• 25 year old female | married | 2 children (3-5 yrs) | full-time job as a nurse in a nursing home
• Referred for exercise therapy to your obesity program as currently non-eligible for bariatric surgery
• Body composition
  • Length: 162,4 cm
  • Weight: 98,3 kg
  • BMI 37,3kg/m²
  • Waist circumference: 116 cm
• Medication: none
• Medical history: none
• Cardiovascular risk factors:
  • physical inactivity
  • obesity
    
    -> important to know by heart

CPET

• Test result
  • 20 Watt + 20 Watt per minute.
    • Test was stopped by patient due to pain in left knee
    • Peak RER: 1.07
    • Peak Load: 16 seconden 200 Watt
    • Borg: 15/20
    • Peak VO2:  2304 ml/min or 110% of predicted values Wasserman (2010)  of 23.4 ml/min/kg of  6.7 METS
    • ECG: negative
    • Peak HR: 166 bpm
    • VT1: 120 Watt (HR of 132 bpm)
    • VT2: not achieved
    • BP: 110/79 evolving to 179/85 mmHg

Other physical fitness tests

• 6MWT
  • 479 m or 63% of predicted
  • Dyspnea: score 6/10
• Grip
  • 36 kg or 112% of predicted
• Isometric knee
  • 174Nm or 69% predicted

Aims of the exercise program

• Aerobic conditioning
• Increasing her functioning
• Increasing muscle strength
• Reducing abdominal circumference and reducing fat mass
• Maybe weight loss
  

Recommendation endurance exercise

• Standard: Aerobic Continuous training
  
• Progression
  • duration ok => increase intensity (HR between VT1 and VT2)
  • 
    • higher intensity a few times a week
      • more satisfaction, better variety
  • 
• Dynamic strength exercise + stabilisation
  •