Exercise Refferal Case Study for Rheumatoid Arthritis, Depression & Elderly
Summary of clients details
Name: Ms. Lewis
Gender: Female
Age: 66
Contact No: 01234 5678910
Next of Kin: Mrs Levenhulme
Referral reason: Rheumatoid Arthritis, Depression & elderly
Medication: Acelofenac & Nortriptyline
Physiological Information
Blood Pressure (seated): 122/82 mmHG
Resting Heart Rate: 64 bpm
Predicted VO2max: 24 ml/kg/min
Present physical activity:
Very low, essentially sedentary
Patient’s statement regarding state of change:
“I want to exercise, and I think I can do it, but I will need some support” (Preparation)
Medical conditions
Rhematoid Arthritis – Is an autoimmune disease which can cause chronic inflammation of body`s organs, joints, and the surrounding tissue of the joints. It can be defined as:
“a disease of synovial tissue, i.e. a joint linings, tendons, tendon sheaths and associated structure. So widespread is the inflammatory process that inflammatory nodules may form almost anywhere, the extensor surfaces of the limbs being most common, such as elbow and forearm nodules, but nodules may also form in the lungs and other visceral tissue”
(Wright Foundation Exercise referral manual, 2008)
The onset of Rheumatoid Arthritis is generally between 45-65 years (Stenstrom & Minor, 2003)
Specific inclusion criteria –Mild to moderate severity
Specific exclusion criteria – Severe severity
Depression – “An illness that involves the body, mood, and thoughts, that affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. Without treatment, symptoms can last for weeks, months, or years.”
(http://www.medterms.com/script/main/art.asp?articlekey=2947)
Specific inclusion criteria –Mild to moderate severity
Specific exclusion criteria – Severe severity
Additional Information
As the client is 66 years of age she will be considered as elderly.
Elderly – Whilst aging there is a steady functional decline, cardio-vascular, flexibility and strength. Reduction
Name: Ms. Lewis
Gender: Female
Age: 66
Contact No: 01234 5678910
Next of Kin: Mrs Levenhulme
Referral reason: Rheumatoid Arthritis, Depression & elderly
Medication: Acelofenac & Nortriptyline
Physiological Information
Blood Pressure (seated): 122/82 mmHG
Resting Heart Rate: 64 bpm
Predicted VO2max: 24 ml/kg/min
Present physical activity:
Very low, essentially sedentary
Patient’s statement regarding state of change:
“I want to exercise, and I think I can do it, but I will need some support” (Preparation)
Medical conditions
Rhematoid Arthritis – Is an autoimmune disease which can cause chronic inflammation of body`s organs, joints, and the surrounding tissue of the joints. It can be defined as:
“a disease of synovial tissue, i.e. a joint linings, tendons, tendon sheaths and associated structure. So widespread is the inflammatory process that inflammatory nodules may form almost anywhere, the extensor surfaces of the limbs being most common, such as elbow and forearm nodules, but nodules may also form in the lungs and other visceral tissue”
(Wright Foundation Exercise referral manual, 2008)
The onset of Rheumatoid Arthritis is generally between 45-65 years (Stenstrom & Minor, 2003)
Specific inclusion criteria –Mild to moderate severity
Specific exclusion criteria – Severe severity
Depression – “An illness that involves the body, mood, and thoughts, that affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. Without treatment, symptoms can last for weeks, months, or years.”
(http://www.medterms.com/script/main/art.asp?articlekey=2947)
Specific inclusion criteria –Mild to moderate severity
Specific exclusion criteria – Severe severity
Additional Information
As the client is 66 years of age she will be considered as elderly.
Elderly – Whilst aging there is a steady functional decline, cardio-vascular, flexibility and strength. Reduction
References: Bearne L.M., Scott, D.L. & Hurley, M.V. (2002). Exercise can reverse sensorimotor dysfunction that is associated with Rheumatoid Arthritis without exacerbating disease activity. Rheumatol, 41, 157-166 Cattaneo, D., Jonsdottir, J Clarke, M. G., Rattigan, S., Clerk, L. H., Vincent, M.A., Clark, A. D., Youd, J. M., Newman, J. M (2000). Nutritive and non-nutritive blood flow: rest and exercise. Acta Physiologica Scandinavica, 14, 519-530 Clarke, M.S.F Cook, W. L., Tomlinson, G., Donaldson, M. & Markowitz, S. N., Naglie, G., Sobolev, B., Jassal, S. V. (2006). Falls and Fall-related injuries in older Dialysis patients. Clinical Journal of American Society of Nephrology, 1, 1197-1204. Després, JP & Lamarche, B. (1994). Low-intensity endurance exercise training, plasma lipoproteins and the risk of coronary heart disease. Journal of International Medicine. 1, 7-22 Folsom, A Forbes, G. B. & Reina, J. C. (1970). Adult lean body mass declines with age: some longitudinal observations. Metabolism, 19, 653-663 Garber, C.E Hepple, R.T., Mackinnon, S.L., Goodman, J.M., Thomas, S.G. & Plyley, M.J. (1997). Resistance and aerobic training in older men: effects on VO2peak and the capillary supply to skeletal muscle. Journal of Applied Physiology. 82,1305-1310. McAuley, E. (1993). Self-Efficacy and the Maintenance of Exercise Participation in Older Adults. Journal of Behavioral Medicine, 16, 103-13 McAuley, E., Blissmer, B., Marquez, D.X., Jerome, G.J., Kramer, A.F Stenstrom, C. H. & Minor, M.A. (2003). Evidence for the Benefit of aerobic and strengthening Exercise in Rheumatoid Arthritis. Arthritis & Rheumatism, 49, 428-434 Thompson, L.V Manuals Wright Foundation Exercise referral manual, 2008