Jacob C. Newman, Mark Erickson, Patti Bauer. Florida Gulf Coast University, Fort Myers, FL.

BACKGROUND: This case report discusses the outcomes of an exercise intervention and corrective exercises following the ACSM guidelines for a 59-year-old female with a pacemaker as administered by a student enrolled in an exercise science program. There is limited research for pacemaker response with the effect of regular exercise; therefore, the purpose of this case report is to describe heart-rate response and other pertinent outcomes to initiating physical activity in a client with a pacemaker. METHODS: The subject has been dependent on a pacemaker for 20 years and was recently diagnosed with stage 2 breast cancer. Her primary goals included weight loss, increased energy, strength, and overall health and the main barriers were fatigue, pain, and time. The 12-week intervention incorporated the following assessments: PAR-Q, health history, Quality of Life and Lower Extremity Index Scale, Review of Systems, vital signs, balance, Elliptical equivalent of the Åstrand-Rhyming cycle ergometer test, static posture assessment, overhead squat assessment, plank test, flexibility, range of motion, and strength. Weekly workouts included moderate-intensity aerobic training on an Elliptical twice, Yoga once, and full-body resistance training at the local gym once. For progressions, increases were implemented in wattage and interval training for the Elliptical, time for Yoga, and weight/volume for resistance training. Corrective exercises for overactive gastrocnemius, excessive anterior pelvic tilt, and forward head posture were prescribed. RESULTS: Outcomes attributed to the intervention included decreased pain/fatigue and increased energy levels, confidence/motivation to exercise, and cardiovascular endurance. Posture related to forward head and pelvic tilt improved to a noticeable degree in standing. Heart rate and blood pressure did not undergo any distinct change in resting or exercise. In addition, Quality of Life and Lower Extremity Function have both improved by 5%, and weight decreased by 5 pounds. CONCLUSION: This case report indicates that with heart rate monitoring and medical clearance, a comprehensive exercise prescription designed and implemented by an exercise science student can contribute to meaningful changes in a previously sedentary adult female with multiple system comorbidities to improve the overall quality of life even when new health challenges arise.

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