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Course Details: Manchester, Davy Hulme 14 – 18th September 2009 Lecturer: Gavin Loze
Exercise Referral Foundation Course
Assessment 2: Case Study Report
1. Summary of the client details
Peak Flow 400
BMD 2.5 SD Norm (vertebrae, Wrist)
TYPE 1 Osteoporosis
Smoking (10 per day) decided to stop
Low self efficacy
Low self esteem
2. Medical conditions
Blood pressure is the pressure the blood exerts on the artery walls. The pressure increases when the heart contracts and decreases as the heart relaxes. Systolic blood pressure (SBP) is the pressure exerted during the contraction phase of the heart where as diastolic blood pressure (DBP) is the pressure exerted when the heart relaxes. This pressure is recorded as SBP over DBP and is measured in millimetres of mercury Lawrence (2006). The British Hypertension Society has classified levels of BP as highlighted below in Table 1. As blood flows it has to overcome various variables including that of total peripheral resistance (TPR) which may include fatty deposits. Internal forces may stop the rate of flow and cause pressure to rise and over time without lifestyle changes and PA can ultimately lead to clotting and heart attack (MI)
HTN or high blood pressure (HBP) can be defined as “having a sustained blood pressure of 140/90mmHg or above”. The implications for having such a condition can be very serious. HBP if not controlled or ignored can lead to other issues such as the development of CHD. Individuals who have a BP > 160/95mmHg have up to a 300% higher incidence rate for developing such heart conditions when compared to someone with normal values (normotensives), Taylor et al, (1996). As the blood flows through the system under high pressure, blood forced can damage the artery walls, in particular the point at which blood flows around bends (the outer walls). Often referred to as the silent killer hypertension has no signs and symptoms but in cases of high readings individuals may experience visual problems, nose bleeds and dyspnoea. Many risk factors include age; body mass index (BMI), body fat % (BF) salt intake, alcohol, smoking, genetics, stress and lack of physical activity (PA).
The most effective exercise prescription usually consists of rhythmical continuous exercise that is low to moderate intensity (aerobic), thus having significant improvement upon the cardiovascular (CV) system (muscle pump/vascular and pulmonary function); in fact research suggests that this type of exercise can reduce SBP by up to 7mmHg. Wilkins (2006), moreover resistance exercise that is low into moderate intensity can also be adopted providing it is safe and effective for the individual.
Table 1 shows the classification of BP levels of the British HTN Society. My client’s BP prior to drug therapy was classified as Grade 2 at 165 SBP, and 95 DBP, to note even though her DBP was classified as Grade 1 HTN as highlighted below. The higher value in this particular case the SBP reading takes priority therefore classification is Grade 2. Drug therapy has lowered both SBP and DBP to 126 / 86 (seated) respectively which is well within the normal classification. This level is safe for exercise and hopefully long term as exercise is introduced BP can reduce further thus allowing the GP to reduce the dosage of medication.
|Table1: Classification of blood pressure levels | |Category |Systolic BP (mmHg) |Diastolic BP (mmHg)...