Case Study: Rose
For this discussion, assume the role of a non-physician who is trained in conducting clinical exercise testing. The following events happen on a sunny day in August: You receive a call from Jake, a personal trainer at XYZ Gym. Jake is with a client, Rose (age 26), who has decided to lose weight. She wants to start cardiorespiratory endurance training and take some group fitness classes at the gym. Rose’s goal is to work out five times per week for one hour each day to get in shape by December, as she is engaged to be married on New Year’s Eve. However, Rose has never exercised before; she has a BMI of 36 and has Type 2 Diabetes. She has a family history of cardiovascular disease. She has not seen a practitioner for 10 years, and therefore, no other health-related data is available. Jake does not feel comfortable administering an exercise test on Rose and is therefore referring the client to you. Rose does not feel she should be tested as she feels fine. She has expressed her readiness to exercise and lose some excess weight.
Given this scenario, address the following in your response:
- Analyze whether Rose should undergo clinical exercise testing. Support your decision with a clear rationale.
- Explain your role and duties to Rose, as well as your recommendation for or against clinical exercise testing. Be convincing in your explanation so that Rose fully understands your recommendations and rationale.
- Assess Rose’s potential risks and complications involved in exercising and/or exercise testing.
- Recommend a specific intensity and duration for daily exercise to Rose. State the rationale for your recommendation.
- Recommend two specific dietary changes which may aid Rose in losing weight.
Support your work with your course text and the Supervision of Exercise Testing by Nonphysicians article. You may utilize additional resources, as desired. Your initial posting must be at least 250 to 300 words in length.
Guided Response: Respond to two peers by Day 7. Each reply should entail a minimum of 100 words and encompass a comparison of your decisions and rationale. Compare and contrast your assessment of risks and complications, as well as recommendations for exercise and dietary changes to the work of your peers.
Replies
Thomas Lyons
Jun 10, 2021 at 5:39 PM
Analyze whether Rose should undergo clinical exercise testing. Support your decision with a clear rationale.
Rose should definitely consider undergoing clinical exercise testing, although she is fairly young and feels she is ready to lose weight through physical exercise. Rose has never exercised before and she wants to begin exercising five times a week for one hour each day which can risk injury or devastating health complications. Rose’s BMI of 36 is very high and she would be placed in the obese category with a BMI of 30 or greater. She also has a Type 2 Diabetes, a history of cardiovascular disease and has not seen a practitioner in 10 years so there may be more underlying health conditions to assess.
Explain your role and duties to Rose, as well as your recommendation for or against clinical exercise testing. Be convincing in your explanation so that Rose fully understands your recommendations and rationale.
Hi Rose,
I’m Thomas Lyons and I am not a physician, however I am trained in conducting clinical exercise testing and your physical trainer Jake has referred you to me. I completely understand you would like to begin exercising as soon as possible to begin your weight loss journey. However, with your diabetes, prior medical history and your current weight I highly recommend that we begin by conducting a clinical exercise test to further assess your capabilities, before clearing you to begin physical activity for five days a week. Physical exercise will be of great benefit to you, yet we do not want to put your health at risk. With this clinical exercise test, we will be able to monitor your physiological responses and produce an exercise regimen for you that will be most efficient and achievable. It is amazing that you are trying to better your overall health especially with a pending wedding, however we must take one step at a time to ensure your safety.
Assess Rose’s potential risks and complications involved in exercising and/or exercise testing.
Rose is already at risk due to her being overweight and a type 2 diabetic. No physical exercise or practitioner visits can also play a factor in any risks that can occur. These clinical exercise tests require effort and can complicate areas of health for any individual with diabetes with symptoms like low blood sugar, feelings of weakness or exhaustion. I would recommend that Rose closely manages her blood sugar levels every 15 minutes to make sure she is not approaching a level of hypoglycemia. If blood sugar drops between 55-69 mg/dL you should have 15 grams of carbs and recheck 15 minutes later. This is the 15-15 rule for low blood sugar. Repeat if you are still below your target range. (CDC, 2021).
Recommend a specific intensity and duration for daily exercise to Rose. State the rationale for your recommendation.
Rose should start her daily exercise after her clinical exercise tests by beginning light intensity physical activity for a maximum of 30 minutes a day. As Rose begins to show progress, intensity and duration of exercise can be subject to change, but for the time being, Rose should begin on the lighter end of the physical exercise spectrum. Activities like walking and household chores where movement is required can greatly benefit Rose at this moment.
Recommend two specific dietary changes which may aid Rose in losing weight.
For Rose’s current situation, living with type 2 diabetes and being overweight, nutrition is imperative. Sticking to a healthy nutrition plan can help manage her blood sugar levels, by consuming a well-balanced amount of carbohydrates, lean protein, fruits, vegetables and drinking water. If Rose is eating unhealthy junk foods and consuming too much sugar, she will be asked to remove these meals and drinks from her diet if she would like to see and feel the difference that a proper nutritional diet can achieve.
References
Centers for Disease Control and Prevention. (2021, March 25). How To Treat Low Blood Sugar (Hypoglycemia). Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/basics/low-blood-sugar-treatment.html.
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