Physiotherapy Case Study: Exercise Plan for Hypertension and Diabetes, Cheat Sheet of Physiotherapy

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Case study:

A 62-year-old is diagnosed with HTN and T2DM (dual)

is being referred to physiotherapy for exercise

advice. BP= 146/93mmHg

PHT 625 PRACTICAL

ASSIGNMENT

Subjective assessment:

Name: Vijen Prakash Gender: male Race: indo Fijian Phone contact: 9998888 Home address: Toorak, suva Main Problem: diagnosed with hypertension and diabetes and is overweight Main concern: Uncontrolled blood pressure and blood sugar, What has been done so far? The patient has been taking medications only (metformin and amlodipine) Previous health condition/ Recent hospitalization: history of gastritis (burning sensation in upper abdomen) Family history: diabetes and myocardial infarction Diet: unhealthy meals from restaurants – order takeways such as pizza, chicken and chips, spicy curry Allergies: N/A Levels of Physical activity: sedentary patient, personal maid at home to do household chores such as cooking, laundry, cleaning. Signs of concern with physical activity: Experience Shortness of breath (SOB) while climbing up the stairs at work, calf pain CVD Risk Signs: experience chest pain, SOB, calf pain Signs and symptoms: polyuria, polyphagia, polydipsia, dizziness from hypoglycemia Medications: non-compliant with metformin and amlodipine Occupational history: Accountant with good pay Financial status: middle income Behavioral habits: Smoke cigarettes everyday twice a day, drinks alcohol every Tuesday (temple gathering), Consume fast foods on a daily basis, mentally stressed person(burnout) and sedentary lifestyle. Cultural beliefs: to live life and enjoy by eating whatever he loves to eat, and says grandfather smokes everyday but he lived for 100 years.

Objective Assessment:

Blood pressure 146/93mmHg >140/90 hypertension (stage 1) and the

Sit and Reach Interpretation

Balance Test Interpretation

Strengthening Sit-up Test

Patients Interpretation

Sit and reach test 5.4 cm Poor flexibility, needs

improvement

Balance Test 4.9 seconds Extremely poor balance.

Strengthening sit up test 9 sit ups in one minute Poor strength endurance.

Overall goals/Aims of treatment:

 Control and monitor blood sugar levels and blood pressure

 Lose weight by incorporating endurance exercise to improve heart and lung function

 Enhance functional mobility, improve strength and reduce risk of falling by including

(balance exercises, flexibility, joint mobility, muscle strength, and coordination

exercises)

Precautionary measures:

1. Monitor blood pressure and blood glucose levels-

Exercise Plan- Tuesday

WARM UP: Marching on spot (2 minutes) FLEXIBILITY 8 reps, 2 sets: Time: 1.) Neck stretches - 10 seconds (in standing) 2.) Side reaching stretches - 15 seconds 3.) Chair seated hamstring stretch - 15 seconds 4.) Wall assisted quad stretch - 15 seconds ( in standing) 5.) Ankle circles - 15 seconds (standing with support) Reps: 8 Reps 6.) Shoulder rolls - in standing 7.) Arm circles - in standing 8.) Hip extension - standing with support. BALANCE: Balance Exercises for Seniors STRENGTHENING: 8 reps, 2 sets 1.) Seated shoulder press 2.) Seated knee raise hand slaps 3.) Seated leg raises 4.) Canoe paddling 5.) Seated ball circles 6.) Seated heel raises 7.) Seated jumping jacks ENDURANCE: Seated Zumba: 8 reps, 2 sets 1.)Marching -1 minute (standing)

2. Lateral twist (standing)
3. Knee arm raises (seated)
4. Knee elbow (seated)

COORDINATION:

Improve Coordination for Seniors & Beginners, Brain Body Exercises

5. Knee punches (Seated) COOL DOWN: seated
6. Neck stretches -15 second
7. Shoulder stretch -15 second
8. Side stretch – 15 second
9. Hamstring stretch – 15 second

PHYSICAL ACTIVITY LAYOUT: 6 weeks

Frequency Intensity Time Type 2 days/ week

• Mondays & Wednesday
  • Start at light intensity activities.
  • Slowly progress to moderate intensity at 3rd week ● 2-3 sets of each exercise. ● Chair exercise: 8-12 reps ● *Standing exercises: 5-7 reps with 3 sets ● Rest between sets: (1- minutes to recover) Duration for Muscle Strengthening Exercises

● Each Session : Aim for 30-

minutes per session. This includes warm-up, exercise, and cool-down periods. Chair exercises: 1.) seated shoulder press 2.) seated front shoulder raises 3.) seated chest press 4.) seated bicep curls 5.) tummy twists (1 rep= 1 full rotation) 6.) seated lateral raises 7.)single arm triceps -Can use water bottles half –

Duration for endurance exercise; Aim; 30minutes till tolerable Goal; improve cardio-respiratory endurance 20-30second hold stretch- warm and cool down> 5-10minutes ● Brisk-walking ● Stair-climbing & cycling 2 times a Week Fridays and Tuesdays Low intensity exercises on rest day Starting with one Yard work: Basic outdoor chores like mowing the lawn, pruning, weeding and planting veggies Duration: for 30 minutes of work to burnt calories. Breaks of 1-2 minutes in between Yard work: lawn mowing, pruning, weeding and other house chores Taking plenty of breaks in between and staying hydrated with sun protection (hat)