EXERCISE PRESCRIPTION FOR OBESITY PATIENTS


Obesity is a chronic disease for which short term intervention has limited effectiveness and long term success is rare and primarily limited to surgical treatment. Clinicians should approach obesity as a disease in itself as well as managing its co morbidities.
Exercise has an important contribution in the management of obesity as a vital adjunct to diet, drugs, and surgical treatment.                                      
An Exercise prescription for weight loss requires manipulating intensity and duration to benefit caloric expenditure and may not provide cardiovascular improvements in those patients with comorbidities that require associated fitness benefits.

Medical History and Diagnosis                                       
Mr x is a 52 years old banker    with 36% fat and he was told to reduce his weight because of his obesity, his boss believes he is unable to perform duties.He has 60 pack per year history of smoking but quit 5 years ago. 
He has progressively gained weight over the past 10 years. In the past year there was a 30-Ib weight gain. Hypertension diagnosed 6 years ago is being treated with Tenormin. The patient admits to a sedentary lifestyle and his boss advised him to join our health club.

Clinical Data.                                         
Age                                            =52 years.                       
Sex                                            =M                                      
Height (in.)                                 =70                    
Weight (Ib)                                 =230                       
BMI (kg. m)                                =32.8                 
Body Fat (%)                              =36                    
Blood pressure (mmHg)               =144/92.                                 
Total cholesterol (mg. dl)             =237                                          
High density Lipoprotein(mg.dl)    =48.          
Low density lipoprotein (mg. dl)  =153                                 

 Triglyceride (me. dl)                    =189 
Glucose (mg. dl)                         =128

Exercise Prescription           
Type           :  Aerobic.                            
Mode  :walking, jogging, water activities, resistance training.                                  
Frequency :3 to 5 times /week or most days of the week.                                     
Duration     :20 to 60 min.         
Intensity     : 50% to 75% of maximal aerobic capacity.      
Energy expenditure :700 to 2000 kcal. week.                   
Type           :resistance.                     
Mode          :free weights, machines, elastic bands.    
Frequency  :at least 2 times per week, but never on consecutive days.               
Duration     :10-15 repetitions per set, 1 to 2 sets per type of specific resistance exercise.                              
Intensity      :60% of 1 repetition maximum.            

Special Considerations       

  • Search for vascular and neurological complications, including silent ischemia, that might alter exercise prescription or contraindicate exercise.         
  • Consider an exercise electrocardiogram in patient with known or suspected coronary artery disease, those who are greater than 30 years of age.                        
  • Instruct patients to warm up and cool down.                   
  • Carefully select exercise type and intensity.                 
  • Promote patient education.    
  • Encourage patients to wear proper footwear.                   
  • Teach patients to avoid exercise in extreme heat or cold.                                        
  • Teach patients to avoid exercise metabolic control is poor.  
  • Instruct patients to maintain adequate hydration.               

Question:
Mention 6 Exercises you can prescribe for obesity patient.

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