PTY608 Exercise Physiology & Rehabilitation Summative Assessment 1 2026
PTY608 Assignment:
Examined learning outcomes
LO1 Explain the acute physiological changes and long-term adaptations to the body’s systems to exercise and inactivity in healthy and selected populations
LO2 Identify and interpret physiological, functional and behavioral issues specific to the individual and develop goals to address these issues.
LO3. Justify and demonstrate the principles, applications and safe practice of exercise testing and functional assessment in healthy and selected populations.
LO5 Present work at an appropriate academic standard
Summative Assessment Information
Please refer to the Student Handbook (available in canvas) for information about student support and the assessment and grading process (including special considerations, reconsideration and appeals).
Summative Assessment 1
Title of assessment task: Written Assignment (2000 words excluding tables)
This assessment task relates to the following learning outcomes: LO1, LO2, LO3, LO5
Instructions: First, read the case scenario, directly below and then read the assignment guidelines followed by the marking criteria.
Case Scenario
Mr. Carter is a 57-year-old male, who has been referred to you 10 weeks following a burst appendix where he received emergency surgery and went into septic shock. He was in intensive care for four days and remained in hospital for another two weeks. At the end of his hospital stay he performed a cardiopulmonary exercise test (results are shown below) and cleared for exercise. He was advised by his doctors to initially take it easy and but to slowly get back into activity. However, he has not been very active. He tried to walk about two weeks ago but had to take a break every five minutes because he “felt a bit puffed”. He walked about 15 minutes in total and final stopped because of fatigue and achy knees.
Mihimihi (Initial engagement)
Mr. Carter lives in his family home and cares for his aging mother who is not very mobile but is able to perform self-cares. His mother requires Mr. Carter to take her on excursions such as doctors’ visits and shopping. The family home has a upper and lower level located on large section. His bedroom is on the upper level and he is finding it more hard to climb the 10 stairs from the lower to upper level. He recently tried mowing the lawns, but had to stop after about 10 minutes due to fatigue.
Mr. Carter describes his activity over the past week as driving a forklift for about 4 hours per day five days per week. His work did also involve lifting of 10-15 kg packages, but since his recent hospitalisation he finds he is too weak to do this, so is currently on light duties (forklift driving only). After work he usually comes home and helps with dinner but then spends the remainder of the day primarily sitting and watching TV or the internet. He does drive to get his groceries and is able to walk around the supermarket 1-2 times per week.
When asked about what he wants to achieve from the physiotherapy intervention he says he would like to be able to get a fitter so he can do the lawns and garden, walk up and down stairs from his bedroom to the main living area and get up and down off the couch more easily.
General health
Tinana (physical health of the patient)
Mr. Carter had a chronic history of smoking (1-2 packets a day) and hypertension. He stopped smoking last month and is currently using replacement nicotine patches. He has mild interstitial lung disease. He has an occasional drink of alcohol but does not overindulge.
Table 1. Results of Recent Investigations
| Measure | Value |
|---|---|
| Lipid Profile | |
| Total cholesterol (TC) | 3.7 mmol/l |
| Low density lipids cholesterol (LDL) | 1.7 mmol/l |
| High density lipids cholesterol (HDL) | 0.82 mmol/l |
| Triglycerides | 2.0 mmol/l |
| TC/HDL ratio | 4.5 |
| HbA1c | 48 mmol/mol |
Past Medical History
Tinana (physical health of the patient)
A previous hospitalisation 1 year ago with pneumonia.
A minor stroke 2 years ago with no evidence of muscle weakness. He was discharged and did not attend any formal rehabilitation. His only symptom from the stroke is feeling a little imbalanced when walking on uneven surfaces.
Drugs
Bendroflumethiazide 5 mg 1 x daily
Losartan potassium 100 mg 1x daily
Spironolactone 25 mg 1 x daily
Labetalol hydrochloride 100 mg daily
Rosuvastatin 10 mg 1 x daily
Physical tests (Tinana)
Cardiopulmonary Exercise Testing (CPET) on cycle ergometer
His VO2 peak was 15 ml.kg.min. The test was terminated at 82 Watts at Borg’s rating of Perceive Exertion (RPE) of “19”. His anaerobic threshold was 10 ml.kg,min1 and occurred at 40 watts with a RPE of 13 (somewhat hard), and a heart rate of 105 BPM. His maximal heart rate was 160 beats per minute. Throughout the duration of the test his electrocardiogram (ECG) showed normal sinus rhythm with no ST segment changes and oxygen saturation remained at 98%. He stopped the test mainly because of leg discomfort (not pain) and slight breathlessness (3/10 Borg dyspnoea scale).
Table 2. Knee extensor strength measured by isokinetic dynamometry
| Left Quadriceps | Right Quadriceps | Left Hamstrings | Right Hamstrings |
|---|
| Peak Torque |
| Isokinetic 60°/sec | 96 | 97 | 60 | 58 |
Objective measurements taken by you at your initial consultation with Mr Carter
Weight: 108 kg
Height: 162 cm
Waist to hip ratio: 1.3
Resting pulse rate: 85 beats/min (regular)
Resting blood pressure: 145/90 mmHg
Range of motion. Normal shoulder, knee and ankle range of motion.
Gait and sit to stand. During sit to stand he uses a support (chair arms) as an aid. He struggles to sit to stand without these supports.
Single leg stand. Right: leans to the right and holds balance for 5 seconds. He can balance for 8 seconds on the left.
Hinengaro (Psychological and emotional wellbeing, and patient beliefs)
Mr. Carter explains that since his hospitalisation he has lost his confidence and is fearful pushing himself too hard. He believes that exercise may aggravate his condition and has been told that dieting is the key way to improve his health. He does not want to attend an exercise program at the hospital because all his previous hospitalizations have been negative experiences.
Other Family (whānau) History
His father died of lung cancer at 70 years and mother is 75 years old. Mr. Carter has a brother and sister but has not really communicated with them over the past two years. He is single and has no children.
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Assignment guidelines
Based on the above information you are required to write an essay that meets the learning outcomes 1, 2, 3, and 5. First, carefully read the marking criteria to see what is required of you. Then, carefully read the following instruction to aid the development of your assignment. Note approximate word counts for each section are provided to aid your planning.
Introduction
Approx. 150 words
The introduction should only be 1 paragraph. Your introduction should briefly introduce the main theme and provide a brief summary of the topics that you will address in the essay.
Analysis of the scenario (Some of LO1 and some of LO2)
Approx. 800 words.
LO1 Explain the acute physiological changes and long-term adaptations to the body’s systems to exercise and inactivity in healthy and selected populations
LO2 Identify and interpret physiological, functional and behavioral issues specific to the individual and develop goals to address these issues
Analyze the above scenario. In your analysis include functional limitations (e.g. gait, stairs, jumping, inability to participate in recreational (limited walking distance capacity) and sporting activities, poor scores in functional questionnaires) and how these functional limitations link to deficits determined by physiological and functional outcome measures (e.g. strength (1-10 RM, manual muscle testing, 30 second stair test), endurance (number of reps at 60% 1RM, timed isometric holds) flexibility (range of motion tests), power (hop, stair, 10 m walk test) aerobic fitness (submaximal and maximal predictive tests for peak VO2). Then provide possible physiological adaptations associated with disuse that may have contributed to poor test performance and reduced function. Support your analysis with relevant literature, preferably from papers describing these changes in the specific population of interest (e.g. Diabetes, elderly, pancreatic surgery). By interpreting and linking appropriate assessment findings together key themes will be identified. Mr. Carter has a number of health issues.
Themes could include but not limited to:
Muscle weakness
Reduced aerobic fitness
Reduced flexibility (ROM)
Behavioral (engagement, fear avoidance, perception of exercise/activity) Health screening findings and risk of developing further health conditions
The paragraph below, in italics, is an example of a student’s previous work. This is a small section of their analysis of a case study. The case study included an individual with partial meniscectomy and debridement of his right knee..
Mr. Sorensen has difficulty stepping on and off the tractor and knee instability when under load. This may be attributed to his unilateral quadricep muscle weakness event on his right side. Quadricep strength deficits were also found in other post-meniscectomy patients of up to 31% when compared to the contralateral side (Gapeyeva et al., 2000). Muscle weakness can be attributed to a range of alterations, including architectural remodelling. Glatthorn et al. (2010) found changes in pennation angle and fascicle fibre length in similar groups, whilst Akima et al. (2008) found a 15% decrease in quadricep muscle mass in meniscectomy patients. These changes were found to decrease strength and rate of torque development both pre- and post-surgery (Cobain et al., 2017). Decreased neural activation such as atherogenic muscle inhibition (AMI) can also be attributed to a range of post- meniscectomy factors such as swelling, inflammation, joint laxity and receptor damage (Rice & McNair, 2010). AMI can cause a decrease in the excitability and activation of contractile structures leading to a reduction in contractile force (Rice & McNair, 2010).
Problem identification and goal setting (LO2)
Approx. 400 words
LO2 Identify and interpret physiological, functional and behavioral issues specific to the individual and develop goals to address these issues
From your analysis of the case study, you should be able to identify key problems and state clear goals based on the issues that you have identified. You need to identify specific problems (that she has currently) that relate to his function, physiology and patient perception/beliefs. She may also have potential problems (i.e. is Mr. Carter at risk of developing further health conditions).
Next, you need to set realistic goals for Mr. Carter. You should include and justify one to two meaningful goals that Mr. Carter would think up. These are usually related to functional activities she has difficulty with and wants to improve (e.g. difficulty with stairs). They could be short term (within the next few weeks) and/or long term (next few months). Your goals should follow the framework of SMART and be justified with appropriate research.
You can present your key problems and goals in table format. However, you must ensure that you that you describe key problems and goals in your main text. You are given an example from a past student on describing meaningful goals and part of a table demonstrating problem identification, goal setting and research to support goal (Table 2).
As a result of the analysis of Mr. Sorensen’s health and function, there are a range of physiological, functional and behavioural issues that can be improved. His long-term goals include getting back into playing touch rugby, being able to keep up with his grandchildren and completing more activities around the whānau’s rural property. However, to achieve these goals, Mr. Sorensen’s physiological, functional and behavioural problems need to be addressed (Table 1). To address his goals the SMART criteria will be used as outlined by Bovend’Eerdt et al. (2009) as specific, measurable, attainable, realistic and timed, in order to improve goal attainment, which has been reported to increase his likelihood of success (Bovend’Eerdt, Botell, & Wade, 2009). Success for of Mr. Sorensen will also come from self-efficacy. Exercise self-efficacy (ESE) is how one believes they can cope with exercise and overcome barriers (Azizan, Justine, & Kuan, 2013; Neupert, Lachman, & Whitbourne, 2009). Those with greater ESE have greater drive to achieve their goals however people who engage in a sedentary lifestyle tend to find excuses.