Mrs. Jones is an “apparently healthy” adult. She is a 47-year-old stay-at-home woman who comes to you for advice on starting an exercise program after having a satisfactory graded exercise test with her physician. Mrs. Jones is 5 ft 4 in tall and weighs 147 lb. She has not done any structured physical activity since her days as a public school student more than 30 years ago. She occasionally walks with her friends for almost 1.5 miles at a sustainable pace about two to four times per month over the last several years. Mrs. Jones reports that she is starting to notice various weaknesses in her abilities to carry out her activities of daily living (ADLs) and an increasing balance deficit upon standing. In addition, she reports seeing a physician on a yearly basis for checkups but has no major health problems. She did have an exercise test at her physician’s urging, and the results were unremarkable except for her rather low cardiovascular fitness. She does report a history of diabetes on her father’s side of the family. She also had a hysterectomy operation after her third child about 10 years ago. Also, she denies any symptoms associated with coronary heart disease (e.g., chest pain, shortness of breath) but reports to feel “tired” after her regular walks for about day or so. Mrs. Jones takes only a women’s multivitamin and a calcium supplement. Her vitals include a resting heart rate of 78 bpm and a resting blood pressure that averages around 124/80 mm Hg. Her most recent blood work reported a total cholesterol of 187 mg ?? dL??1 and an estimated LDL-C of 108 mg ?? dL??1 and a measured HDL-C of 52 mg ?? dL??1. Her fasting blood glucose was also reported as 103 mg ?? dL??1.Case Study QuestionsGive a brief summary of Mrs. Jones overall health and risk for chronic disease. ( how many CHD risk factors?)? Calculate BMI to determine obesity.Would you recommend medical clearance or any further follow-up with a physician before starting a total program? Why or Why not? Refer to the ACSM algorithm.
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