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juggernaut

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I have never done this before. Most of the time, I get people in their 20-40s, once in a blue moon I get people hitting 50. Today, I had a 64 year old client come in and say that she wanted to lose weight. I took a fitness assessment. Her bodyfat was in the 45% range. She weighed almost 230 lbs. She said she wasn't afraid of doing free weights, and would listen to anything I'd say. She's committed.

Here's my problem: I'm thinking of using compound lifts with her with both a Smith Machine and some free weight work, a full body routine 3x weekly, 2-3 sets of 8-12 reps for each bodypart, with a heavy emphasis (about 4x a week) on low impact treadmill walking at 60% of her heart rate. I'm thinking, make it as basic as possible, recruit as many muscle fibers as possible, and don't make it too complicated. Thought I'd start her out with 3-4 weeks of two day weight training sessions during the week, but keeping the cardio constant. Then, after taking her through the fourth week, take her to 3x a week and continue from there.

Would this help her achieve these goals? Diet isnt an issue. She started and is on her second week of a doctor prescribed Atkins-type ketogenic diet.
 
I didn't do her evaluation but I would point out these things:


a) at that body weight the bike might not be the best bet right now. a lot of it depends on how she carries herself and walks though. did you do a gait analysis? I would probably go with the bike.

b) what compound exercises can she do? what did your evaluation consist of? I am not a fan of the smith machine. I would probably start someone that is this deconditioned with basic things on the table like glute bridges, side lying abduction, blood pressure cuff abdominal contractions or quadraped contractions if you don't have a BP cuff. You can progress to some sit to stands with a chair or even some get up and go stuff once her work capacity rises and she becomes more mobile. I would focus on things like rows for her upper body and maybe even start her with machine chest presses since push ups are out of the question and I couldn't see her lying down on a bench and then getting back up. I would go even higher with the rep range and do ciruit work, allowing her to rest as needed and making sure that you keep notes about when she rests and how long. Another idea may be to abolish repetitions at first and work on time....3 sets of 20 sec of work and increase from there.

c) at that weight, pretty much anything you do is going to help her lose body fat. i would work on increasing her level of conditioning since she is so out of shape. Also, I would look at how she moves her posture in standing and her posture during movement and assess what things need to be addressed as far as flexibility concerns and weaknesses. Look for asymetries between both sides and go from there.
 
About 18 months ago, I was in a similar situation: 42% body fat and it was difficult to even stand up. I did most things p-funk suggested plus walking. I began with 3-5-minute sessions and God only knows how exhausting they were for me at that time. I also watched my MHR, and the initial limit was 55%.
I did a lot of rowing and back exercises like pull downs, too.
 
Well, today is the second part of her eval. I gave her some homework (keeping a food journal, how she feels during certain periods of the day, get a physical, etc) today I will be checking her flexibility, endurance and muscular strength. This will give more insight as to what she is capable of doing.
 
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