Talk:Main Page

From PEKN4P22 FWD03 2013 Group 06

Jump to: navigation, search

Group 6: Caroline Andrade, Craig Lawrie, Cydney Cowperthwaite, Jason DiBiase and Sam Hart


First Meeting with Client - Tuesday 28/01/2014 at 2 -3 pm, with Cydney, Jason and Caroline


Initial Meeting Questions


1.Prior to this program have you participated in any physical activity?

2.What goals are you to planning to achieve through this program?

3.Are there any medical conditions or medications that may affect your athletic training that we should be made aware of?

4.What are your expectations of us coming into this program?

5.What time would you like to meet and how many times a week would work for you?

6.Are there any comfort issues that you would like to discuss(I.e. touching ,preference of women or men)?

7.Are there any activity preferences that you would like us to incorporate into the program?

8.Do you have any oppositions to exercise?


SMART GOALS

Get the client independent on stairs, going up and down.

Stability on sitting.

Increase Upper body, Lower body and Core muscle strength.

Flexibility.


Client Assessment - Friday 31/01/2014 at 12:30 - 2 pm, with Craig, Jason, Sam, Cydney and Caroline


Flexibility and Range of Motion (ROM)

-Our group measured the range of motion of the shoulders, elbows, hips, knees using Goniometry.

 •Shoulder - flexion (Left 160; Right 140), hyperextension (Left 70; Right 65), abduction (Left 165; Right 155), horizontal abduction (Left 54; Right 52) and horizontal adduction (Left 115; Right 113).
 •Elbow - flexion (Left 33-151; Right 25-150) and extension (Left 151-33; Right 150-25).
 •Hip - flexion (Left 95; Right 105), adduction (Left 25; Right 32), abduction (Left 40; Right 36)
 •Knee - flexion (Left 98; Right 90)
  • These recordings were used to give us a base line of our client’s flexibility and ROM, however it should be noted that they may differ from day to day depending on our client’s level of pain, stiffness or spasticity.
  • These values were also recorded using passive range of motion where our client was passive moved through different ROM’s


Strength

-This was assessed using sets working up to one set of max repetitions, on the following exercises: Barbell bench press, Leg press.


Leg Press: 1 set x 5 reps at 180lbs, 1 set x 5 reps at 155lbs, 1 set x 5 reps at 90lbs

  • The first set was used to help bend the clients knees and also gave us an indication of how much weight we should use. The second and third set will be a more appropriate weight to use during subsequent workouts.

Bench Press: 1set x 10 reps at 45lbs (bar weight)

  • Each rep was racked for a couple seconds and then lifted again. The emphasis here was to establish good technique which will need to be worked on, rather than a true assessment of strength.


Additional notes: Our group had designed the workout to include more exercises to test strength however this is all that our client and our group could complete on this day.

This was a good workout to understand and discuss where our client is in terms of current fitness.

The group assisted the transfer and positioning of the client on the machines and was aware to the client's perceived exertion and if any discomfort or pain was present. Modifications were made to exercises to suit the client's needs.

Although our group will have a workout plan going into each workout we understand that based on how our client is feeling that day not everything can be completed and adjustments may need to be made to exercises to fit our client’s needs.


First Training Session - Sunday 09/02/2014 at 2 - 4 pm, with Craig, Cydney, Caroline and Jason.

 •Walking up stairs holding rail on left side and crutch on right side, with some assistance for feet placement
 •Walking down stairs hold rail on right side and crutch on left side, no real assistance needed
 Image:Stairsss.png
 Weight room rowing centre:
 •Leg Press: 2 sets x 10 reps at 90lbs
 *keep knees apart and feet placement even
 Image:Leg press.png
 •Lat Pull-Down: from wheelchair 2 sets x 10 reps at 50lbs, 1 set x 10 reps 60lbs
 *use buckle on chair to keep client from raising up out of the chair
 Image:Lat pull down.png
 •Bench press: 1 set x 2 reps, 4 reps, 5 reps, 5 reps, 5 reps, 8 reps to failure all sets at 45lbs (bar weight)
 Image:Barbell bench press.png
 •Crunches with rope pull and assisted back support: 1 set x 10 reps
 *use alternating hands one over the other to help pull as client crunches
 Image:Lying crunches.png


Second Training Session - Wednesday 12/02/2014 at 12:30 - 2:30 pm, with Caroline, Sam, Craig and Jason.


 •Client's Physio stretching plan
    Passive ROM Stretches from supine position: 
    Single Knee to chest: Each leg was bent slowly into position to unlock knees and hips due to extensor tone in the legs, held for 1 minute.
    Single leg Knee up and hip external rotation: To stretch the glutes and piriformis, held in position for 1 minute.
    Double knees up, hip side to side rotation: With knees bent, feet flat on floor, both legs were held to one side then the other to stretch     glutes, piriformis and lower back, held for 1 minute each.
    Straight leg hamstring stretch: Both legs were held straight and up past the hip for 1 minute.
    Single leg hip adductor stretch: One leg was held in position flat on the floor while the other leg was moved laterally away from middle line to stretch the hip adductors.
    Knee over Knee quad stretch: Bending client’s knee over trainer’s knee and applying pressure downward on tibia to stretch the quad muscles held for 1 minute.
    *The stretching is done at the beginning of the session to break down the client's spasticity and make the following exercises easier.
 •Leg Press: 2 sets of 11 reps at 90lbs, 1 set 8 reps at 90lbs
 •Cable row: 1 set x 28 reps at 20lbs, 2 sets of 12 reps at 40lbs
 *with feet hooked into bench and hips held down by trainer
 Image:Cable row.jpg
 •Bench Dips: 1 x 12 at Bodyweight (BW), 2x10 at BW with assistance on concentric phase
 *dips where done off of cable row bench about 6-8 inches off floor
 Image:Bench dips.jpg
 •Crunches with rope pull and assisted back support: 1 set x 10 reps
 *might be more useful to use a thicker, easier to grab rope
  • Notes: Due to client’s spasticity today she was less pliable when putting her through various ROM stretches


Third Training Session - Friday 14/02/2014 at 12:30 - 2:30 pm, with Jason, Craig and Caroline.


 •Passive ROM Stretches from supine position: 
   -Single Knee to chest: Each leg was bent slowly into position to unlock knees and hips due to extensor tone in the legs, held for 1 minute.
   -Single leg Knee up and hip external rotation: To stretch the glutes and piriformis, held in position for 1 minute.
   -Double knees up, hip side to side rotation: With knees bent, feet flat on floor, both legs were held to one side then the other to stretch     glutes, piriformis and lower back, held for 1 minute each.
   -Straight leg hamstring stretch: Both legs were held straight and up past the hip for 1 minute.
   -Single leg hip adductor stretch: One leg was held in position flat on the floor while the other leg was moved laterally away from middle line to stretch the hip adductors.
   -Prone position quad stretch: Holding the hips down bend the knee and push the tibia towards the head, stretch held for 1 minute.
Weight training: 
 •Leg Press: 1 set x 5 reps at 90lbs, 2 sets x 6 reps at 135lbs
 *We used this before the ROM exercises to help stretch out and flex knees
 •Lat Pull-Down: 1 set x 15 reps at 50lbs, 1 set x 10 reps at 60lbs, 1 set x 18 reps at 60lbs
 •Wall Squat: 1 set x 10 reps
 *With feet braced on the floor, foam roller between knees, hands holding a stable bar and back up against the wall
 Image:Wall squat.jpg
 •Bench Press: 1 set x 10 reps at 45lbs, 2 sets x 6 reps at 55lbs
 •Seated Dumbbell Biceps Curl to Overhead Press: 3 sets x 10 reps at 5lbs each
 *The weight was good for the overhead press but a bit light for the curls
 Image:Biceps curls.png    Image:Seated overhead press.png


Fourth Training Session - Sunday 16/02/2014 at 1:00 - 3:00 pm with Jason, Craig and Caroline.

 •Walking up stairs with crutch in left hand and holding rail with right hand
 •Walking down stairs with crutch in right hand and holding rail with left hand
 *assistance was only needed to help foot placement going up the stairs
 *client had an easier time going up the last time we tried walking up the stairs the opposite way, with crutch in right hand and holding rail in the left.
 •Passive ROM Stretches from supine position: 
   -Single Knee to chest: Each leg was bent slowly into position to unlock knees and hips due to extensor tone in the legs, held for 1 minute.
   -Single leg Knee up and hip external rotation: To stretch the glutes and piriformis, held in position for 1 minute.
   -Double knees up, hip side to side rotation: With knees bent, feet flat on floor, both legs were held to one side then the other to stretch     glutes, piriformis and lower back, held for 1 minute each.
   -Straight leg hamstring stretch: Both legs were held straight and up past the hip for 1 minute.
   -Single leg hip adductor stretch: One leg was held in position flat on the floor while the other leg was moved laterally away from middle line to stretch the hip adductors.
   -Prone position quad stretch: Holding the hips down bend the knee and push the tibia towards the head, stretch held for 1 minute.
Weight training: 
 •Leg Press: 3 sets x 10 reps at 135lbs
 *We used this before the ROM exercises to help stretch out and bend the legs
 •Lat Pull-Down: 1 set x 15 reps at 50lbs, 1 set x 12 reps at 60lbs, 1 set x 10 reps at 70lbs
 •Dumbbell Overhead Shoulder Press: 1 set x 11 reps at 5lbs, 1 set x 12 reps at 5lbs, 1 set x 14 at 5lbs
 *assistance is given by trainer guiding the wrist
 •Seated Dumbbell Biceps Curl: 1 set x 10 reps at 8lbs, 1 set x 12 reps at 8lbs, 1 set x 14 reps at 8lbs
 •Bench Dips off low bench: 2 sets x 10 reps, 1 set x 15 reps, body weight.
 *assistance is given on the concentric part of the lift by having the trainer pull up underneath the arms


Fifth Training Session - Tuesday 18/02/2014 at 1:00 - 3:00 pm, with Jason, Cydney and Caroline.

 •Passive ROM Stretches from supine position: 
   -Single Knee to chest: Each leg was bent slowly into position to unlock knees and hips due to extensor tone in the legs, held for 1 minute.
   -Single leg Knee up and hip external rotation: To stretch the glutes and piriformis, held in position for 1 minute.
   -Double knees up, hip side to side rotation: With knees bent, feet flat on floor, both legs were held to one side then the other to stretch     glutes, piriformis and lower back, held for 1 minute each.
   -Straight leg hamstring stretch: Both legs were held straight and up past the hip for 1 minute.
   -Single leg hip adductor stretch: One leg was held in position flat on the floor while the other leg was moved laterally away from middle line to stretch the hip adductors.
   -Prone position quad stretch: Holding the hips down bend the knee and push the tibia towards the head, stretch held for 1 minute.

Weight training:

 •Leg Press: 3 sets x 10 reps at 135lbs
  *We used this before the ROM exercises to help stretch out and bend the legs
  *Hold at bottom of last reps on last set to help stretch out the legs
 •Cable Row: 1 set x 15 reps at 30lbs, 1 set x 11 reps at 40lbs, 1 set x 10 reps at 50lbs
 •Bench Press: 1 set x 10 reps at 45lbs, 2 sets x 10 reps at 55lbs
  *will need to work on technique
 •Wall Squat: 2 sets x 10 reps
  *Only holding bar for support on 2nd set
 •Crunches (with rope pull assistance): 1 set x 11 reps
 •Single-Leg, Leg Extensions: 3 sets x 10 reps (machine weight with no added plates)
 *Good to have client doing each leg individually to help balance out strength in both legs
 Image:Leeeg extension.jpg


Sixth Training Session - Wednesday 05/03/2013 at 12:30 - 2:00 pm with Craig, Sam and Caroline

 •Leg Press: 3 sets x 10 reps, 135lbs
 •Passive ROM Stretches from supine position:
   -Single Knee to chest: Each leg was bent slowly into position to unlock knees and hips due to extensor tone in the legs, held for 1 minute.
   -Single leg Knee up and hip external rotation: To stretch the glutes and piriformis, held in position for 1 minute.
   -Double knees up, hip side to side rotation: With knees bent, feet flat on floor, both legs were held to one side then the other to stretch     glutes, piriformis and lower back, held for 1 minute each.
   -Straight leg hamstring stretch: Both legs were held straight and up past the hip for 1 minute.
   -Single leg hip adductor stretch: One leg was held in position flat on the floor while the other leg was moved laterally away from middle line to stretch the hip adductors.
   -Butterfly stretch: On her back, feet flat on the ground, knees are pushed apart at same time and hold for 1 minute.
   -Prone position quad stretch: Holding the hips down bend the knee and push the tibia towards the head, stretch held for 1 minute.
 •Lat Pull-Down: 3 set x 15 reps, 50 lbs first set, 60 lbs second and third sets.
 •Triceps Bench Dips off low bench (body weight): 3 sets, 10 reps
 •Wall Squat: 2 sets x 10 reps 
 •Shoulder press: 3 sets, 13 reps, 5lbs
  • note: it doesn't apply changes in intensity, but progression in type (mode) and time (rest) are encouraged.

Seventh Training Session - Friday 07/03/2013 at 12:30 - 2:00 pm with Cydney, Jason and Caroline

 •Leg press: 3 sets x 10 reps, 135lbs
 •Stretching
   -Single Knee to chest: Each leg was bent slowly into position to unlock knees and hips due to extensor tone in the legs, held for 1 minute.
   -Single leg Knee up and hip external rotation: To stretch the glutes and piriformis, held in position for 1 minute.
   -Double knees up, hip side to side rotation: With knees bent, feet flat on floor, both legs were held to one side then the other to stretch     glutes, piriformis and lower back, held for 1 minute each.
   -Straight leg hamstring stretch: Both legs were held straight and up past the hip for 1 minute.
   -Single leg hip adductor stretch: One leg was held in position flat on the floor while the other leg was moved laterally away from middle line to stretch the hip adductors.
   -Prone position quad stretch: Holding the hips down bend the knee and push the tibia towards the head, stretch held for 1 minute.
 •Cable Row: 1 set x 10 reps at 30lbs, 2 sets x 10 reps at 40lbs
 •Bench Press: 1 set x 10 reps at 45lbs, 2 sets x 8 reps at 55lbs
 •Crunches (with rope pull assistance): 1 set x 12 reps

Eighth Training Session - Friday 14/03/2014 at 12:30 - 2:00 pm with Jason, Sam and Cydney

  • session done in the Dance studio because Rowing Centre was crowded, equipment was limited.
 •Stretching
   -Single Knee to chest: Each leg was bent slowly into position to unlock knees and hips due to extensor tone in the legs, held for 1 minute.
   -Single leg Knee up and hip external rotation: To stretch the glutes and piriformis, held in position for 1 minute.
   -Double knees up, hip side to side rotation: With knees bent, feet flat on floor, both legs were held to one side then the other to stretch     glutes, piriformis and lower back, held for 1 minute each.
   -Straight leg hamstring stretch: Both legs were held straight and up past the hip for 1 minute.
   -Single leg hip adductor stretch: One leg was held in position flat on the floor while the other leg was moved laterally away from middle line to stretch the hip adductors.
   -Butterfly stretch: On her back, feet flat on the ground, knees are pushed apart at same time and hold for 1 minute.
   -Prone position quad stretch: Holding the hips down bend the knee and push the tibia towards the head, stretch held for 1 minute.
 •Triceps Dips: 3sets x 10 reps with assistance 
 •Dumbbell floor Press: 1 set x 10 reps at 8lbs, 3 sets x 10 reps at 10lbs
 •Overhead dumbbell press: 3 sets x 10 reps at 5lbs
 •Seated dumbbell press: 1 set x 15 reps at 5lbs and 2 sets x 15 reps at 8lbs

Ninth Training Session - Wednesday 19/03/2014 at 12:30 - 2:00 pm with Jason, Craig and Caroline

 •Leg press: 3 sets x 10 reps, 135lbs
 •Stretching
   -Single Knee to chest: Each leg was bent slowly into position to unlock knees and hips due to extensor tone in the legs, held for 1 minute.
   -Single leg Knee up and hip external rotation: To stretch the glutes and piriformis, held in position for 1 minute.
   -Double knees up, hip side to side rotation: With knees bent, feet flat on floor, both legs were held to one side then the other to stretch     glutes, piriformis and lower back, held for 1 minute each.
   -Straight leg hamstring stretch: Both legs were held straight and up past the hip for 1 minute.
   -Single leg hip adductor stretch: One leg was held in position flat on the floor while the other leg was moved laterally away from middle line to stretch the hip adductors.
   -Butterfly stretch: On her back, feet flat on the ground, knees are pushed apart at same time and hold for 1 minute.
   -Prone position quad stretch: Holding the hips down bend the knee and push the tibia towards the head, stretch held for 1 minute.
 •Bench Press: 3 sets x 10 reps at 45lbs - focusing on technique
 •Crunches (with rope pull assistance): 1 set x 13 reps
 •Hip flexion activation on side: client laying on side trying to activate hip flexors with assistance, 3 sets x 12 reps.

Tenth Training Session - Friday 21/03/2014 at 12:30 - 2:00 pm with Jason, Cydney, Craig

 •Leg press: 3 sets x 10 reps, 135lbs
 •Stretching
   -Single Knee to chest: Each leg was bent slowly into position to unlock knees and hips due to extensor tone in the legs, held for 1 minute.
   -Single leg Knee up and hip external rotation: To stretch the glutes and piriformis, held in position for 1 minute.
   -Double knees up, hip side to side rotation: With knees bent, feet flat on floor, both legs were held to one side then the other to stretch     glutes, piriformis and lower back, held for 1 minute each.
   -Straight leg hamstring stretch: Both legs were held straight and up past the hip for 1 minute.
   -Single leg hip adductor stretch: One leg was held in position flat on the floor while the other leg was moved laterally away from middle line to stretch the hip adductors.
   -Butterfly stretch: On her back, feet flat on the ground, knees are pushed apart at same time and hold for 1 minute.
   -Prone position quad stretch: Holding the hips down bend the knee and push the tibia towards the head, stretch held for 1 minute.
 •Cable Row: 1 set x 10 reps at 30lbs, 1 set x 10 reps at 40lbs, 1 set X 10 reps at 50 lbs
 •Bench Press: 3 sets x 10 reps at 45lbs
 •Crunches (with rope pull assistance): 1 set x 15 reps
 •Hip flexion activation on her back: client laying in supine trying to activate hip flexors with assistance, 2 x 10 reps

Eleventh Training Session - Wednesday 26/03/2014 at 12:30 - 2:00 pm with Jason, Sam and Caroline

 •Leg press: 3 sets x 10 reps, 135lbs
 •Stretching
   -Single Knee to chest: Each leg was bent slowly into position to unlock knees and hips due to extensor tone in the legs, held for 1 minute.
   -Single leg Knee up and hip external rotation: To stretch the glutes and piriformis, held in position for 1 minute.
   -Double knees up, hip side to side rotation: With knees bent, feet flat on floor, both legs were held to one side then the other to stretch     glutes, piriformis and lower back, held for 1 minute each.
   -Straight leg hamstring stretch: Both legs were held straight and up past the hip for 1 minute.
   -Single leg hip adductor stretch: One leg was held in position flat on the floor while the other leg was moved laterally away from middle line to stretch the hip adductors.
   -Butterfly stretch: On her back, feet flat on the ground, knees are pushed apart at same time and hold for 1 minute.
   -Prone position quad stretch: Holding the hips down bend the knee and push the tibia towards the head, stretch held for 1 minute.
 •Cable Row: 1 set x 10 reps at 30lbs, 1 set x 10 reps at 40lbs, 1 set X 10 reps at 50 lbs
 •Bench Press: 4 sets x 10 reps at 45lbs
 •Crunches (with rope pull assistance): 1 set x 15 reps
 •Hip flexion activation on her back: client laying in supine trying to activate hip flexors with assistance, 2 x 10 reps
 •Lat Pulldown: 3 sets x 10 at 40, 50 and 60 lbs

Twelth Training Session - Friday 28/03/2014 at 12:30 - 2:00 pm with Jason, Craig and Cydney

 *Post-test was done first followed by the training

Range of Motion (ROM)

-Our group measured the range of motion of the shoulders, elbows, hips, knees using Goniometry.

 •Shoulder - flexion (Left 179; Right 181), hyperextension (Left 81; Right 85), abduction (Left 156; Right 151), horizontal abduction (Left 30; Right 47) and horizontal adduction (Left 140; Right 145).
 •Elbow - flexion (Left 25-155; Right 30-162) and extension (Left 155-25; Right 162-30).
 •Hip - flexion (Left 105; Right 110), adduction (Left 30; Right 35), abduction (Left 30; Right 42)
 •Knee - flexion (Left 101; Right 92)
 notes:Client had rowed the day before and said shoulders were sore and tight.
      Client said that spasticity medication had been reduced twice since first meeting and that she should technically be tighter.
      Otherwise client said that first time she works with anyone she is more spastic until she gets more comfortable.

Strength

 •Leg press: 1 set x 5 reps at 135, 1 set x 5 at 180, 1 set x 5 at 225, 2 sets x 5 at 270lbs
 •Cable Row: 1 set x 10 reps at 40lbs, 2 sets x 10 reps at 50lbs
 •Bench Press: 4 sets x 10 reps at 45lbs
 •Crunches (with rope pull assistance): 1 set x 17 reps
 •Hip flexion activation on her back: client laying in supine trying to activate hip flexors with assistance, 2 x 10 reps
 •Lat Pulldown: 1 set x 10 at 50,60 and 70lbs


The goals the group had at the beginning of the program could not be reached because of limitation of time related to client's specific needs. Due to client's disability, 6 weeks of training were not enough to acquire great results, since it requires a longer time to show them, although the client still showed good Range of Motion and Strength results. It is important to remember that the values of Range of Motion are passive of day-to-day changes depending on client's spasticity level.


The group will provide for the client a sheet with the exercises and pictures that were done throughout the program, with a comparison of pre-test and post-test results, sets, loads and values in case she wants to continue the training with another group.


Image:Chart progression.png Image:Chart progression 2.png

Personal tools
Bookmark and Share