Sedentary Sally

Sarah Azhadi Brian Lannin

Heather LoweKatherine MacInnes

Mike Smit

About Sally45 year old femaleDivorced mother of two (12 and 4)Office supervisor = high stress jobPost-menopausal Family history of heart disease, stroke and breast cancer Fluctuating body weightLacto vegetarian Supracondylitis (tennis elbow)Osteoporosis in the spinal vertebrae and long bones of the legsHas relapsed in past attempts

Sally’s GoalsLose weightImprove overall health through diet and exercisePrevent chronic health problemsDecrease stress

Recap of Previous Sessions

Has been prescribed an exercise routine Has been referred to a registered dieticianWorkplace assessment was completedWas referred to a physiotherapist but has now finished her last sessionAddressed injuries

Previous Exercise RoutineUsing a theraband for office and trips

Shoulder press 2 X 10 repsChess press 2 X 10 repsBiceps 2 X 10 repsTriceps 2 X 10 reps

Squats using chair as support 2 X 10 repsBiking 30 minutes 2 times a weekIsometric contractions of abs held for 2 X 10 secondsCalf raises 2 X 10 reps

NutritionFollow Canada’s Food Guide

Substituting meat and eggs for soy, nuts, hummus, legumes, beans, etc

Has done a food diary and suggestions were made to change some aspects of her diet

Asked her in her last session to bring in a new diary to see her progress

Workplace AssessmentWorkplace has been assessed and the following recommendations have been made:

Ergonomic chairErgonomic keyboard and mouseStand station to work

Has created a lunch group walk club

Physiotherapist ReferralWas working in conjunction with the physiotherapist but has completed all the recommended sessions and is now working solely with the kinesiologist.

Previous Injuries - Prescription

Supracondylitis Started isometric exercisesProgressed to theraband exercisesSuggested ice

OsteoporosisIncrease calcium intakeTheraband exercisesBiking

The Current Session

6th Session(End of 2nd month)

Client Objectives of Current Session

Continuing weight lossIncrease motivation and prevent relapsePresentation of current food journalStress management

Behavioural PrescriptionMotivation

PedometerLunch group walking clubSelf-efficacy theoryAdding onto the exercise prescriptionPersonal rewards (eg. Sally Day)

Pedometer PrescriptionA reasonable goal for most people is to increase average daily steps each week by 500 per day until you can easily average 10,000 per day

Week 1 Aim for 3500 steps per day

Week 2 Aim for 4000 steps per day

Week 3 Aim for 4500 steps per day

… Week 14 Aim for 10 000 steps per day

Physical PrescriptionChange cardiovascular program

Change biking to alternate between swimming and biking

While son is in swimming lessons, she can do laps and/or aqua aerobics classes

Increase strength trainingIncrease reps

Internal and external rotationIncorporate theraband into calf raises and squats

Exercise Sets/Reps Modifications

Shoulder press 2 X 15 Increase reps

Chest press 2 X 15 Increase reps

Biceps curls 2 X 15 Increase reps

Triceps extensions

2 X 15 Increase reps

Squats 2 X 15 Use theraband

Calf raises 2 X 15 Use theraband

Crunches 2 X 15 Use yoga mat

Internal Rotation

2 X 10 Use theraband

External Rotation

2 X 10 Use theraband

Physical PrescriptionAt home, incorporate weights into squats and calf raises

Change over previous theraband exercises to weightsPerform crunches with Swiss Ball

Stress ManagementTry to organize a monthly routine

Visit a massage therapist once a monthOrganize a Sally day bi-weeklyBreathing and relaxation techniques implement 5:1 ratio

Nutritional PrescriptionDiscuss old food diary and look over new food diary

Old Food DiaryMonday Tuesday Wednesday

Breakfast Pastry and coffee with cream and sugar

Pastry and coffee with cream and sugar

Apple juice and coffee with cream and sugar

Snack Donut and coffee with cream and sugar

Donut with caramel macciatto

Donut with coffee with cream and sugar

Lunch Pre-made sandwiches, muffin and diet pop

Veggie pizza with double cheese and diet pop

Lick’s veggie burger with lots of mayo with diet pop

Snack Apple and water Chocolate éclair and coffee with cream and sugar

Muffin and coffee with cream and sugar

Dinner White pasta with deep fried tofu and cheese

Pint of Hagen Daaz therapy

Four cheese mac and cheese

New Food DiaryMonday Tuesday Wednesday

Breakfast Oatmeal with half a grapefruit and coffee with cream

Pancakes with a banana and coffee with cream

Waffles with strawberry and whip cream and coffee with cream

Snack Fruit cup with water

Yogurt parfait with granola topping

Banana and coffee with cream

Lunch Homemade sandwich with fresh cut veggies and V8 juice

Left over whole wheat pasta with alfredo sauce and lemonade

Veggie wrap with ranch dressing and orange juice

Snack Chocolate granola bar and non fat latte

Mars bar with diet pop

Latte

Dinner Whole wheat pasta with alfredo sauce

Veggie stir fry with whole grain rice and bean salad

Spaghetti with ground round and spring salad with chickpeas

Recommendations

Substitute milk for cream in coffeeTry to keep it non-fat latte’sTry non-fat milk instead of cream sauce for pastaTry non-fat dressings instead of ranch

Relapse Prevention Techniques

Family and friends support networkKeep a personal journal that records feelings before and after exercise

Future Projections

1 Year LaterLost 20 poundsMaintained a proper dietErgonomic aids, exercises, reduced pain associated with supracondylitis and osteoporosisGroup network helped reduce stress

Post 1 YearEx-husband became a drug addict and went to prisonSally took full custody of childrenSally was promoted to Regional ManagerThe added stressors negatively affected Sally, who relapsed; however, she has gone back to the kinesiologist to help her get back on track