A new client, Drew, a 47-year-old man, recently joined and e…
A new client, Drew, a 47-year-old man, recently joined and exercise facility in town and is referred to you, the PT, by his PCP to assist in development of an appropriate and safe exercise program. He currently weighs 315 pounds, and is 5 feet, 11 inches tall with a current waist circumference of 127 cm. Because of his waist girth and weight, body composition estimation was not possible via skinfolds. He currently does not engage in any regular physical activity. At his initial consultation, you measured his resting heart rate at 58 bpm, and his resting blood pressure was 138/72 mmHg. At his most recent doctor’s visit (18 months ago), his fasting blood measures were as follows: total cholesterol = 192 mg/dL, HDL-C = 41 mg/dL, LDL = 117 mg/dL, triglycerides = 169 mg/dL, and glucose = 137 mg/dL. On his health history questionnaire, Drew states that he has previously been diagnosed with high cholesterol, high blood pressure, and diabetes mellitus. He reports no symptoms suggestive of ischemia. He is currently on several medications including Lipitor (statin for cholesterol), Atenolol (beta-blocker for blood pressure), and Metformin (biguanide for glucose control). He reports that his father was diagnosed with diabetes in his 40s and had a nonfatal heart attack at age 52. He denies any other medical condition or any bone, joint, or soft tissue problems. During your initial consultation, Drew discussed his desire to improve his overall health and prevent the occurrence of a premature myocardial infarction. He realizes that he is not in good health and not physically active. He wishes to make the necessary changes to lose weight, to improve his risk factor profile, and hopefully not to go down the same path as his father. In designing a physical therapy plan of care for Drew, what is the most appropriate initial aerobic exercise prescription?