From PEKN4P22 FWD03 2013 Group 01
Group members: Natasha Chang, Rita Kutepova, Kyle Fraser, Moe Chaudhry, Shawn Andrews
 Initial Client Consultation
Date: January 28th,2014 Time: 2:30pm - 3:20pm Group members: Moe Chaudhry, Shawn Andrews, Rita Kutepova
1. What are the goals you expect to achieve by the completion of the program?
2. How many exercise sessions per week would you devote yourself to?
3. How long would you want your exercise sessions to be and what is the most convenient time?
4. How active have you been in the past year? (Has your level of physical activity changed over the years?)
5. What is your current level of activity? (How active are you throughout an average week?)
6. Have you had any previous injuries? What limits you the most in keeping yourself physically active?
7. What is your attitude towards physical activity/ motivation?
8. What are your preferences regarding physical activity
a) types of exercise b) location/ atmosphere
9. Do you have any preference of the way we provide explanation of exercise (show, explain, visual guide)?
10. Based on your previous experiences of physical activity, what keeps you motivated through your exercise session?
11. What are your interests/ hobbies?
12. Do you feel that engaging in more regular physical activity will benefit your function in daily activities such as homemaking, dressing, shopping, food preparation?
13. Plan for emergency cancellation (email, call)?
 Physical Activity Readiness Questionnaire (PAR-Q)
Location: Rowing Center Time: 11:00am - 12:00pm Date: February 28th Group Members Present: Natasha & Kyle
1. Warm Up
5 minutes. Wheeling to the front of the Walker Complex and then back to the rowing center.
2. Muscle Screen and Manual Muscle Testing Lab We will be testing our clients muscle strength using the Muscle Screen Routine (adapted from: Clinical assessment Procedures in Physical Therapy, by M. Palmer and M. Epler) We will only be testing in the sitting position, and testing the muscles that are specific to our patient's needs. We are looking to test for any weaknesses or any muscular imbalances. LeeAnn scored 5 on all of the manual muscles tests.
3. Flexibility/Goniometry Testing We will be testing the range of motion in the shoulders, elbows and wrists. There were no extreme lack of joint range. There was a difference in the left compared to the right shoulder. The left shoulder is on average 5 degrees less flexible than the right shoulder. She also has limited wrist flexion and extention.
4. Muscle Endurance testing We will be testing our client's aerobic ability by having her complete a timed trial on a Nustep/arm erg. We will measure her maximal output over a three minute span, we will also measure her HR at the conclusion of the test. We do not have comparative norms, we will only seek to improve them by the end of our sessions because the client requested to do an activity that was opposite to her normal movements (pulling rather than pushing). We will also be performing a 7-10 RM which will give us her 1RM. We will do this on bench press, biceps, triceps and a lat pull down.
http://www.exrx.net/Calculators/OneRepMax.html This site will be used to calculate the 1RM.
Muscle Endurance Testing For Lats, Tricepts, Bicepts, and Pectorials 30 minutes
For the following muscle groups we are going to find the calculated the following 1RMs using a 7RM protocol listed above. We will be using the chest press machine,to test pectoral strength. Yet to be tested.
We will use the down bar, to test upper back strength. (Latissimus dorsi, Teres Major, rhomboid, posterior deltoid strength)
We will be using free weights to test biceps and triceps strength. The bicep curl: 1RM for right arm is 18 lb. 1 RM for left arm is 12lb.
Over the head triceps extension: For either arm, LeeAnn's 1RM is 12lb.
5. Cool Down For a cool down we will encourage the client to do a couple laps around the track, for 7-10 minutes.
Notes: The assessment on Friday was slightly modified due to lack of equipment. There wasn't a chest press machine, so we did not test pectoral strength. We also did not go around the track, but walked from the "Cage" area to the front of the Walker Complex and up the ramp in order to warm up the client. The testing went well, LeeAnn responded well to instructions when correcting technique. It is important to note that LeeAnn is afraid of falling forward. we need to be cautious with pulling exercises and making sure she can lean back enough to stabilize herself with her back muscles.
 Smart Goals
1. Correct muscle imbalance to equalize muscle strength on left an right sides.
We will do this by having both sides work simultaneously as much as possible We will be using equal weights or degrees of resistance if using bands We will monitor her technique in case we observe one side compensating for the other side.
- for example when doing bicep curls we will make sure the bar is horizontal (when performing bilateral curls)
- In order to test for improvements, we will be looking at her scores for 1RM testing and see if they are similar on either side during the post testing.
2. Increase core stability.
We will be doing exercises that engage the core as much as possible,for example, wall throws with a basket ball, medicine ball throwing and catching, seated rows and lat pull downs. To test for improved core stability we will collect qualitative information from the client.
3. Correct internal rotation of shoulders to improve posture and increase range of motion, and protect from impingement.
Because of her wheeling, Leeann's shoulders are internally rotated which could cause problems in the future.
4. Maintain cardiovascular fitness.
Through integration of aerobic training in the form of Nustep and arm ergometer exercise
 Final Assessment and Initial Workout Plan:
March 4, 2013
We propose to finish the assessment that we were not able to conduct due to limitations in the Rowing Center and lack of documentation to meet at the BRIC building. The assessments that we would like to finish are Cardiovascular fitness and initial CV capacity. We propose to conduct an erg for 1 mile to simulate the Rockport Test. This would give us an assessment of LeeAnn's CV fitness levels and we can start to tailor a program based on outcomes to increase her CV capacity.
 Training Session #1
Location: Rowing Center Date: March 5th Time: 1pm - 3pm Group members: Kyle & Rita
For the session - Introduce LeeAnn to the various equipment that will be used throughout her training program and start upper body resistance training. The goal of this session is to make sure we can come up with initial weights that are suitable for each exercise that we would like to prescribe in future workouts. We are limited to upper body training as she is unable to innervate her lower body and we do not have access to Functional Electrical Stimulation devices. Lastly we want to start working on strength training as we have limited time to work with LeeAnn to begin with. She has goals of maintaining core stability and increasing back strength. The reason we have chosen to work on shoulders, back and core stability in this session is to gauge her ability to perform these exercises and to make sure we are able to provide sufficient overload. Shoulders were added as they are the biggest joint available to any SCI individual and is used to perform every task they conduct.
- Wheelchair up the ramp beside Walker Ian Beddis 5 times - Shoulder Abducted Rotation stretch x 10 - Broomstick stretch, Using wooden dowel, internal and external rotation x 10 - Side reach opposite arms touching the floor x 10 each side alternating - Reaching forward and touching opposite foot x 10 alternating sides
- Lat Pull Down- 50lbs? x 10-12 reps x 3 sets - Seated Row - Medium resistance band (red) x 10-12 reps x 3 sets - Resistance band pulls (light resistance band Green) x 10-12 reps x 3 sets(hold a resistance band out in front of chest,and pull them apart using Rhomboids)
- Lateral Deltoid raises - 10 lbs? x 10-12 reps x 3 sets - Horizontal Deltoid raises - 10 lbs? x 10-12 reps x 3 sets - Seated Shoulder Press 15 lbs? x 10-12 reps x 3 sets
- Seated back extensions arms out in front (unweighted) x 10-12 reps x 3 sets - Seated lateral med ball twist throws 2 lbs ( throw to one side 10-12 times and the other side 10-12 times) x 3 sets
- Row out of the rowing center to the ramp (not up the ramp) and back to the rowing center - Static Elbows touching stretch and hold 15 secs x 2 - Flex neck, internally rotate shoulders forward, and depress shoulders hold 15 secs x 2 - neck side to side held with hand stretch hold for 15 secs x 2 either side - stretch pectorals against wall with arm stretched out facing the other way hold for 15 secs x 2 each pec
- Record the exercise training and likes and dislikes of the exercises - Make sure you tell LeeAnn this was he initial to get base line weight numbers and next one will be a little more progressive - Record details on wiki here
 Training Session # 1 (what actually happened)
Location: Rowing center Date: March 5th Time: 1:30pm - 3pm Members present: Rita & Kyle
- Wheelchair up the ramp beside Walker Ian Beddis 3 times (up and down the ramp) at a moderate pace Stretching - Internal rotators caff (subscapularis & pectoralis major) - External rotators caff ( infraspinatus, supraspinatus, teres minor) - Arm cross stretch (rhomboids, upper trapezius) - Chest Stretch
- Lat pull down (4 sets: 1. 30lb/5reps 2. 40lb/10reps 3. 50lb/15reps 4. 6olb/15reps) - Seated Row (2 sets: 10lb/10reps) - Resistance bands pulls ( Using green bands - lighter resistance; 2 sets: 20 reps each)
Resistance band was attached to a pole while a client was holding each end of the band, resulting in a fast concentric (shortening) phase and slower eccentric (lengthening) phase.
- External rotation with retraction shoulder exercise( rhomboids , middle trapezius)
Move the hands apart to rotate the shoulders, whilst squeezing the shoulder blades together. Keep in position for 2 seconds (2 sets: 5 reps)
- Lateral deltoid raises (2 sets: 5lb/15 reps on each hand) - Seated shoulder press (3 sets: 1. 5lb/5reps 2. 5lb/12 reps 3. 5lb/16reps)
Seated balance exercise creating instability, forcing the body to react thereby strengthening the supporting muscles and increasing positional awareness. The client transferred to a firm surface support and was asked to raise hands to the chest shoulder level and keep in position as horizontal as possible for as long as she is able to balance until tipping over (which she did mostly to the front, however was helped to regain the initial position with our help as we were closely monitoring the safety of exercise) Four timed trials were performed with average time of 16 seconds.
- Wheelchair up and down the ramp beside Walker Ian Beddis once at a slower pace
Due to the Rheumatoid arthritis the client was not comfortable holding the resistance bands in the way that the exercise intended when performing resistance band pulls. The client had to be constantly reminded of maintaining the proper postural alignment while performing exercise as she tend to tilt to the right side often due to scoliosis and muscle imbalances. The client was not able to reach forward for more than approximately 2-3 cm in forward direction away from her wheelchair back support. She was reminded to maintain proper breathing pattern as she focused all of the attention on performing the right technique. The seated row exercise was one of the hardest for the client to perform partially due to the way the equipment was possible to get adjusted. Even though the client understands we are limited in timing of the training, she is excited and wishes to see the results which will motivate her to further improvements.
 Training Session #2
Location: Rowing center Date: March 7th Time: 3pm Members present: Moe & Natasha
As it was suggested to find out the condition of Leann's spinal column and if she has a fixation rod in place. We will determine the cause of limited trunk flexion and extension which was a limitation from the previous workout. The goal today is to continue and overload her upper body muscles that we have identified in our assessment. As observed in the previous session, the ability to maintain her self in an upright posture was difficult which will be addressed in this session. We want her to perform exercises with proper breathing patterns while maintaining god posture to maximize the workout benefit. Because transfer in between workout stations is sufficient rest we will promote circuit training. The benefits of circuit training are robust in the SCI population. The while maintaining her strength training program, we can use circuit training to keep her HR elevated for a longer period of time to reap CV fitness benefits as well. This session will work on 3 exercises per circuit with an active recovery component. After completing the circuit 3 times through she will be given adequate rest to recover before starting the second circuit. Leann has a training background and we will use this to our advantage to maximize training benefits in each session.
- Wheelchair up the ramp beside Walker Ian Beddis 5 times
- Shoulder Abducted Rotation stretch x 10 - Broomstick Stretch, Using wooden dowel, internal and external rotation x 10 - Side reach opposite arms touching the floor x 10 each side alternating - Reaching forward and touching opposite foot x 10 alternating sides
Workout Out - Each Circuit will be performed 3 times through
- Seated upright back flys 8 lbs 10-12 reps - Seated Shoulder Press 15 lbs 10-12 reps
- Seated Dumbbell Curls - 15 lbs 10-12 reps
- Active wheelchair beside the water tank 30 secs
- External shoulder rotation 5 lbs 10-12 reps - Internal Shoulder rotation 5 lbs 10-12 reps - Med Ball Chest pass 3 lbs 10-12 reps - Active wheelchair beside water tank 30 secs
- Lateral Shoulder raises 8 lbs 10-12 reps
- Horizontal Shoulder raises 8 lbs 10-12 reps - Upright Posture Med ball Transfer 5 lbs 10-12 reps - Active wheelchair to The Zone
- Lat Pull Down on cables Weight to be determined* - Anterior Deltoid raises - 10 lbs 10-12 reps
- Cable chest press - Weight to be determined* - Active recovery will not be possible due to zone population status**
Cool Down - Each stretch should be held for 15 secs minimum
- Wheelchair around the track - 2 laps - Static stretching on the track - Chest stretch against the wall - Dowel shoulder rotation stretch and held
- Wrist flexion and extension held
For this work out we had to do many alterations. The first circuit the client did with little complications, but the second circuit had to be completely changed. We did 3 exercises with the exercise band bar which belongs to Leeann. We did seated rows, overhead triceps extension, and seated chest press. We then moved to the Zone and focused on isolated strength exercises. We did benching and shoulder presses. In this section the client was able to lift much more weight, but in the first section, the client was able to get more of a cardio work out and even sweat a little bit. Leeann was happy with her work out. We all realize that we have to be open to trial and error especially with Leeann. We need to be cautious of Leeann's rods bending between T1-T8. Leeann transfers well onto the machines in the zone, so we shouldn't limit her to only using her chair.
 Training Session 3
Location: Power Cord Lab Date: March 10th Time: 1:30 Members Present: Moe & Shawn
Today we will focus on new possibilities for LeeAnn's training in the lab location. We will attempt to do an amount of exercise, but mostly it will be orientating Leeann with the lab.
Today Leeann will be warming up on the arm ergometer for 15 minutes at a moderate intensity.
Workout/trial error period
Since LeeAnn has never tried any of the exercise machines in Power Cord Lab, we will be trying out each of the machines and activities and discussing the possible benefits and detriments of each of them. We will decide as a group which ones work for LeeAnn, and which exercises do not benefit her. We may do some strength training with the machines, and also some stabilizing exercises with the punching bag and the trampoline ball, depending on what works for LeeAnn.
Training Session #3 Summary
We had goals of starting with an orientation of the lab with LeeAnn so she could become accustomed to the various pieces of equipment the lab has to offer. We went throughout the lab and tested each equipment to see if there were limitations that we will have to consider going forward. With approval from Dr. Ditor and lab instructors we have decided as a group to meet SOLELY at the BRIC building as it offers more variety in training programs and her comfort zone increases dramatically when training.
Our feedback from group members and LeeAnn was a 'mixture of both strength and circuit training' which we can incorporate into her training sessions. In our post workout consultations, she mentioned that she likes doing strength training with accessible machines and resistance bands however, she is also interested in exploring circuit training. We tried circuit training with LeeAnne and found that was very taxing with stability based exercises. Moving forward and looking at our Assessment results, we want to continue working on core stability as she has some activation which is not clear. Her doctors have mentioned she has some core innervation and it may be stronger on the left side when compared to the right side. This may have to do with her floating hip. This is why we will continue to stress core activation while doing exercises in a circuit matter. We would like to further look at her daily posture that is based on being hunched over constantly as she is wheeling around. Constant internally rotated shoulders have limited her shoulder range of motion. We need to incorporate external rotation and shoulder abduction with care of her rotator cuff muscles.
 Workout Plan for Session 3
- 15 min CV training on arm erg
- We have gone through measuring heart rate and we would like to keep her between 130 -150 bpm for 15 min - As a SCI patient, sweating is not a good indication of RPE so we will have to make sure we are more accurate with HR
Monitoring Using a Heart Rate monitor for future workouts is highly suggested and we should get into a habit of signing them out due to secondary health concerns
Circuit #1 - Repeat 3 times through
- Shoulder rope pull downs and reset 12 reps
- Medicine ball throws on trampoline 30s
- Seated dynamic shoulder push 12 reps - Medicine ball throws on trampoline 30s
- Seated shoulder press 40 lbs x 12 reps x 3 sets
- Seated* Pec Flys 50 lbs x 12 reps x 3 sets
- Seated row 40 lbs x 12 reps x 3 sets
- Lat Pull Downs 60 lbs x 12 reps x 3 sets
Circuit #2 - Repeat 3 times through
- Seated Chest press 12 reps red band
- Seated Row 12 reps red band
- Full Body Dips 4 reps Body weight
- Rest 1 min
- Door way stretch - Shoulder rotation stretch - Pec stretch
- Shoulder external rotation stretch
- Tricep extension stretch
She was very sore after this workout but thoroughly enjoyed herself. Must make sure she isn't pushing herself too much as we do not want her sore for the whole week.
 Training Session #4
- there was supposed to be a work out on March 13 but it was missed because the lab was closed, it ended up working out because Leeann was very sore becasue of her work out on March 10 and because of a bone infussion (treatment for osteoporosis)
Location: Power Cord lab (BRIC) Date: March 19th Time: 10:30am - 12pm Members present: Rita & Natasha
Last training session was very good to say the least. We have all worked with her and have a good idea of what she is capable of doing in the BRIC building. We will continue to build circuit training in conjunction with strength training to overload her muscles. We want to make sure her shoulders are protected and she is working on keeping her posture upright and correct as she goes through her exercises. We will incorporate the Nustep which is another modality of CV training/ a good method of warming up with range of motion in her hips/knees.
Between each set and each circuit we will give her a 60-90 second rest.
- Nustep 15 mins at 90 - 121 bpm
Circuit #1 Repeat three times through
- Lat pull downs (1)40lbs, (2)40lbs, (3)50lbs - Medicine Ball throws 30s (1)purple ball - 2 lbs, (2)blue ball - 4lbs, (3)blue ball - Chest press
- Medicine Ball throws 30s (1)purple ball - 2 lbs, (2)blue ball - 4lbs, (3)blue ball
- Rickshaw dips set 1 = 60lbs x 12 reps set 2 = 75lbs x 12 reps set 3 = 90lbs x 12 reps
- Preacher Curls 40 lbs x 10 reps x 3 sets
- Shoulder press set 1 = 50lbs x 12 reps set 2 = 60lbs x 12 reps set 3 = 60lbs x 12 reps
Circuit #2 Repeat 3 times through
- Cattle bell rope pulls 15lbs x 5 reps - Seated row
- Wood Cutter to the sides (2.5lbs) (pulling the rope to the opposite side - left and right) x 6 reps on each side
- Cattle bell pick up from the floor (left side) placing on the table in front and bringing over to the right side placing on the floor and back on to the table and left side x 5 reps
- Door way stretch - Shoulder rotation stretch - Pec stretch - Shoulder external rotation stretch - Tricep extension stretch
LeeAnn was cheerful and enjoyed the workout, commenting on the valuable equipment the lab has, such as rickshaw dip machine which is a great way for strengthening the muscles that assist in transferring (i.e. in and out of the chair as well as the bath). She has experienced some numbness in her fingers and forearm after performing shoulder press which may have been due to the change to an unusual position of the hands over the head (some fingers got numb as well at the beginning of a workout which might be due to the arthritis). LeeAnn did not feel very comfortable performing wood choppers (due to rotating movement - the exercise was simplified by only rotating the shoulders/ upper back when bringing straight hands to the side) however improved her technique with subsequent repetitions of the movement by maintaining a better stabilizing position working on the balance. It also helped that Dr. Ditor was there to reassure her that the exercise was not harmful to her. Leeann's ideal heart rate is some where between 115-125 bpm.
 Training Session #5
Location: Power Cord lab (BRIC) Date: March 24th Time: 1:00PM Members present: Kyle & Shawn
This session we wanted to focus primarily on core and chest with a small amount of work on the back and shoulders. We built in circuit training as well as strength training. Due to the first training session being so intense we decided to eliminate the second circuit and extended her breaks by 30 seconds to ensure that she got adequate rest.
- 10 minutes on the arm ergo
- Kettle Bell Rope pulls 10lbs 12 reps - 4 lbs medicine ball throws (blue ball) 30 seconds - Seated dynamic shoulder push (no excess weight) 12 reps - 4 lbs medicine ball throws- 30 seconds
REPEATED 3 TIMES
- Body dips (full weight) 6 reps x 3 sets - Pec Deck 60 lbs x 12 reps x 3 sets - Resistance band chest press (medium) 12 reps x 3 sets - Lat Pull Down 50 lbs x 12 reps x 3 sets - Back rows 50 lbs x 12 reps x 3 sets
- Pec stretches 30 second hold - Shoulder circles - Shoulder shrugs
- Shoulder external rotation stretch - Tricep extension stretch
We had to adjust the weight on the rope pulls as she said she had too much trouble with it last time. 12 reps at 10lbs is sufficient for her to get the proper technique. She pointed out they her form has gotten much better over the last few weeks and she is able to move both arm together to compete a task. Overall she is very happy with how things are going and will try and up her training to 3 times a week, 2 with our group and another individually.
 Training Session # 6
Location: Power Cord Lab Date: March 26 Time: 1:00 pm Members present: Rita, Moe & Natasha
Today we are going to continue with two circuits mainly focusing on cardio, doing as many different activities as possible with Leeann, in order to acquaint her with as many exercise possibilities before leaving the lab. We will be targeting her core, and her biceps.
- Arm Erg - 10 minutes
- Dynamic arm circles, external and internal rotation whatever else LeeAnn wants to stretch
-Two handed rope whip 30 seconds
-Punching bag pummel 45 seconds
-Ball throws 4 kg 45 seconds
-Platform dumb bell lifts 10 lb, 10 times, (5 times per side)
- Preacher curls 20lb 10 reps x 3 sets
- Shoulder Press 70lb 10 reps x 3 sets
- wood cutters 5.5 lb 12 times per side x 3 sets
- Rickshaw dips (1)60lbx12 (2)120lbx12 (3)135lbx12
- Rope pulls (1)10lbx20 (2)10lbx12 (3)10lbx12
- Chest press (1)70lbx12 (2)90lbx12 (3)60x12
- Door way stretch
- Triceps stretch (assisted)
- Pec stretch (assisted)
- Shoulder external rotator stretch (assisted)
- Neck stretches (assisted)
- Arm circles
 Training Session # 7
Location: BRIC Building Date: April 2 Time: 1:30 pm Group Memeber: Moe
Today we started with a circuit and ended with a circuit. It was a long session and it was explained to LeeAnne that deviations would occur as it would be my (Moe) last session with her and I wanted her to get the most benefit out of her workout as possible. Wanted to learn to switch between circuit training and strength training and become familiar with every piece of equipment in the gym. We were distracted as there was a need to transfer a quad into the nustep as well.
Arm Erg 15 minutes at 70% RPE
Arm Circles in both diredctions 2 sets of 10 reps
Forward Reach 2 sets of 10 reps
Broom stick Shoulder Rotation 2 sets of 10 reps
Pec flys 60 lb 3 sets of 12
Over head Shoulder press 70 lb 3 sets of 12
Richshaw Dips 100 lbs 3 sets of 12
Rope Pull 10 lbs 10 reps
Speed Bag 30 Secs
Over head Ball throws 3 lb 30 Secs
Back Rows 60 lb 3 sets of 12
Lat pull downs 60 lb 3 sets of 12
Bicep Curls 25 lbs 3 sets of 12
Tricpet Dips (body weights) 3 sets of 4
 Training Session # 8
Location: Power Cord Lab (BRIC)Date: April 7 Time:1:30pm Members present: Natasha Chang
Originally we were going train strength and circuit for arms and legs, but when Leeann came into the session she reported that she was feeling a lot of tightness in her legs and hip areas so we added a lower body stretching component before and after the workout and cut out one of the planned circuit training. -
- Passive and manual stretching of the Lower back, oblique and leg flexors 3 reps holding for 30 seconds - 10 minutes on the arm erg
- Rope pulls (1) 10lb x 7 reps (2) 10lb x 7 reps (3) 15lb x 7 reps - Ball throw 6 lb 45 sec for all three sets - Speed bag 45 sec for all three sets
- Chest press 60lb x 10 reps for all three sets
- Pull ups (1) 7 reps (2) 6 reps (3) 5 reps of chin ups
- Lat pulls 60lb x 12 reps - Seated row (1) 70lb x 12 reps (2) 80lb x 12 reps (3) 90 lb x 9 reps - Assisted one arm shoulder press with long bar 3 sets of 5 reps alternating arms every rep
- Triceps dips (1) 7 reps (2) 6 reps (3) 7 reps
- Passive and manual stretching of the Lower back, oblique and leg flexors 3 reps holding for 30 seconds - Upper body stretching including shoulder chest and neck
During the last stretching session there was much less tension in LeeAnn's hips and legs, they didn't go into spasms when she transferred at the end of the working out, like they did in the beginning of the work out. LeeAnn thought that the pull ups and the triceps extensions had allowed her hips, back and legs to relax and release the spasms from earlier.
 Post - Assessment and Training Session # 9
Location: Power Cord lab (BRIC) Date: April 9 Time: 1:00 pm Attending: Kyle & Shawn
Our goals for this workout were to focus on strength rather than circuit training. We also completed the post assemement which mainly consisted of 1RM (7 RM) testing.
Our workout Consisted of:
10 minutes on the arm erg
Strength Bicep Curls 3 sets x 30lbs x 8 rep (or till failure)
Tricep Extensions 3 Sets x 20 lbs x 8 rep (or till failure)
Chest Press 3 sets 90 lbs x 8 reps
Lat Pull down 3 sets x 70 lbs x 8 reps
Shoulder Press 3 sets 15 lbs x 8 reps
Side Dumbbell raises 3 sets x 10 lbs x 8 reps
Front dumbbell raises 3 sets x 3lbs x 8 reps
Tricep Dips body weight (till failure) 1 set x 7 reps 2 set x 6 reps 3rd set x 4 reps
Stretching of chest, shoulders and back
 Post - Assessment Results
For our post assessment we completed LeeAnn's 1 RM test using the 7RM protocol
For her free weight bicep curl, the 1RM was 24 lbs in both arms, this was an increase of 6lbs in her right and 12 in her left.
Her free weight tricep extension, the 1RM was 24lbs as well. This was a 12 lb increase in both arms.
The 1RM lat pull down was 132 lbs, this was an increase in 84 lbs.
 Final Client Consultation
Location: Walker Cafeteria Date: April 11th Time: 12pm Members present: Natasha & Rita
The final client consultation took place in the Walker cafeteria On Wednesday the 9th at noon. The group members present were Natasha and Rita. The purpose of the consultation was to make conclusions about overall program, providing LeeAnn with her results and the goals that were met in relationship with our program. Regarding to the strength training her 1RM maxes for each exercise were calculated prior to the meeting and were given to LeeAnn in the written form in a chart format that could be found in the “Client Take Home Materials”. Beside the improvement related to her strength, description of exercises was given, providing thorough instructions of a correct form for performing each exercise as well as benefits and precautions were highlighted. Visual representation of each exercise was also provided in hope that she will be able to use the materials for constructing her future workouts and perform it effectively and safely.
 Were the Goals Met?
Overall LeeAnn improved in her workout, she has stated that she is noticing a difference in her stability and her ability to hold object out in front of her. Since it was an issue for her when she first began the program as the program came to an end it can be said that the core stability has improved due to multiple balance exercise which were incorporated into the training sessions.
Through the program the client has been engaging in bilateral strength training in order to try to reach the goal of correcting muscle imbalance and equalize muscle strength on the left and right sides. After the completion of the final assessment it has been shown that the client’s 1 RM for biceps curls has equalized. The stronger side (right) improved and the weaker side(left) caught up with the right side of the initial strength and further improved to be balanced with it.
The range of motion of the trunk has improved as by the end of the program the client is able to reach to the sides more freely and with higher confidence (for example: to reach for an object to the left or to the right)
 Client's Take Home Materials
We created a take home workout booklet describing each (main) of the exercises that were performed during the workout sessions. It is divided into sections based on the exercises performed during the warm up, circuit training, strength training and the cools down. Also provided for the client is the workout template for designing the training sessions that the client is able to do at home based on provided exercises. Multiple pages were printed out in hope that it will be motivating and interesting designing a program on her own and which will also help to keep her work outs pre planned and organized. Also an exercise tracker chart for monitoring the weight, sets and repetitions during strength training was provided in order for her to be able to calculate her further improvements and therefore further progress the design of the programs based on the improvements achieved. The client was introduced to the online 1Rep max calculator.
 Summary of the Program and Progression of Client's Achievements over Time
- errors are when the side of the platform touches the plinth.