Individual Exercise Prescription Project Client Background

The client that we have chosen for this project is LL. He is 21 years old, male, with his

height being five foot and eight inches (68 inches) and a weight of 155 pounds (70.45

kilograms). His blood pressure was taken on two individual occurrences, the initial time his

blood pressure was 126/82 mmHg, and the second time it was 122/80 mmHg. He currently has a

body mass index of 23 kg/m2, and he is sedentary most of the time. He always walks across

campus to each of his classes and on weeks when the weather is good he will walk for about 30

minutes around campus. He does not have any pertinent family history regarding his parents or

any siblings. This presents a risk factor because he does not satisfy the ACSM requirements to be

considered physically active. In addition, he does not have knowledge of his cholesterol levels

which could be a risk factor. Overall, he does not indicate that he has any current signs and

symptoms that could potentially inhibit him from performing at a low, moderate, or vigorous

level of physical activity.

Our client has completed multiple aerobic exercise tests that we have calculated his

VO2max for each of the tests that were conducted. He completed the YMCA bike test, the

1-stage submaximal treadmill walk test, and the single-stage treadmill jog test. Each of these

tests was completed on different occasions for the most accurate results. His calculated Vo2max

for the YMCA test was 26.8 mL/kgm. The jog test showed a Vo2max of 42.9 mL/kgm. Lastly,

for the walk test, his Vo2max was 47.5 mL/kgm.

Additionally, he occasionally completes a routine of strength training as a form of

musculoskeletal exercise. The client explained that he does not perform musculoskeletal exercise

on a regular basis, and only partakes in this type of exercise when it fits into his schedule. This in

turn suggests that he does not have a musculoskeletal exercise routine that he completes on a
basis that is consistent with the ACSM guidelines for strength training. This is one of the things

that he hopes we will be able to assist with. We plan to give him a better idea of different

exercises that he can be doing in a gym setting.

In addition, our client has expressed some of his preferences and attitudes regarding his

exercise routine. He is available most of the day on Mondays, Wednesdays, and Fridays and

during the afternoons on the weekends. He is not available for exercise on Tuesdays and

Thursdays due to the amount of time he spends accomplishing assignments and being in classes

and work.

Lastly, our client does have some motivations for completing physical activity which

include overall improvement of health and wellness as an individual. Although, some barriers

that our client has are time constraints and little knowledge about overall fitness. Throughout our

time, we would like to help our client determine time management for setting time to work out

and improve his knowledge. Having a schedule of when he can complete physical activity can

help our client understand how much time he should be spending on physical activity to reach his

overall goals. From his exercise goals, we will be able to show him some of the different

exercises that he can accomplish that work with his goals of having a set training routine for

musculoskeletal exercises.
 Client’s Current Exercise History

Aerobic Exercise

Frequency Intensity Type Time Location

3d/week RPE = 9-10 Walking 30 minutes-45 Outdoors at

(Days vary, but minutes Seton Hill or on

typically M, W, a treadmill in

or F) McKenna

Resistance and Flexibility Exercises

Exercise Frequency Intensity Sets Reps Additional Info

Squats Occasionally, Bodyweight 3 8-10 Sometimes holds

when in position for 20
possible seconds

Pushups Occasionally, Bodyweight 2 15-20

when
possible

Bicep curls Occasionally, 15 lbs (each 3 8-10

when hand)
possible

Leg press Occasionally, 50 lbs 3 6-8 Single or double

when leg (if single,
possible weight decreases)
 Fitness Components (Specific to Client)

Fitness can be described using five major components. Each component is important for

each individual for their own reasons, whether that be related to fitness or activities of daily

living. The first component is muscular strength, which is the muscle’s ability to exert force or to

overcome resistance. Strength is important even for basic activities, such as walking - without

strength, this would be difficult and require a lot of extra effort. In terms of fitness, increasing

your muscular strength will help to grow your abilities by allowing you to lift heavier weights

and increase muscle mass. Muscular strength can also be important in your everyday life.

Increased strength can help with activities such as carrying heavy groceries (such as bags of cans

or a case of water). As a college student, you move in and out of dorm rooms often. The increase

in strength will help you to move heavy boxes more efficiently, making moving less strenuous.

Another component of fitness, also in the realm of musculoskeletal fitness, is muscular

endurance. Muscular endurance is the ability of the muscles to exert force for multiple

repetitions or for an extended period of time. Increasing your muscular endurance will allow you

to move weight for more repetitions. This along with your increased muscle strength will help to

grow your muscle mass - which will bring you closer to your desired fitness outcome. Muscular

endurance can also help improve the length of time you are able to run or walk. The skeletal

muscles in the legs will gain endurance through training. This component is also important in

activities of daily living. Endurance will help to improve quality of life by allowing you to

participate in activities for longer periods of time.

A third component of fitness is cardiovascular endurance. This simply means the ability

of the cardiovascular system (heart, vessels, and blood) and the respiratory system (lungs) to

deliver oxygen to the body and continue movement/exercise. In fitness, cardiovascular

endurance works alongside muscular endurance to prolong the amount of time your body can

continue exercise. Just as your leg muscles will gain endurance, your cardiovascular and

respiratory system will as well. This will make doing prolonged aerobic exercise (such as

running or walking) easier on your body. This component of fitness is important in your daily

life for multiple reasons. Living on a college campus means a lot of walking to get from class, to

your dorm, or even to the dining hall. Having an increased cardiorespiratory fitness means you

will not fatigue as quickly and will be able to perform these activities more efficiently.

Body composition is the next component of fitness. Having an increased body fat

percentage or high body mass index can cause a lot of underlying issues, such as cardiovascular

disease. Increased body fat can also make exercise more difficult. By improving the other

elements of fitness through training, body composition should improve alongside.

Flexibility, the last component of fitness, is the muscle’s ability to stretch. Flexibility is

important in fitness because it allows for greater range of motion while doing certain exercises,

especially in strength training or yoga. In your daily life, having greater flexibility can decrease

the risk of injury. When the muscle is more flexible, it is less likely to tear when there is an

extreme stretch.

Overall, every component of fitness will benefit you in both your fitness journey and

your general quality of life. Through training, the goal is to increase all components and

encourage you to continue to improve.

 Intended Outcomes and SMART Goals

1. Intended Outcome - Exercise More

a. The client expressed that he wanted to increase his weekly exercise volume for

health and mental health reasons. He prefers this is done through strength training

with light/minimal cardiorespiratory exercise.

b. Behavioral Goal: Use an aerobic machine at a comfortable resistance level/speed

(moderate intensity) for 3 days a week while doing lightweight resistance or

bodyweight exercises for the first week.

2. Intended Outcome - Eat Healthier

a. The client expressed wanting to eat healthier as his diet right now consists of a lot

of fried and processed foods. He also does not intake as much water and feels like

he is constantly “run down”. He asked if eating breakfast would make him feel

more energized during the day so that is being added to his goals.

b. Behavioral Goal: Eat some type of fruits and vegetables in 4 meals, lunch or

dinner, during the week. Eat breakfast, even if it is small, before starting your day

for a week. Increase water intake to 32 oz a day for a week.

 First Week of Exercise Prescription - Overview (Written to Professional)

The FITT prescribed for this program was based on the client's current exercise

experience as well as what they want to achieve in terms of health and fitness. The frequency

was chosen based on the client’s schedule. We worked to match his current exercise activity

although this was limited. The frequency for aerobic exercises is every session but for a short

amount of time. This was because our client expressed more interest in strength training.

However, we explained that aerobic activity still needed to be included. Since the client has

relatively low experience with exercise, he has never exercised at a high intensity. We decided to

increase the intensity to moderate (around 14 RPE) to allow him to adapt to higher intensity

movement than he is used to. Frequency, intensity, and time were all chosen to enhance the

achievement of the client’s intended outcomes.

The client had expressed that he wanted to increase his exercise volume for his own

health and mental health reasons. We decided to try to achieve this by incorporating different

types of cardiovascular fitness exercise into his program. In the initial interview, the client had

made a comment stating that he did not necessarily enjoy walking or running on the treadmill. To

increase the client’s autonomy, we made sure to include other types of aerobic exercises. These

included the rowing machine, the stationary bike, and the elliptical. We already had data on this

client using the stationary bike due to a previous VO2max test. During that test, the client

mentioned that he enjoyed biking. We hope that he will enjoy the other implemented aerobic

exercises as well. The intensity of all aerobic activity is monitored by the clients RPE, using the

BORG 6-20 scale, overall comfortability, and heart rate (at least for the first few sessions). We

also decided to incorporate more muscular fitness exercise because his previous exercise
program only included it occasionally. The client also claims to prefer muscular fitness over

cardiorespiratory fitness.

The first intended outcome, exercising more, will be met by having the client start to

incorporate different types of cardiorespiratory and muscular fitness exercises during his

prescribed program. Specifically, for cardiorespiratory exercise, the stationary bike, rowing

machine, and elliptical will be used. The intensity for these were chosen based on previous

testing conducted to determine an intensity of around 14 RPE. In terms of muscular fitness,

exercises such as squats, bicep curls, leg press are consistently used during sessions as the client

has done these before and feels comfortable with them. However, lat pull downs, triceps

extensions, crunches, and chest presses are added to challenge the client and make sure all major

muscle groups are being stimulated. The resistance for each muscular fitness exercise was

chosen based on previous data but also by having the client perform 3-5 repetitions with a base

weight. If this base weight was too heavy or too light, the resistance was increased/decreased by

2-5% until it was comfortable. Intensity for muscular fitness was monitored by client response.

The crunches, chest press, and lat pull downs were added to stimulate other muscle groups and

ensure a full-body workout. Most muscular fitness exercises are performed for 8 repetitions for

3-4 sets. An exception to this includes the crunches which are performed for 30 repetitions. To

help the client reach his goals, we increased the frequency of all training exercises to 3 days a

week to meet the ACSM guidelines. Adding more full-body (aerobic and muscular) exercises to

the client's current prescription will help increase their overall health and mental health by

reducing the risk of disease, strengthening bones and muscles, and boosting energy.

Since the client’s second intended outcome was eating healthier, the client was instructed

to add more fruits and vegetables to his diet. During the initial interview, he had mentioned that
he eats a lot of fried and processed foods. This change may be difficult for the client, so we

started small by suggesting he add a fruit or a vegetable to at least 4 meals a week, whether it is

lunch or dinner. Over time, this will be increased to every meal. By adding fruits and vegetables

into the client's diet, the risk of high blood pressure, heart disease, and high blood sugar

decreases. This also increases his overall mood. Our client also mentioned that he did not eat

breakfast. Therefore, his behavioral goal also included eating a small breakfast every morning.

Eating breakfast will allow the client to gain more energy in the morning that he claims he was

lacking previously. Finally, the last part of the behavioral goal for eating healthier is to increase

water intake to 32 ounces a day. Hydration is important for energy because a lack of fluid can

cause your heart to work harder to pump oxygen all throughout the body. This expended energy

can be what can cause the feeling of tiredness, sluggishness, and being less focused. Having the

client increase their water intake to 32 ounces per day will help increase their energy levels and

overall health.

All of the behavioral goals mentioned are for the course of one week. We intend to

continue the program and suggestions until the client feels comfortable maintaining a new

lifestyle. However, we believed it was best to start small and not overwhelm the client with loads

of new information.

Specifics of the Exercise Prescription (Written to Client)

Based on the SMART goals that you have set for yourself, we have put together an

exercise prescription for you to complete over the next few weeks. Along with your SMART

goals, there are FITT principles that are considered in exercise training. FITT is an acronym that

stands for frequency, intensity, type, and time. Intensity is how often you exercise, intensity is
how hard you exercise, time is how long each session lasts and what time of day you exercise,

and type is what activities you do and in what mode. All of these pieces are interconnected and

have to be considered as a whole for the entire principal to be assessed.

For your workout, we have allotted 50 minutes per session consisting of a 10-minute

warm-up, a 10-minute cool down, and a 30-minute conditioning session. During the warm-up for

the first day, you will first complete a five-minute walk on the treadmill at three percent grade

and at three miles per hour. Next, you will complete dynamic stretches, including walking

lunges, hamstring pulls, arm circles, and a walking quadriceps stretch. Walking lunges begin by

standing in an upright position and leaning forward into a lunge, switching legs between each

repetition for one minute. Hamstring pulls are a stretch for your hamstring, the muscles in the

back of your thighs, in which you will stand on one foot and pull your hamstring upward and

toward your chest and take a step to keep rotating between legs for one minute. Arm circles are

the next warm-up movement where you will put your arms straight out to your sides and move

your arms in a circular position. Begin with small circles and gradually increase the size to

loosen your muscles. Lastly is a quadriceps stretch in which you will stand on one leg and hold

your foot to where your calf is touching the back of your thigh and hold. Then, you should take a

step and do the same again, continuously switching legs.

Next is the conditioning phase of the exercise routine. You will begin with the rowing

machine. The intensity is moderate, so you should feel around a 14 on the RPE scale you have

seen in previous tests. Next is the leg press - here you will begin your first repetition at 50

pounds and complete three sets with eight repetitions each with a heavier weight each set if you

are comfortable. Continuing on, there are bicep curls, weighted squats, and chest press where

you will use 15 or 20 pounds for three sets of eight repetitions. During a bicep curl, you will be
holding a 15 pound dumbbell with your palm facing upward. Slowly curl the weight up by

bending your elbow, keeping your elbow close to your body. Then, slowly lower the weight to

the starting position. A weighted squat is where you stand with your feet shoulder-width apart,

bend into a squat until your knees are 90 degrees, then stand back up into a straight leg position.

During this, you will be holding the weight in front of you, with your elbows bent at 90 degrees.

For the chest press, you will lay on a bench, holding two dumbbells by extending your arms.

However, they should not be fully locked out. On an inhale, lower the dumbbells slightly wider

than your mid-chest, slowly and with control. Gently touch the dumbbells to your chest. On an

exhale, press your arms upwards, keeping your elbows slightly bent. Lastly is body weight

crunches where you will be laying on the ground with your knees bent. Try to bring your

shoulders toward your knees. Once your hands move forward about 12 inches, then you can lay

back down and repeat for 30 repetitions.

During the last portion of the workout, you will be completing a cool down to give your

muscles a recovery and allow your heart rate and blood pressure to decrease to a pre-exercise

level. First, you will be walking on the treadmill for five minutes at three miles per hour with no

grade. You will also be completing flexibility during your cool down that contains downward

dog, child's pose, cobra pose all for 30 to 45 seconds. Downward dog is a position that places

your heart above your head, allowing gravity to increase blood flow and improve your

circulation. Downward dog opens up the chest and shoulders, which can help straighten your

vertebrae and align your spine, leading to overall improved posture. The child's pose helps to

stretch your back and muscles around your hips. In this pose, kneel and sit back on your knees.

Lean forward, keeping your buttocks on your heels, and rest your forehead on the floor. Move

your arms so they're above your head, palms facing down. Cobra pose is a gentle backbend
practiced from a face-down position that strengthens the spine while opening the chest. To enter

the pose, lie down on your stomach with your legs stretched out behind and the tops of the feet

on the ground, then push up with your hands until your chest and the top of your abdomen has

left the floor.

For the following two days, you can complete the same warm up and cool down routine -

just the conditioning phase of the exercise will be changed. Instead of completing the rowing

machine, you will work on a stationary bike and elliptical for your cardio exercises. There will

also be slight variation in your resistance training - please see below. We will work together to

determine comfortable adjustments for your exercise if necessary.

Day 1/3
- Warm-up:
- 5-minute walk
- 3mph, 3% grade
- Dynamic Stretching
- Walking lunges (about 1 minute)
- Hamstring pulls (about 1 minute)
- Arm circles (about 1 minute)
- Walking quadricep stretch (about 1 minute)
- Conditioning:
- Rowing machine
- 10 minutes, aiming for 14 RPE
- Leg Press
- 50 lbs
- 8 repetitions for 4 sets
- Bicep curls
- 15 lbs
- 8-10 repetitions for 3 sets
- Weighted squats
- 15 lbs
- 8 repetitions for 3 sets
- Chest press
- 20 lbs
- 8 repetitions for 3 sets
- Crunches
 - Body weight, 30 repetitions
- Cool-down:
- 5-minute walk
- 3.0 mph, 0% grade
- Flexibility:
- Downward dog, child's pose, cobra pose
- Hold all for 30-45 seconds
Day 2/3
- Warm-up:
- 5-minute walk
- 3mph, 3% grade
- Dynamic Stretching
- Walking lunges (about 1 minute)
- Hamstring pulls (about 1 minute)
- Arm circles (about 1 minute)
- Walking quadricep stretch (about 1 minute)
- Conditioning:
- Stationary bike
- Comfortable resistance, aiming for 14 RPE
- 10 minutes
- Leg Press
- 50 lbs
- 8 repetitions for 4 sets
- Bicep curls
- 15 lbs
- 8-10 repetitions for 4 sets
- Weighted squats
- 15 lbs
- 8 repetitions for 3 sets
- Lat pull downs
- 20 lbs
- 8 repetitions for 3 sets
- Cool-down:
- 5-minute walk
- 3.0 mph, 0% grade
- Flexibility:
- Downward dog, child's pose, cobra pose
- Hold all for 30-45 seconds
Day 3/3
- Warm-up:
 - 5-minute walk
- 3mph, 3% grade
- Dynamic Stretching
- Walking lunges (about 1 minute)
- Hamstring pulls (about 1 minute)
- Arm circles (about 1 minute)
- Walking quadricep stretch (about 1 minute)
- Conditioning:
- Elliptical
- Comfortable resistance, aiming for 14 RPE
- 10 minutes
- Leg Press
- 50 lbs
- 8 repetitions for 4 sets
- Bicep curls
- 15 lbs
- 8-10 repetitions for 4 sets
- Weighted squats
- 15 lbs
- 8 repetitions for 3 sets
- Tricep extensions
- 30 lbs
- 8 repetitions, 3 sets
- Crunches
- Bodyweight, 30 repetitions
- Cool-down:
- 5-minute walk
- 3.0 mph, 0% grade
- Flexibility:
- Downward dog, child's pose, cobra pose
- Hold all for 30-45 seconds

Reflection
The exercise prescription that was written for our client was crafted to guide them to their

intended outcomes and behavioral goals. The goal that was focused on mainly in the prescription

was exercising more. However, outside of the program, the client was instructed to add

vegetables to meals, drink more water, and take time to have breakfast to magnify the effects of
the exercise prescription. After finishing one day of the exercise program, we discussed the

program and received feedback from the client about the program. The client feels that this

program is challenging him to be better and gain experience with exercise. Once he overcame the

initial anxiety of working out, he felt more confident in his ability to complete the program and

be successful in reaching his behavioral goals. Specifically, his favorite exercises from the first

day included leg press and bicep curls. In terms of warm up exercises and stretches, the client

enjoyed the walking quadricep stretch. At first, he was intimidated by the amount of new

exercises but did very well in overcoming this fear and producing an efficient movement.

We believe that this program will help the client to reach their goals. The program is

encouraging him to partake in more exercise, which also seems to be encouraging him to

continue to eat healthier. Our hope is that this program will have a high rate of success and

adherence. Other than a few struggles with proper form, the client performed very well in all

exercises and flexibility movements. Over the course of the program, we intend to work with

him to improve form and introduce new exercises that might have been intimidating before

beginning a consistent exercise regimen.

After the first day of training, the only exercise that seemed to cause significant issues

was the rowing machine. The client had issues with finding the proper technique for this. After

an explanation and demonstration, the client still seemed slightly discouraged. We hope that,

over time, with more technique, the client will be more comfortable with this exercise.

The first day of training went very well in terms of form, success, and the client’s overall

enjoyment. After analyzing his movements and attitudes towards the specific exercises, we

decided that some changes may be necessary to enhance the overall experience of the program.

The client struggled with form when using the rowing machine and was getting frustrated. After
speaking to him about it, we gave him the choice to eliminate the exercise entirely moving

forward or to decrease the length of time he would need to use it. The client decided that he still

wanted to try to perform the exercise correctly, with some extra guidance and demonstration. We

have decided to decrease the time of the rowing machine to 5 minutes. Eventually, further into

the program, it is our hope that the client will be able to increase the amount of time on the

rowing machine again.

The other change we have decided to make was to try the squats without a weight.

During this exercise, the client’s form was correct, but he seemed uncomfortable. After checking

in with him, he admitted that he would prefer to try this exercise without weight next time until

he is more comfortable with it. We want the client to have as much of an opinion as possible,

while still remaining safe. Because of this, we have decided to remove the dumbbells from this

exercise moving forward. When, and if, the client feels comfortable with body weight squats, we

will suggest adding a small weight and progressing from there.

All other exercises, including flexibility, cardiorespiratory, and resistance training,

seemed to be received well by the client. He made a few comments about which exercises he

enjoyed the most. There is already an exercise he feels able to increase the weight on - the leg

press. Moving forward, we will slowly increase the resistance on this machine.

We plan to meet with the client again after each session to ensure that he is feeling

comfortable and successful in the program.

This project taught us a lot about how all aspects of fitness are related. Although we had

been learning about writing prescriptions, choosing safe exercises and intensities, and

encouraging clients, this was the first time we had to sit down and put it all together. The client

we chose was basically starting from the beginning. At first we thought this would be more of a
challenge, but overall we actually found that it was easier to build a program from nothing.

Unfortunately, we were not actually able to walk our client through his program due to time

constraints. However, we let him read it and he agreed that this would be a program he would

enjoy and feel successful in. For the first time, we all feel like we took material from multiple

classes we have completed and used it to craft this exercise prescription.

This assignment also taught us how to work better as a team, specifically within the three

of us. The fact that there were so many different parts of the assignment caused us to rely heavily

on each other to ensure each part was completed on time. After we each wrote our part, we

proofread and made adjustments together.

Overall, this project showed us a deeper look into what our future careers might look like.

Although we all plan to go on separate career paths, there were many aspects of this assignment

that are relevant to our future careers. We were able to incorporate testing results from the lab to

better create the exercise prescription. In theory, we started with a new client, tested him to get

baseline information, then used it to write an individualized program. This is very similar to what

we will be doing in the future. The further we get into our classes, the more we get to do

hands-on activities, such as this, that prepare us for the “real world” that is coming up very soon.
 Professional Data Sheet

Day One

Warm-Up Exercise RPE Client Comments Professional

Comments

5 minute walk 11 “Good speed, Was able to keep

3mph, 3% incline is new” up and felt loose
after

Walking Lunges 8 Good form

Hamstring pulls 7 “Hard to get the Struggled with

form down” proper form at
first

Arm circles 6 Looked very

comfortable

Quadricep pulls 6 Really enjoyed Use this stretch

this stretch often for client
enjoyment

Conditioning Exercise RPE Client Comments Professional

Comments

Rowing, 16 New exercise, Struggled with

15 minutes, form was difficult, form and
aiming for was not a favorite continuing, got
RPE=14 aerobic exercise frustrated

Leg Press, 50lbs, 13 Really enjoyed Will keep

8 reps for 4 sets this, wants to implementing this,
increase weight increase weight

Bicep curls, 15lbs, 13 Feels stronger Start focusing on

8-10 reps for 3 with upper body lower body
sets than lower exercises as well

Weighted squat, 15 Prefers to try Struggled with

15 lbs, 8 reps for 4 without weight keeping back
sets straight

Crunches, 13 Good form

bodyweight, 25
reps for 2 sets
Cool Down Exercise RPE Client Comments Professional
Comment

5 minute walk, 10 Was nice to keep Should probably

3mph, 0% moving after walk a little
longer

Yoga - childs 7 Enjoys stretching Client looked very

pose, downward relaxed
dog, cobra pose