Specialist Diploma in Sports and Exercise Science

SD-SES 02

Sports and Exercise Prescription

CA2

Program Design and Implementation

Name: Ginno Yong

NRIC: S7502987Z
Due date: 24th March 2010
Introduction

The client is an 18 year old student who does rock climbing actively. His goal is weight

loss, because he feels he is too heavy and that has affected his performance in rock

climbing.

Pre-exercise Test

The client’s Health History Questionnaire (Appendix B) indicates that he does not have

any past or present health problems or physical impairments. His family is also free from

health problems and therefore rules out the possibility of any hereditary health issues.

Considered together with his PAR-Q (Appendix A), the client is suitable for physical

activities without the prior need for a doctor’s assessment and approval.

His CVD Risk Stratification Questionnaire (Appendix C) however, categorizes the client

as having moderate risk level according to ACSM’s guidelines (Swain & Leutholtz,

2007). He has 2 risk factor as shown in Appendix C indicated by items with the “+” sign

in the last column. There is no information regarding the client’s cholesterol and fasting

glucose level and therefore left as non-contributing factors. The 2 risk factors are

smoking, and a BMI of 25.5 kg/m2. His BMI is considered of moderate risk if based on

the Asian’s recommendations (BMI Calculator, n.d.). Further body composition tests

using a body impedance analyzer indicates that his body fat percentage to be at 19.8%

which has exceeded the upper limit of 15% for adults who are physically active

(Heyward, 2006). This confirms that the client is overweight despite his stocky frame,

and justifies his weight loss goal.

During the client interview, it was further revealed that the client faces problems with the

standing broad jump station during his yearly NAPFA test. His NAPFA record is

retrieved (Appendix D-1) and compared to the NAPFA standards (Appendix D-2). The

client passes all stations except the standing broad jump. His excellent pass in the shuttle

run station reduces the possibility that his failure in standing broad jump is caused by a

genetic inadequacy of fast twitch muscles.

Goals

The client agreed to include an additional goal of improving his standing broad jump

results on top of his weight loss goal. The reasons for recommending an additional goal

were: firstly, the client has to serve national service and the standing broad jump is one of

the compulsory test stations in national service’s fitness test (IPPT). Secondly, standing

broad jump is an assessment of the muscular power of the legs (Hoffman, 2006).

Improving the client’s muscular power will help increase if not maintain his fat free mass

and therefore help to reduce his body fat percentage (Heyward, 2006).

Weight Loss

The exact amount of weight loss is calculated and detailed in the following table:

Weight Loss Calculation

Body Mass (kg) 64.5 Fat mass (kg) 1.94
% body fat 19.8 Fat free mass (kg) 62.56

Target % body fat 15

Target body mass (kg) = 64.5 * (1 - 0.198)/(1 - 0.15)
60.86
Target weight loss (kg) 3.64
The timeline for achieving this weight loss goal is set at between 4 and 7 weeks. ACSM

recommends that the rate of weight loss should be between approximately 0.5 to 0.9 kg

per week (Jakicic et al, 2001). Heyward (2006) recommends that weight loss should be

gradual. Therefore, based on the guidelines, the client should achieve his target weight in

about 4 to 7 weeks.

Standing Broad Jump

The client needs only 2cm more to pass in the NAPFA test. However a higher target of

performance grade “D” is set. For a “D” performance grade, the client needs to improve

his standing broad jump by 12cm or more. A resistance training program is prescribed to

achieve this goal.

Skeletal muscles of the lower body adapt to resistance training between 4 to 6 weeks

(Staron et al, 1994). However, the amount of improvements varies between individuals.

Therefore, a more conservative and less ambitious timeline of 12 week is set.

Goals Summary

Goal # Description Specifics Timeline (weeks)

1 Weight Loss 4 kg 4–7
2 Improve Standing Broad Jump 12 cm 12

Assessments

The client read and signed the Informed Consent Form for Physical Test (Appendix E)

before any physical assessment is conducted.

 Cardiovascular Fitness

Although there is no urgent need to improve the client’s cardiovascular fitness

considering he gets at least 30 min of physical activity most days of the week (based on

his CVD questionnaire, Appendix C) and achieved a performance grade of “D” for his

2.4km run-walk station in his NAPFA test (Appendix D), cardiovascular exercises will

nevertheless be prescribed in his weight loss program because the aerobics form of

exercise provides the best factors for maximizing caloric expenditure (Heyward, 2006).

Therefore there is a need to assess his cardiovascular fitness. Because of his moderate

risk level according to the CVD risk stratification, a submaximal test is administered to

determine his VO2max level (Heyward, 2006). The Bruce submaximal treadmill test is

selected because the client is familiar with the exercise (walking/running) he is required

to perform during the test.

The record of the client’s test can be found in appendix F-1. The following table is

created to calculate his VO2max:

 Bruce Submaximal Treadmill Test Calculation
yrs
Age 18

bpm
HR2 121
HR3 152

km/h m/min %
S2 4 66.67 G1 12 0.12
S3 5.5 91.67 G2 14 0.14

mL/(kg.min)
SM2 24.56772
SM3 35.76784

b 0.361294194

mL/(kg.min)
VO2max 53.83254968 METS 15.38073

The client’s cardiovascular fitness is in the “Excellent” range when compared against the

closest age group in the norms table produced by The Physical Fitness Specialist Manual

(Appendix F-2). This supports the earlier stand that improving his cardiovascular fitness

is not priority and any aerobics exercise prescribed should focused on enhancing weight

loss.

Legs Muscular Strength

The exercises selected for assessments are squats and calf-raises. The squat with barbell

exercise is selected because there is a strong correlation between 1-RM squat strength

and the performance of standing broad jump (Koch et al, 2003). The calf-raise with

barbell exercise is selected because the contributions to a standing broad jump propulsion

by the muscles moving the hip, knee, and ankle joints are 45.9%, 3.9%, and 50.2%

respectively (Robertson & Fleming, 1987). This shows that the calf muscle plays an
important part in the performance of standing broad jump since the calf muscles move the

ankle joints.

The submaximal muscle endurance test method is employed to estimate the client’s 1-

RM in squats and calf-raises. The submaximal muscle endurance test method is

employed because the client has little experience in both lifting exercises and may be

uncomfortable in performing the 1-RM maximal test, where he would be required to lift

very heavy loads (Heyward, 2006). The record of the client’s squat and calf-raise lifts

with barbell can be found in appendix G-1.

The Wathan formula is used to estimate the client’s 1-RM because it yields the most

accurate prediction for squats (LeSuer et al, 1997). His 1-RM for squats is predicted to be

approximately 87kg, whereas his calf-raises 92kg (1-RM Calculator, n.d.). Expressed as

1-RM to body mass ratio, the client scores 1.35 for squats and 1.43 for calf-raises.

The client’s 1-RM to body mass ratio for squats is considered poor when compared

against the closest age group in the norms table for relative squat strength shown in

appendix G-2 (Hoffman, 2006). No norms data could be found for calf-raise. Regardless,

the resistance program designed to improve the client’s standing broad jump results

comprises of both exercises.

Weight Loss Program

The most recommended weight loss program is based on the simple concept of caloric

intake vs. caloric expenditure (Heyward, 2006) and will therefore be employed for this

client. To calculate the client’s caloric intake, the client needs to keep a record of his food

consumption for the past 3 to 7 days (Heyward, 2006). To calculate his caloric

expenditure, it is necessary to estimate the activity level based on the activities the client

performs on a daily basis.

Caloric Intake

The client’s food intake record can be found in appendix H. Based on the record, the

client takes 4 meals a day and has quite a normal food selection with a slight aversion to

vegetables. He takes his meals on regular timing and does not skip meals. The only

problem is his habit of taking sandwiches with mayonnaise and cheese for supper.

Mayonnaise has very high fat content. In fact, 99% of its calorie comes from fat.

Using the data recorded by the client, his average caloric intake per day is calculated to

be approximately 2817 kcal (Energy and Nutrient Composition of Foods, n.d.; Nutrition

Data, n.d.).

Caloric Expenditure

There are many different formulas to calculate the daily caloric expenditure or TEE

(Total Energy Expenditure). Most of them require the estimation of the client’s PAL

(Physical Activity Level). The following table template (Gerrior et al, 2006) calculates an
 estimate of the client’s PAL and TEE by filling in the daily activities and their

corresponding METs values.

The client’s daily activities and their estimated durations are recorded through a client

interview. The METs value for each activity is referenced from Appendix E.4 in

Heyward (2006). Two TEE values were calculated: one for a day the client has rock

climbing training and another for a day that he does not. The average daily energy

expenditure of the client over 1 week is approximately (3334 * 3 + 2407 * 4)/7 = 2804

kcal.

Table. Template for Calculation of Estimated Energy Requirements

(Mon, Wed, Fri)

Age Weight Height BEE Duration
Man (y) (kg) (m) (kcal) Activity 1 (min) 2 METs ΔPAL 3 PAL PA TEE (kcal)
18 64.5 1.594 1604.842 Light activity while sitting 540 1.5 0.24265245242895
Walking, average pace 30 2.5 0.04044207540483
Rock climbing 120 11 1.07845534412867 2.46 1.54 3334.2703

(Tue, Thur, Sat, Sun)

Age Weight Height BEE Duration
Man (y) (kg) (m) (kcal) Activity 1 (min) 2 METs ΔPAL 3 PAL PA TEE (kcal)
18 64.5 1.594 1604.842 Light activity while sitting 540 1.5 0.24265245242895
Walking, average pace 30 2.5 0.04044207540483
Rock climbing 0 11 0.00000000000000 1.38 1 2406.722

BEE indicates basal energy expenditure; METs, metabolic equivalents; PAL, physical activity level; PA, physical activity coefficient; TEE, total energy expenditure.
1
Activity: activities performed in the past 24 hours
2
Duration: length of each activity performed
3
ΔPAL: physical activity impacts on energy expenditure

The PAL average over 1 week is estimated at ((2.46 * 3) + (1.38 *4)) / 7 = 1.84. This

PAL average is used in another TEE estimation formula provided by the Institute of

Medicine (Heyward, 2006) and yields a TEE of 2953 kcal per day. The table below is

created to calculate the TEE using the formula provided by the Institute of Medicine.
 TEE Calculation
Age (yr) 18
Ht (m) 1.59
Wt (kg) 64.5
PAL 1.8 PA 1.26
TEE (kcal/day) 2953.28
Institute of Medicine Formula (Heyward, 2006)

The TEE values estimated using the 2 formulas do not differ by much and therefore

acceptable to assume the average of these 2 values (2878 kcal) to be the client’s daily

TEE.

Energy Balance

The estimated TEE differs very little from the average daily caloric intake. Given that

these values are estimates, it is safe to regard that the client experiences energy balance

provided he engages in rock climbing activities 3 times a week. This implies that any

additional physical activities that the client performs will lead to a negative energy

balance, and consequently, to a loss of body weight.

 Training Log

Tuesday Thursday Saturday

Mode Running outdoors Running outdoors Running outdoors
(school) (school) (park)
Intensity Moderate Light Moderate
40-59% of VO2R 20-39% of VO2R 40-59% of VO2R
Target VO2 = Target VO2 = Target VO2 =
6.75-9.48 METs 3.88-6.61 METs 6.75-9.48 METs

Target HR = Target HR = Target HR =

125-149bpm 99-123bpm 125-149bpm

RPE = 13-16 RPE = 9-12 RPE = 13-16

Duration 40 to 60 min 51 to 100 min 40 to 60 min
Type LSD LSD LSD
Distance 6km 5km 6 km
Pace 6.75 METs: 3.88 METs: 6.75 METs:
6.75*3.5 = S * 0.2 + 3.5 3.88*3.5 = S * 0.2 + 3.5 6.75*3.5 = S * 0.2 + 3.5
S = 101 m.min-1 S = 50.4 m.min-1 S = 101 m.min-1
or 6 km.h-1 or 3 km.h-1 or 6 km.h-1
9.48 METs: 6.61 METs: 9.48 METs:
9.48*3.5 = S * 0.2 + 3.5 6.61*3.5 = S * 0.2 + 3.5 9.48*3.5 = S * 0.2 + 3.5
S = 148 m.min-1 S = 98.18 m.min-1 S = 148 m.min-1
or 8.9 km.h-1 or 5.9 km.h-1 or 8.9 km.h-1

6 to 8.9 km.h-1 3 to 5.9 km.h-1 6 to 8.9 km.h-1

Energy 6.75 METs: 3.88 METs: 6.75 METs:
consumed 6.75*wt*t 3.88*wt*t 6.75*wt*t
= 6.75*64.5*(60/60) = 3.88*64.5*(100/60) = 6.75*64.5*(60/60)
= 435 kcal = 417 kcal = 435 kcal
9.48 METs: 6.61 METs: 9.48 METs:
9.48*wt*t 6.61*wt*t 9.48*wt*t
= 9.48*64.5*(40/60) = 6.61*64.5*(51/60) = 9.48*64.5*(40/60)
= 408 kcal = 362 kcal = 408 kcal

Avg: 422 kcal Avg: 390 kcal Avg: 422 kcal

Target VO2 = 1MET + % of VO2R
VO2R = VO2max – 1MET
Target HR = RHR + % of HRR
HRR = 220 – age – RHR
VO2 = S * 0.2 + 3.5mL.kg-1.min-1, where S is speed in m.min-1, where a grade of 0% is assumed,
which is applicable if the route starts and ends at the same point.
1 MET = 1 kcal.kg-1.hr-1
wt – weight of the client in kg
t – duration of the exercise in hr

Type
Running is selected for the following reasons: firstly, the client is familiar with the

exercise. Secondly, the client already engages in rock climbing, which is primarily

anaerobic, for 3 days per week. The client will furthermore, participate in an additional

resistance program designed to improve his standing broad jump. Introducing aerobics

exercise will add variety into his weekly physical activities. Thirdly, aerobic exercise of

light to moderate intensities allows one to perform it for a long duration of time and as a

result, expend more energy to achieve a negative energy balance necessary for weight

loss (Heyward, 2006). And fourthly, the introduction of aerobic exercises will help

improve the client’s cardiovascular fitness.

Frequency

The frequency of exercise in this program is 3 days/week and does not seem to fulfill the

5 to 7 days/week frequency as recommended by ACSM’s standpoint for weight loss

(Jakicic et al, 2001). However, the client has rock climbing training on 3 other days

(Mon, Wed, Fri) of the week. If a higher frequency is prescribed, the client may

experience overtraining or affects his rock climbing performance.

Intensity

The translation of intensity classification to % VO2R is based on data from Pollock et al,

1998 (Heyward, 2006). Basically, light intensity translates to 20-39% VO2R whereas

moderate intensity translates to 40-59% VO2R.

RPE values are included in the training log to help the client estimate his HR during the

runs without a heart rate monitor, as the client does not own one. These RPE values are

derived by referencing the target HR values in the training log against the HR and

corresponding RPE the client experiences when performing the Bruce Submaximal

Treadmill test (appendix F-1).

Duration

Duration of each run is calculated based on the target VO2R level, which directly affects

the speed of the run, and the distance of the route. The distance of the route is determined

by a number of rounds around the school campus or a park near the client’s home. The

route starts and ends at the same point, which makes the effective grade of the route 0%.

Energy Expenditure

As this is a weight loss program training log, the estimated average energy expenditure

per session is also included in the training log to facilitate the calculation of energy

deficit and the timeline for the completion of this program. The total energy expenditure

per week attributed by this program is approximately 1234 kcal.

Diet

A weight loss program is more effective if suitable dieting is included (Heyward, 2006).

The supper component of bread with mayonnaise and cheese is removed from the client’s

diet, especially since mayonnaise is 99% fat. As a result, his average daily calorie
consumption reduces by 462 kcal (Nutrition Data, n.d.). Over a week, his calorie

consumption reduces by approximately 3234 kcal.

Mode Calorie Deficit (kcal/week) Remarks

Exercise 1234
Diet 3234 Deficit of 462 kcal/day
Total 4468 Weight loss of

~0.64 kg/week

Target weight loss (kg) 4

Required energy deficit (kcal) 4 * 2.2 * 3500 = 30800
Estimated timeline (weeks) 30800 / 4468 = ~7

As shown in the table above, the client should be able to achieve his target weight in 7

weeks by exercising according to the training log and revising his diet as recommended

above. This weight loss program follows the recommendation made by ACSM (Jakicic et

al, 2001), complying to the following points:

* Does not exceed 1000 kcal of energy deficit through diet.

* At least 1200 kcal of energy is consumed each day through diet.

* Weight loss is gradual of not more than 2lbs per week.

Evaluation

After the program is completed after 7 weeks, the client will be assessed again on his

body weight and body composition using the same tests mentioned above in the
Assessment section. If the target weight loss is achieved, the client will move on to the

weight loss maintenance phase.

However, if the target weight loss is not achieved, the client will be interviewed again to

find out if he has followed the training log and diet revision correctly, or if he has

encountered any problems in following the program. If there are no problems with these

factors, the whole process of assessment shall be repeated and another weight loss

program shall be customized and prescribed again to the client.

Weight Loss Maintenance

In order to correctly advise the client on maintaining his weight loss, his TEE needs to be

recalculated again because his body weight and fat free mass will now be different after

the loss of weight. Generally, the client can choose to reduce the frequency of the runs, or

resume taking supper but on healthier food choices, or a combination of both. The most

important factor is that energy balance must be met using his new TEE.

ACSM also recommends a weekly energy expenditure of 2000 kcal for effective weight

maintenance (Jakicic et al, 2001). However, the client meets this recommendation easily

even if he stops the running sessions altogether because of his regular engagement in rock
 Warm up and Cool down

The client is instructed on how to perform the warm up and cool down exercises before

and after a run. Warm up exercises consist of dynamic and light static stretches on the

muscles used during running. These include, and not restricted to, the calves, hamstrings,

quadriceps, gluteals, transversus abdominis and deltoids. Cool down exercises consist of

static stretches of the same muscle groups.

Standing Broad Jump

A resistance training that comprises of squat and calf-raise exercises with barbell is

employed to improve the lower body muscular strength and power of the client in order

to improve his standing broad jump results.

Training Log

The 12-week training log for squats is as follows:

Squats with barbell (FW) Frequency Twice / week

Tues and Thurs
Week 1RM (kg) Weight (kg) Reps Sets Rest Tempo
Period
1 87 80 (~ 90% 1-RM) 4 2 5 minutes 2:1:2

2 87 60 (~ 70% 1-RM) 8 3 3 minutes 2:1:2

3 87 74 (~ 85% 1-RM) 5 3 5 minutes 2:1:2

4 87 80 (~ 90% 1-RM) 4 2 5 minutes 2:1:2

5 87 74 (~ 85% 1-RM) 5 3 5 minutes 2:1:2

6 87 60 (~ 70% 1-RM) 8 3 3 minutes 2:1:2

7 87 74 (~ 85% 1-RM) 5 3 5 minutes 2:1:2

8 87 80 (~ 90% 1-RM) 4 2 5 minutes 2:1:2

9 87 60 (~ 70% 1-RM) 8 3 3 minutes 2:1:2

10 87 74 (~ 85% 1-RM) 5 3 5 minutes 2:1:2

11 87 60 (~ 70% 1-RM) 8 3 3 minutes 2:1:2

12 87 80 (~ 90% 1-RM) 4 2 5 minutes 2:1:2

The 12-week training log for calf-raises is as follows:

Calf-raises with barbell (FW) Frequency Twice / week

Tues and Thurs
Weeks 1RM (kg) Weight (kg) Reps Sets Rest Tempo
Period
1 92 74 (~ 80% 1-RM) 6 3 5 minutes 2:1:2

2 92 64 (~ 70% 1-RM) 8 3 3 minutes 2:1:2

3 92 80 (~ 85% 1-RM) 4 3 5 minutes 2:1:2

4 92 64 (~ 70% 1-RM) 8 3 3 minutes 2:1:2

5 92 80 (~ 85% 1-RM) 4 3 5 minutes 2:1:2

6 92 74 (~ 80% 1-RM) 6 3 5 minutes 2:1:2

7 92 80 (~ 85% 1-RM) 4 3 5 minutes 2:1:2

8 92 74 (~ 80% 1-RM) 6 3 5 minutes 2:1:2

9 92 64 (~ 70% 1-RM) 8 3 3 minutes 2:1:2

10 92 74 (~ 80% 1-RM) 6 3 5 minutes 2:1:2

11 92 80 (~ 85% 1-RM) 4 3 5 minutes 2:1:2

12 92 64 (~ 70% 1-RM) 8 3 3 minutes 2:1:2

Type
As mentioned earlier, the squat exercise is selected because there is a strong correlation

between 1-RM squat strength and the performance of standing broad jump (Koch et al,

2003). The calf-raise exercise is selected because calf muscles contribute the most during

the propulsion phase of standing broad jump (Robertson & Fleming, 1987). Applying the

principle of specificity, improving the muscular strength and power of these 2 muscle

groups will improve the client’s standing broad jump results.

The squat exercise is selected over seated leg extension because it is closed kinetic chain,

whereas the seated leg extension is open kinetic chain. Close kinetic chain exercises have

benefits over open kinetic chain ones in improving sports-specific or functional/multi-

joint movements (Closed kinetic chain exercises, n.d.). The calf-raise exercise is also

closed kinetic chain.

Free weights are preferred over machine weights as it provides the added advantage of

excising the minor stabilizer muscles which are required during standing broad jump and

most other sports (Heyward, 2006).

 Order

The squats should be done first before the calf-raises because the quadriceps is bigger

than the calf muscles. Moreover, the squats exercise is a multi-joint exercise, whereas the

calf-raise is primarily a single-joint one (Heyward, 2006).

Frequency

The frequency of exercise is twice a week as recommended by Heyward (2006) for the

optimization of strength gain. At least 48hrs of rest between workouts is recommended to

prevent injury from overtraining. The exercises are therefore scheduled on Tuesdays and

Thursdays. Furthermore, they are rest days in the client’s rock climbing schedule

therefore ensuring there will be no clashes between the 2 training schedules. Tuesdays

and Thursdays are also school days, meaning he will have access to the school’s gym

where he can perform these exercises.

Intensity

Since the standing broad jump is an assessment of muscular power (Hoffman, 2006), the

program work on the power improvement of the involved muscles. Heyward (2006)

recommends resistance intensities of over 80% 1-RM for power gains. Of the 3

microcycles prescribed for both exercises in this program, two of them have intensities

above 80% 1-RM. The third microcycle has a lower resistance intensity of 70% 1-RM to

provide some rest to the worked muscles and to reduce the risk of injury.
In fact, the training program employs the undulating periodization model to maximize

response of the neuromuscular system (in this case, strength and power gains) and to

minimize overtraining and injury (Heyward, 2006). The undulating periodization model

is selected over other preriodization models because it is found to be superior in

developing strength gains in young men who train under duration and frequency similar

to this training program (Heyward, 2006).

Volume

The volume varies in inverse correlation with the resistance intensities following

periodization principles. Lower volume is prescribed for higher intensity and vice-versa.

Data from Baechle, Earle and Wathen (2000) is used to provide some gauge on the

absolute number of reps that can be prescribed to each of the microcycle intensities since

they are all above 75% 1-RM in this training program. However, the volume still needs to

be adjusted according to the client’s ability to perform the exercises in correct form and

posture. For example, only 2 sets are prescribed for squats using intensity of 80 kg as it is

very close to the client’s 1-RM limit (~90%).

The number of reps prescribed also follows recommendations by Heyward (2006). In

general, 3-6 reps for sets devised for power gains, and 8-12 reps for sets devised for

strength gains.
 Rest Period

The rest period between sets lasts 5 minutes for sets of intensities above 80% 1-RM, 3

minutes for sets of intensities 70% 1-RM. Longer rests are required for heavier intensities

to avoid muscle injuries (Heyward, 2006).

Progression

Upon the completion of the above 12-week program, the client is assessed again on his

standing broad jump. If the goal of “D” performance grade is achieved, the client can

move on to the maintenance phase. If the goal is not achieved but improvement is

witnessed, the client will be assessed on his squat and calf-raise 1-RM again. Using the

new 1-RM values, which should be better than the previous ones, a new 12-week training

log will be devised. The absolute intensities of each microcycle in the new training log

should be higher, but the other factors (periodization, frequency, etc) will be kept the

same, with minor adjustments to volume if necessary.

Maintenance

Based on the reversibility principle, the client may lose the muscular improvements if

detraining is experienced. If the client stays physically active and participates regularly in

sports or games that require jumping or sprinting, it should take a long time for detraining

to occur. If detraining does occur, the client will just need to devise a new training

program following the same principles described above. However, faster improvements

would be expected because of the muscle memory principle (Muscle Memory, n.d.).
 Warm up and Cool down

The client is instructed on how to perform the warm up and cool down exercises before

and after performing the resistance exercises. Warm up exercises consist of dynamic

stretches of the muscles involved in the resistance exercise. It is important to move the

joints involved through their full range of movements. A set or two of the same resistance

exercise with zero intensity is recommended. Cool down exercises consist of static

stretches of the same muscle groups.

Conclusion

The client is prescribed an exercise program designed to achieve weight loss and another

to improve his standing broad jump performance. Both programs are devised such that

they can fit into his existing schedules with as little clashes as possible. For the weight

loss program, running at low to moderate intensities is selected to maximize his energy

expenditure on days that the client does not have rock climbing training. His diet is also

adjusted as effective weight loss programs consist of both dieting and exercise

components.

As for the resistance program, multi-joint and closed kinetic chain exercises using free

weights are employed. The focus is on power and strength gain as standing broad jump is

an assessment of power. Periodization is employed to optimize his improvements and to

reduce the likelihood of injuries. However, periodization makes the training program

complicated. Therefore the training log is important and the client should adhere closely

to its schedule.
Educating the client on the purpose and principles behind the training programs is

important so that the client can understand better the need to adhere to the training logs

and not to modify the logs himself. Educating the client on the importance of warm-up

and cool-down exercise will also help him to reduce the likelihood of injuries.

On the whole, devising an effective exercise prescription can be a complex process that

requires meticulous calculations and considerations on a large variety of factors. The

trainer should consult a physician or nutritionist if he/she has any doubts, if the case is

complex, or if the client does not meet the risk stratification/health history requirements.

(Word count: 4103)

References

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Koch, A.J., O'Bryant, H.S., Stone, M.E., Sanborn, K., Proulx, C., Hruby, J.,
Shannonhouse, E., Boros, R., Stone, M.H. (2003). Effect of warm-up on the standing
broad jump in trained and untrained men and women. J Strength Cond Res., 17(4):710-4.

LeSuer, D.A., McCormick, J.H., Mayhew, J.L., Wasserstein, R.L., Arnold, M.D. (1997).
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http://www.knowyourbmi.sg/keephealthybmi.aspx

Jakicic, J.M., Clark, K., Coleman, E., Donnelly, J.E., Foreyt, J., Melanson, E., Volek, J.,
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33, No. 12, 2001, pp. 2145–2156.

Staron, R.S., Karapondo, D.L., Kraemer, W.J., Fry, A.C., Gordon, S.E., Falkel, J.E.,
Hagerman, F.C., Hikida, R.S. (1994). Skeletal muscle adaptations during early phase of
heavy-resistance training in men and women. Journal of Applied Physiology, Vol 76,
Issue 3 1247-1255

Hoffman, J. (2006). Norms for fitness, performance, and health. Human Kinetics: USA

Gerrior, S., Juan, W.Y., Peter, B. (2006). An Easy Approach to Calculating Estimated
Energy Requirements. Prev Chronic Dis. 3(4): A129. Retrieved from:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1784117/

Muscle Memory. (n.d.) Retrieved March 23, 2010 from

http://en.wikipedia.org/wiki/Muscle_memory

Closed kinetic chain exercises (n.d.) Retrieved March 23, 2010 from
http://en.wikipedia.org/wiki/Closed_kinetic_chain_exercises

Heyward, V.H. (2006). Advanced fitness assessment and exercise prescription. USA:
Human Kinetics
1-RM Calculator. (n.d.) Retreived March 23, 2010 from
http://www.shapesense.com/fitness-exercise/calculators/1rm-calculator.aspx
 Appendix A (PAR-Q)

PAR-Q &
Physical Activity Readiness
Questionnaire - PAR-Q
(revised 2002)

(A Questionnaire for People Aged 15 to 69)

Regular physical activity is fun and healthy, and increasingly more people are starting to become more active every day.
Being more active is very safe for most people. However, some people should check with their doctor before they start
becoming much more physically active.
If you are planning to become much more physically active than you are now, start by answering the seven questions in
the box below. If you are between the ages of 15 and 69, the PAR-Q will tell you if you should check with your doctor before
you start.
YES NOIf you are over 69 years of age, and you are not used to being very active, check with your doctor.

  1. Has your doctor ever said that you have a heart condition and that you
should only do physical activity recommended by a doctor?
  2. Do you feel pain in your chest when you do physical activity?
  3. In the past month, have you had chest pain when you were not

doing physical activity? Do you lose your balance because of

 
dizziness or do you ever lose consciousness?

4. Do you have a bone or joint problem (for example, back, knee or hip) that
 
could be made worse by a change in your physical activity?

  5.
Is your doctor currently prescribing drugs (for example, water pills) for your
blood pressure or heart condition?
NO to all questions DELAY BECOMING MUCH MORE ACTIVE:
• if you are not feeling well because of a temporary illness such as a
If you answered NO honestly to all PAR-Q questions, you can be reasonably sure that you can: cold or a fever wait until you feel better; or
• if you are or may be pregnant talk to your doctor before you
• start becoming much more physically active begin slowly and build up gradually. This is the
start becoming more active.
safest and easiest way to go.
• take part in a fitness appraisal – this is an excellent way to determine your basic fitness so that
you can plan the best way for you to live actively. It is also highly recommended that you have PLEASE NOTE: If your health changes so that you then answer YES to
your blood pressure evaluated. If your reading is over 144/94, talk with your doctor before you any of the above questions, tell your fitness or health professional.
start becoming much more physically active. Ask whether you should change your physical activity plan.

Informed Use of the PAR-Q: The Canadian Society for Exercise Physiology, Health Canada, and their agents assume no liability for persons who
undertake physical activity, and if in doubt after completing this questionnaire, consult your doctor prior to physical activity.

No changes permitted. You are encouraged to photocopy the PAR-Q but only if you use the entire
form.
NOTE: If the PAR-Q is being given to a person before he or she participates in a physical activity program or a fitness appraisal, this section may
be used for legal or administrative purposes.
"I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction."

NAME: Adib Noor

SIGNATURE: DATE: 23rd Feb 2010

SIGNATURE OF PARENT or WITNESS: _________________________________________

GUARDIAN (for participants under
the age of majority):

.. .
, Note: This physical activity clearance is valid for a maximum of 12 months from the date it is
completed and becomes invalid if your condition changes so that you would answer YES to any of
the seven questions.
 Appendix B (Health History Questionnaire)

Date: 23 / 2 / 2010
HEALTH HISTORY QUESTIONNAIRE
All questions contained in this questionnaire are strictly confidential and will become part of your medical record.

Name: Adib Noor DOB: 12th Feb 1992

MF
ILLNESSES (Check all that apply)

Have you ever been diagnosed with any of the following illness or medical problems? If yes, include approximate date or year.

□ High Blood Pressure Date/Yr: □ Asthma/Bronchitis Date/Yr:

□ Coronary Artery Disease Date/Yr: □ Emphysema Date/Yr:
□ Heart Attack Date/Yr: □ Multiple Sclerosis Date/Yr:
□ Angina Date/Yr: □ Parkinson's Disease Date/Yr:
□ Heart Failure Date/Yr: □ Alzheimer's Disease Date/Yr:
□ Mitral Valve Prolapse Date/Yr: □ Multiple Sclerosis Date/Yr:
□ Heart Attack Date/Yr: □ Seizures Date/Yr:
□ Angina Date/Yr: □ Thyroid Disease Date/Yr:
□ Cerebrovascular Accident (Stroke) Date/Yr: □ Diabetes Date/Yr:
□ Diverticulosis/Diverticulitis Date/Yr: □ Hiatal Hernia Date/Yr:
□ Gout Date/Yr: □ Glaucoma Date/Yr:
□ Depression Date/Yr: □ HIV/AIDS Date/Yr:
□ Cardiac Arrhythmia Date/Yr: □ Transient Ischemic Attack (TIA) Date/Yr:
□ Heart Murmur Date/Yr: □ Deep Venous Thrombosis Date/Yr:
□ Abdominal Aortic Aneurysm Date/Yr: □ Genital Herpes Date/Yr:
□ Pulmonary Tuberculosis Date/Yr: □ Hepatitis Date/Yr:
□ Genital Condyloma Date/Yr: □ Cholelithiasis Date/Yr:
□ Padget's Disease Date/Yr: □ Ulcerative Colitis Date/Yr:
□ Anemia Date/Yr: □ Osteoarthritis Date/Yr:
□ Leukemia Date/Yr: □ Colon Cancer Date/Yr:
□ Cervical Cancer Date/Yr: □ Cystocele/Rectocele Date/Yr:
□ Ovarian Cancer Date/Yr: □ Hodgkin's Disease Date/Yr:
□ Breast Cancer Date/Yr: □ Malignant Lymphoma Date/Yr:
□ Bladder Cancer Date/Yr: □ Lung Cancer Date/Yr:
□ Prostate Cancer Date/Yr: □ Kidney Cancer Date/Yr:
□ Testis Cancer Date/Yr: □ Penile Cancer Date/Yr:
□ Kidney Stones Date/Yr: □ Erectile Dysfunction (ED) Date/Yr:
□ Urinary Incontinence Date/Yr: □ Urinary Tract Infection Date/Yr:
□ Prostate Enlargement (BPH) Date/Yr: □ Prostatitis Date/Yr:
□ Other
OPERATIONS
Please list all surgeries including approximate date or year.
Surgery Diagnosis Date/Yr.

MEDICATIONS
Please list your prescribed drugs and over-the-counter drugs, such as vitamins and nutritional supplement including
approximate start date.
Name of Drug Strength Frequency Taken Start Date/Yr.

ALLERGIES
Please list all drug allergies including type of reaction.
Drug Type Reaction

PERSONAL HISTORY AND HEALTH HABITS

Marital Status □ Married  Single □ Divorced □ Separated □ Widow
Religion Muslim
Occupation Student
Physical Activity □ Non-Ambulatory □ Limited-Mobility □ Inactive □ Walking
□ Running □ Swimming □ Aerobic Training  Strength
Training
 Recreational Activities □ Other
Dietary  Regular □ Diabetic □ Weight Reduction
□ Low Fat □ Renal Failure □ Weight Gain
□ Vegetarian □ Gluten Free □ Lactose Free
□ Other
Alcohol  None
□ Beer No. of drinks / week: Duration in yrs: Date discontinued:
□ Wine
□ Liquor
Tobacco □ None
 Cigarette No. of packs / day: 0.5 Duration in yrs: 1 Date discontinued: Dec 2009
□ Cigar No. / day: Duration in yrs: Date discontinued:
□ Pipe No. / day: Duration in yrs: Date discontinued:
□ Chew No. / day: Duration in yrs: Date discontinued:
□ Snuff No. / day: Duration in yrs: Date discontinued:
Drugs  None
□ Marijuana No. / day: Duration in yrs: Date discontinued:
□ Cocaine No. / day: Duration in yrs: Date discontinued:
□ Others No. / day: Duration in yrs: Date discontinued:
FAMILY HEALTH HISTORY
 No history of family disease
Relative Illness

REVIEW OF SYSTEMS
General □ Anorexia □ Chills □ Fatigue □ Fever
□ Malaise □ Sweats □ Weight Loss

Eyes □ Blurred Vision □ Eye Discharge □ Double Vision □ Vision Loss

□ Eye Pain □ Eye Irritation

Ear, Nose, Throat □ Decreased Hearing □ Hoarseness □ Ringing in Ears □ Pain with Swallowing
□ Ear Pain □ Nose Bleeds
Cardiovascular □ Chest Pain □ Palpitations □ Peripheral Edema

Respiratory □ Cough □ Shortness of Breath □ Wheezing □ Bloody Sputum

Gastrointestinal □ Abdominal Pain □ Diarrhea □ Nausea □ Constipation

□ Vomiting □ Tarry Stools □ Bloody Stools
Genitourinary □ Painful Urination □ Difficulty Voiding □ Blood in Urine
□ Urinary Incontinence □ Sexual Dysfunction
Musculoskeletal □ Back Pain □ Joint Pain □ Joint Swelling
□ Muscle Weakness
Skin □ Dryness □ Itching □ Rash
□ Suspicious Lesion
Neurological □ Dizziness □ Weakness □ Tremors
□ Seizures
Psychiatric □ Depression □ Anxiety □ Memory Loss
□ Hallucinations
Endocrine □ Cold Intolerance □ Heat Intolerance □ Increased Thirst
□ Weight Change
Hematologic and □ Abnormal Bruising □ Easy Bleeding □ Enlarged Lymph
Lymphatic Nodes
Allergic and Immunologic □ Hay Fever □ Itching □ HIV Exposure

CERTIFICATION
The above information is true to the best of my knowledge.

Patient/Legal Guardian/Authorized Person (Signature) Date of Signature

 Appendix C (CVD Risk Stratification Questionnaire)

CVD Risk Stratificaition Questionnaire

Name: Adib Noor Sex: M Date: 23/02/2010
Question Ans Remarks Risk
Factor
1 Have any of your parents, brothers, or sisters had a heart attack, N
bypass surger, angioplasty, or cardiac sudden death?
How old was your relative at the time?
+
2 Have you smoke cigarettes in the past 6 months? Y
3 What is your usual blood pressure? 121/ 70

Do you take blood pressure medication? N

4 What is your LDL cholesterol level?
If you don't know your LOL level, what is your total cholesterol
level?
What is your HDL cholesterol level?

5 What is your fasting glucose?

6 What your height?

159.4
What is your weight? BMI = +
64.5 25.5kg/m2
7 What is your Resting Heart Rate?” 73
8 Do you get at least 30 mins of moderate physical activity most
days of the week? Y
9 Do you ever have pain or discomfort in your chest or surrounding N
areas?
10 Do you ever feel faint or dizzy (other than when sitting up rapidly)? N
11 Do you find it difficult to breathe when you are lying down or N
sleeping?
12 Do your ankles ever become swollen (other than after a long N
period of standing)?
13 Do you ever have heart palpitations or an unusual period of rapid N
heart rate?
14 Do you ever experience painful burring or cramping in the muscles N
of your legs?
Has a physician ever said that you have heart murmur? N
15 If so, has he or she said it was safe for you to exercise?
16 Do you feel unusually fatigued or find it difficult to breathe with N
usual activities?
How old are you? 18
17
18
Do you have any of the following diseases: heart disease, N
peripheral arterial disease, cerebrovascular disease, chronic
obstructive pulmonary disease, asthma, interstitial lung disease,
cystic fibrosis, diabetes, thyroid disorder, renal disease, or liver
disease?
19 Do you have any bone or joint problems, such as arthritis or a past N
injury that might get worse with exercise?
20 Do you have a cold or flu, or any other infection? N
21 Are you pregnant? N
22 Do you have any other problem that might make it difficult for you N
to do strenuous exercise?
If the answer is yes, what are these problems?
Appendix D-1 (NAPFA Test Results)

Adib Noor’s NAPFA Results in 2010

Station Results Grade
Sit-ups 40 B
Standing Broad Jump (cm) 210 Fail
Sit and Reach (cm) 38 C
Pull-ups 10 B
Shuttle Run (sec) 9.98 A
2.4km Run-Walk (min:sec) 12:20 D

Appendix D-2 (NAPFA Standards)

NAPFA Standards

Retrieved from http://acsbr.net/cos/o.x?c=/wbn/pagetree&func=view&rid=10278, 2006

Appendix E (Informed Consent Form)
Appendix F-1 (CRF Assessment)
Appendix F-2 (CRF Norms Table)
Appendix G-1 (Strength Assessment)

Squats with barbell Est. 1-RM: 70kg

Weight (kg) Weight (% of est. 1-RM) No. of Reps
Warm up-1 30 40 10
Warm up-2 50 70 10
Test-1 70 100 7
Test-2
Test-3
1-RM = 87kg (Wathan formula)
1-RM to Body Mass ratio: 1.35

Calf-raises with barbell Est. 1-RM: 70kg

Weight (kg) Weight (% of est. 1-RM) No. of Reps
Warm up-1 30 40 10
Warm up-2 50 70 10
Test-1 70 100 9
Test-2
Test-3
1-RM = 92kg (Wathan formula)
1-RM to Body Mass ratio: 1.43

Appendix G-2 (Norms Tables for Relative Squat Strength)

* taken from Hoffman, 2006. Norms for fitness, performance, and health. Human
Kinetics: USA.
Appendix H (Food Intake Record)