thursday	March/ high knee Box step combo Hip/arm circles Foam roll stretch		Low-mod 50% Moderate 60-75% Mod-Low 50% Low 45%-rest	10 min 50 min 5 min 5 min	Warm-up Main Session Cool down stretch
Friday	Rest day
Saturday	Water jog in place Swim alt. strokes Leg flutters Static stretches	1x/ week	Low-mod 50% Moderate 60-75% Mod-Low 50% Low 45%-rest	10 min 50 min 5 min 5 min	Warm-up Main Session Cool down stretch
Sunday	Rest day