Sedentary Sally

1. Sedentary Sally David Cybulski, Meaghan Hanley, Stephanie Kokoski, Maaz Malik,Jay Moore, Victoria Morris,

2. Client Information • Session two out of eight • She has lateral supracondylitis in her right wrist as well as osteoporosis in her spine and long bones of her legs • Family history of heart disease, stroke, and breast cancer • She is a single mother of two. Sarah, age 4, and a Shawn, age 12, who is involved in hockey twice a week.

3. Client Objectives • Decrease body weight by 20 pounds • Start and continue to exercise • Improve eating habits • Develop stress management skills

4. Injuries • Stretches for her diagnosed supracondylitis • Forearm extensor exercise: Place a rubber band around your fingers and your thumb. Spread fingers apart and bring them together. If it is too easy add more rubber bands. • Forearm flexor exercise: Squeeze the “stress ball”

5. Behavioural Prescription • Following the theory of planned behaviour • Perceived behavioural control • Ex: I can go without having the danish with my coffee • Self efficacy theory • Belief or expectation that one can achieve their specified health change. • Sally’s self efficacy is internally determined. • Ex: I can stop eating fattening desserts even if my friends are ordering them

6. Stress Management • On the off weeks that Sally does not have the kids she will have a “Sally day” This can consist of a bubble bath, massage, pedicure etc… • Sally worries about her children, work and living expenses, she feels overwhelmed by these issues and we have referred her to a free councilor at her local community center. • Also Sally has a stress ball for her injuries but says that she use to use it to relieve her stress.

7. Food Journal

10. Nutrition • Refer to a registered dietician (Dr. Ann Burns) • Refer to Canada’s food guide • For Sally’s milks and creams she should have the reduced fat or light substitutes. • Pre-made lunches, while you are making your children’s lunch. This will help you save money and cut back on oversized portions. • If you are going to have a treat, have one treat instead of four or five in a day • Dessert substitutes: Dessert yogurt, granola bars, fruit etc.. • Need to incorporate more fruit, dairy and protein into your diet. (Beans and legumes) • Since Sally loves to cook, she can buy a vegetarian cookbook and cook meals on weekends and freeze them for the week.

11. Relapse Techniques • Identify high risk situations • Develop coping skills for each situation • Learn to anticipate negative thoughts or statements. Learn to counter them with positive ones • Have Sally rehearse the negative statements and the positive counterstatements • Ex: She ate a danish. • Negative thought: I ate a danish I may as well have a chocolate bar • Positive thought: I ate the danish, which is ok, I will make a harder effort today to eat healthy.

12. Ergonomic Applications • Chair: Set it properly as well as an obus form back support to attach to the chair. • Mouse: A gel mouse pad, or tracking ball mouse • Exercise Ball: Can be used as a chair for periods of time throughout the day (10-15 minutes per period)

13. Physical Prescription • The cardio aspect of the prescription is to help her decrease her risk of heart disease and stroke. • Resistance training to help over all strength and prevent further degeneration of you bones.

14. Stationary Bike • 2 commercial breaks, or 4-5 songs (approx. 15 minutes) • Two times a week

15. Mommy and Me • One one hour class a week • Different choices at the community center

16. Walking • During hockey games, walk around the arena • 20 minutes a practice

17. Chair Squat • Place a chair behind you. • Feet shoulder width apart. • Keep your back straight, • Lower yourself to the chair until you lightly touch the chair and come back up. • TIME: 3 sets of 10 reps, 2 times a week

18. Mid-Row with Theraband • Loop the theraband around something ex: door knob, feet. • Keep your back straight • Start with your arms straight and bring them to a 90 degree angle keeping your elbows close to your body • Keep your hands “happy faces up” • TIME: 3 sets of 10 reps, twice a week

19. Chest Press with Theraband • Place theraband mid back area. • Place your hands in a comfortable position. • Extend your arms in front of you • TIME: 3 sets of 10 reps , 2 times a week

20. Crunches on Ball • Place feet flat on the floor • Place the ball in the lower part of your back • And crunch up • TIME: 3 sets of 10 reps, 4 times a week

21. Sally’s Check List Sunday • 10 crunches • 10 crunches • 10 crunches Monday • 10 Mid row • 10 Mid row • 10 Mid row • 10 Chair squats • 10 Chair squats • 10 Chair squats

22. Tuesday (Shawn’s Hockey Practice) • 10 Chest Press • 10 Chest Press • 10 Chest Press • Mommy and Me class with Sarah Wednesday • Bike for 15 minutes/ 4-5 songs / 2 Commercial Breaks • 10 crunches • 10 crunches • 10 crunches

23. Thursday (Shawn’s hockey game) • 10 Chest Press • 10 Chest Press • 10 Chest Press • Walk around the arena for 20 minutes Friday • 10 crunches • 10 crunches • 10 crunches • 10 chair squats • 10 chair squats • 10 chair squats

24. Saturday • Bike for 15 minutes/ 4-5 songs / 2 Commercial Breaks • 10 crunches • 10 crunches • 10 crunches • 10 Mid row • 10 Mid row • 10 Mid row

25. Referrals • Registered dietician • Counselor for stress • Second opinion for her hormone replacement.