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From PEKN 4P22 D02 2012 Group 02
Group 2: Amy C. Stephanie P. Amber P. Ben M. Brittany B.
Brittany Brown 4818415
Stephanie Pinelli 4523643
Amy Crawford 4529012
Amber Penner 4532685
Ben Murphy 4297701
Contents |
[edit] Consultation
Tuesday, October 2, 2012
Who was Present: Stephanie P., Amy C., Ben M., Brittany B.
[edit] Questionnaire
- 1.What is your ultimate goal you wish to accomplish with this program?
- Increase flexibility
- Maintain general exercise regimen
- Increase core strength
- Increase muscle tone
- 2.What expectations do you have of this program? Of us?
- Patience with injuries
- 3.Have you had any previous injuries? If yes, where?
- Right rotator cuff injury
- Low back
- 4.Do you have any medical conditions we should be aware of when setting up your exercise program?
- Low Blood Pressure
- 5.Is there any part of your body that is sore just from moving day to day?
- Low back, right shoulder, knees
- 6.How active are you on a weekly basis?
- Active (5 days per week)
- Yoga, swimming, fitness classes (ex. body tone class), speed walking
- 7.Do you have access to anything that can assist you in exercising? (ie. gym membership, pool in yard, etc.)
- Zone membership
- 8.What are you comfortable with doing? Uncomfortable with?
- Comfortable with anything
- Uncomfortable with core exercise (poor core strength) but willing to work on, lunges
- 9.Have you been in any previous exercise programs/classes? If yes, what has worked? What hasn't?
- Many, mostly loved everything
- Hard time with pilates due to poor core strength
- 10.Do you have medical clearance from your doctor to participate in this exercise program?
-Yes
- 11.Does your occupation involve some exercise? (ie. walking stairs daily)
- No, long distance driving
- 12.What is the best time during the week to set up your exercise sessions? If possible, twice a week for one hour sessions.
- Anytime
- 13.Could you please tell us your age, weight, and height in order to make an exercise program best suited for you.
- 42, 5"2 1/2, 123lbs
PAR-Q Questionaire
- Answered yes to question 5 (do you have a bone or joint problem (for example, back, knee, or hip) that could be made worse by a change in your physical activity)
- Has already received medical clearance from doctor
[edit] Fitness Assessment Pre-Test
Tuesday, October 9, 2012
Who was present: Brittany B., Ben M.
Range Of Motion
- Completed Joint ROM assessment using goniometer. Past injury to the right rotator cuff, thus wanted to note the extent of joint limitations if any in that shoulder, especially in comparison to the left.
- Flexion: R: 0-167 L: 0-164
- Extension: R- 167-0 L: 164-0
- Hyperextension: R: 0-35 L: 0-37
- Abduction: R: 0-160 L: 0-166
- Medial Rotation: R: 0-44 L: 0-50
- Lateral Rotation: R: 0-76 L: 0-81
- For the majority no display of limitation in right shoulder in comparison to left, and both were within the "normative data" for these joints. The one exception was medial rotation on the right side which had a minor limitation, but not major. Client also expressed not feeling any pain during assessment of shoulder ROM
Manual Muscle Test
- Completed Manual Muscle test specifically targeting the arms/shoulders. Along with the rotator cuff injury post accident client also experiences minor low back pain, thus wanted to explore strength of surrounding muscles in arms as well as hips.
- Shoulder Horizontal Adduction: L: 5 (Normal) R: 4 (Good)
- Shoulder Horizontal Abduction: L: 5 R: 4
- Flexion: L: 5 R: 4
- Extension: L: 5 R: 4
- Medial Rotation: L: 5 R: 4
- Lateral Rotation: L: 5 R: 4
Hips *Measured hip ROM by having client lay flat on back and try to raise legs off ground and hold for 10 seconds
-couldn't hold for 10 seconds
- Slight limitaion in the right shoulder when adding a resistance overload to the shoulders.
- In all cases, the left shoulder, could apply maximum resistance however in the right, could only apply minimum resistance.
- Weakness in right shoulder strength in comparison to left.
- Obvious weakness in flexion of the hips (not completing 10 seconds). Client expressed feeling no pain however struggled to hold position without any resistance. Also displays a weakness in core muscles involved.
Functional Movement Screening (FMS)
- Purpose of FMS was to note of any compromising positions where lack of strength from injuries would be applicable
- Left shoulder reaching above head: score of 1 (fists not within one and a half hand lengths/greater than 9 inches apart)
- Right shoulder reaching above head: score of 3 (fists within one hand length) *hands were touching
*Limited right shoulder flexibility (due to injury)
- Right leg: score of 3 (hips remained on floor, dowel resided between mid thigh and ASIS)
- Left leg: score of 3
*Great hamstring stability and flexibility
- score of 2 (Performed one repetition with thumbs aligned with chin, slight lag in lumbar spine when raising)
*good symmetric trunk stability in the sagittal plane during symmetric upper extremity movement
- score of 2 (performed one correct diagonal flexion and extension lift while keeping torso parallel to board and floor)
*good asymmetric stability of trunk stabilizers
CV Health
- Measured by 12 minute run/walk
- Described to client she had to run for 12 minutes around track, walking as much/far as she needed too, the goal being to get as much distance logged in 12 minutes.
- Estimated clients VO2 max from run
- Used simple submaximal 12 run test because increased cardiovascular endurance was not a goal of the program. Client in initial meeting expressed working out multiple times a week including multiple cardio sessions (major one being walking every morning), therefore wanted to get a base line of CV health in terms of what best mirrors how she achieves cardio endurance and fitness (i.e. walking)
- Client completed 8.125 laps measured from 200m distance equaling 1 lap, therefore for equation 4.06 labs from 400m distance
- 4.06 laps X 400m = 1624m
- VO2 max = (0.0268 X (distance)) - 11.3 = 32.2ml/kg/min
- Compared with values in table 11.17 in textbook client in 60th percentile (average to above average)
Strength
- Used estimated 1RM from 10RM mostly for safety purposes of the client.
- One goal being overall muscle tone, wanted to get a generalized idea for where client stood for upper and lower body muscle strength.
- Used machine for leg press and seated row.
- Described to client purpose behind 10 RM (maximal amount of weight she could lift 10 times)
Estimated 1RM leg press using Bryzki Equation
- 1RM=weight lifted/(1.0278-(0.0278 X reps)) = 60lbs/(1.0278-0.0278 X 10reps) = 80.02
- Estimated 1RM for leg press is 80 lbs
Estimated 1RM seated row using Bryzki Equation
- 1RM=weight lifted/(1.0278-(0.0278 X reps)) = 40lbs/(1.0278-0.0278 X 10reps) = 53.35
- Estimated 1RM for seated row is 53 lbs
Core Muscle Strength and Stability Test
- At consultation client expressed having a very weak core
- One goal of the program being to increase overall strength wanted to get a baseline establishment of core strength
- This planking test involved being in a plank position on the elbows, holding for 60 seconds (during which, raised right arm off ground for 15sec, then left arm off ground for 15 sec, then lifting right leg off ground for 15sec, then left leg 15sec), then additional 30 seconds maintaining original plank position.
- Measured by completion and comparison from pre to post testing
- Client completed without rest, however with extreme difficulty, also with extreme over compensations while lifting each individual base of support (ex. excessively leaning to opposite hip). In last 30 seconds of test in original plank position, hips began to excessively raise (not creating flat back) and lumbar region began to lag.
- One goal for the program being overall muscle tone, wanted to get a generalized idea of where client stood for muscle endurance.
- Push up in a kneeling position with knees flexed at 90 degree angle and ankles crossed.
- Measured by how many pushups could be completed without rest, or no longer touching fist at the bottom of flexion position (1 fist was placed on top of other at chest level of client)
- client completed total number of 20
*expressed having to stop because right shoulder started to become painful, and it gives out after excess load applied
Flexibility
- One goal of the program being to increase flexibility, wanted to get a baseline of current flexibility.
- Used Sit and Reach Test to measure hip and low back flexibility
- Client advised to sit upright with legs straight out
- Tape measure placed on floor, heels of client touched edge of tape at 38cm (acting as "zero").
- Client performed sit and reach 3 times, best trial was taken as score
- Best trial: 26cm (from 38cm).
- Compared with table 11.31 in textbook client lies in 70th percentile (above average)
*displayed great flexibility
[edit] Goals - SMART
*1. Increase flexibility
- Increase range of motion in right shoulder over 5-6 weeks
- Will be done using theraband exercises
- This will be measured through joint range of motion in the right shoulder (goniometry)
- Increase muscle manual testing from 4 to 5
- FMS shoulder mobility increase from 1 to 3 on right side
*2. Increase core strength
- Increase lower abdominal strength
- This will be measured by lying straight and holding her legs straight up for 10 seconds or more
- This will be done by assisted abdominal leg pushes, scissors, and pilates
- This will be done over 5-6 weeks
*3. Increase overall muscle tone
- Working on upper and lower body strength separately on different days
- This will be done over 5-6 weeks
- This will be measured by estimated 1 RM from 10 RM with seated row and leg press and comparing it to the initial assessment
- For lower body exercises we will be using the machines such as the leg press, adductor/abductor machine, assisted calf raise, etc
- For upper body we will use lat pull downs, chest press, push ups, etc.
- Increase muscle manual testing from 4 to 5
*4. Cardio
- Cardio being done on her own time
- Will be reassessed in the end to see if any improvements through the 12 min walk/run
[edit] Thursday's Workouts
[edit] Exercise Session Plan 1
**Exercise Session Plan 1 was done for Thursday, October 11, 2012 and for Thursday, October 25, 2012
- General warm up (5 minutes)
1.Walk around track
- Shoulder Exercises (10 minutes) - This has been added in as of October 25th, 2012 and will be continued throughout the remainder of the sessions.
1.Abduction elastic resistance: 1 set of 10 
- To complete this exercise you need a resistance band. Stand with your feet shoulder width apart and step on the band to create resistance. Hold on to the other end of the band with your palm facing forward (supine), then abduct the shoulder against the resistance completing a full range of motion over your head. Repeat the exercise with both arms.
2.Abduction horizontal with elastic: 1 set of 10 
- Hold on to the resistance band with one hand and abduct your shoulder horizontally across your body. Perform the exercise starting with your arm straight ahead. Have the trainer hold the band on the other end to create resistance or tie the band to a stable surface. Repeat this exercise with both arms.
3.Adduction horizontal with elastic:1 set of 10 
- Hold on to the resistance band with one hand and adduct your shoulder horizontally across the body. Perform the exercise starting with your arm straight out at shoulder level. Have the trainer hold the band on the other end to create resistance or tie the band to a stable surface. Repeat this exercise with both arms.
4.Adduction overhead with elastic: 1 set of 10 
- Stand with both arms overhead holding the resistance band in between. Focus on keeping your posture straight and adduct the arms down while pulling against the resistance band. Keep your arms at the side and not forward or backward. Hold for five seconds then relax and repeat.
- Leg exercises (25 minutes)
1.Lunges once around the track 
- This lunge is performed using just body weight and it increases strength in the quadriceps, gluteals, and hamstring muscles. The patient is required to step forward with the right leg, bending down so that the right knee doesn't go farther then the right foot and the knee is bent at a 90 degree angle. The patient needs to make sure that the left knee that is bent lines up straight with the left hip and back. Next they push off with their back left foot to then bring it forward and repeat the whole process again with the left foot being the one in front
2.Heel raises- 3 sets of 10 reps 
- Heel raises are performed at the edge of the stairs with just the toes on the edge of them. The patient should then raise up their heels like they are going up on the balls of their feet. Then they lower their heels back down and repeat the whole set again
3.Squats- 3 sets of 10 reps 
- Squats are performed with feet shoulder width apart and the patient bends their knees. While they are bending they need to stick their behind out and can bring their arms out in front of them to help with balance. The patient would bend down until they feel a burn in their quadriceps and then they can return to the starting position and repeat it over again
4.Wide leg squats- 3 sets of 10 
- Wide leg Squats are performed with feet shoulder width apart with toes pointing outward and the patient bends their knees. While they are bending they need to stick their behind out and can bring their arms out in front of them to help with balance. The patient would bend down until they feel a burn in their quadriceps and then they can return to the starting position and repeat it over again
5. Step-ups/ stair climber- 3 sets of 10 reps - did not end up doing and took out of workout completely
6. Walk around track, do 10 burpies- 2 laps 
- burpies involve a series of steps in which you repeat. First jump straight up with your arms overhead. Next place your hands on the floor extended and jump your legs back into a plank position. You can add a push-up in next but we did not do so. Then push off with your legs and jump back towards your hands. While standing up, jump straight up and continue the steps again.
- Core (15 minutes)
1.Crunches with medicine ball- 50 
- The patient will start by laying on their back on a mat. They will then bend their knees, so their feet are flat on the ground. Place their hands at their ears. Contract abs and bring head up slightly. Return to the starting position.
2.Plank- 30 second 
- A plank is done by the patient starting on their stomach while laying down. They then raise their bodies up so that they are on their toes and their forearms, The patient then keeps their body in a straight position while holding their body up and focusing on keeping stomach and gluts tight
3.Moving Plank- 45 second 
- Start in the regular plank position described above. Next push up with one hand followed by the other so your arms are fully extended. Make sure your core is engaged and your body is still straight. Then lower one arm back into to beginning position followed by the other. Repeat this series of movements continuously.
4.Plank- 1 minute
- This is described above
5.Bicycles- slow- 20 
- Begin laying in supine position on your back on a mat. Place both hands behind your head as if you were to get ready for a crunch. Next bend your left knee towards your chest while your right elbow goes towards your knee causing your upper back to be off the ground. Lower your knee and leg while simultaneously doing the exercise with the opposite limbs. Repeat the exercise continuously for the entire set.
6.Bicycles- fast- 10
- This is the same as the previous bicycle exercise but involves increasing the tempo as quickly as you can.
7.Assisted abdominal leg pushes- 20 to each side, 20 down the middle 
- For this exercise you will need a trainer or a workout partner. Begin by laying on the mat in supine position. Have the trainer stand behind you with there feet shoulder width apart for balance. Next, reach your arms overhead and hold on to the trainers ankles. While keeping your legs straight, raise them towards the trainer while lifting your hips off the ground. The trainer will then push your legs towards the floor in a variety of directions. Let the trainer push your legs towards the floor but stop your legs from hitting the floor by engaging the core. Repeat this exercise for the entire set.
8.V-up-roll-up- 20 
- Begin this exercise by laying on the mat in supine with your arms extended overhead. Next slowly roll up into the seated position and reach towards your toes. Then as you begin to roll back, raise your legs off the floor while keeping them straight. Once your upper body is back to the starting position roll up again while keeping your legs off the floor. Your body should look in the shape of a 'V' with your back straight. Then simultaneously bring both your upper and lower body back down to the mat. Repeat this exercise.
9.Oblique twists- 50 
- Begin by sitting on the mat with your knees bent and your feet flat on the floor. Lower your back towards the floor to approximately a 45 degree angle. Hold your upper body there while keeping your back straight and engaging the core. Next lift your legs off the ground while keeping your knees bent for comfort. Then place your hands together and begin tapping the mat on either side of your body while twisting your core. Hold this position for the whole work out.
- Cool down (15 minutes)
**Stretching**all for both sides
1.Hands behind the back. Hold for 15-20 seconds 
- Place both your hands behind your back. Clasp your hands together with your thumbs facing your back. Press your chest out forwards while straightening your arms. Hold the stretch.
2.Behind neck stretch. Hold 15-20 seconds 
- Place both arms extended directly over your head. Bend your right arm at the elbow and drop your hand down the middle of your back. place your left hand on the right elbow and gently pull towards the left until you feel the stretch. Keep your back straight while doing this. Hold the stretch and repeat on the other side.
3.Arm circles 
- Extend your arms straight out to the sides of your body. Stand with correct posture and begin rotating your arms in a circular motion forward. Allow the circles to get larger as you rotate. Next, do the same movement but backwards. Keep moving because this is a dynamic stretch.
4.Knee to chest stretch. Hold 15-20 seconds 
- Start in an extended plank position. Then bring one knee up to your chest and relax your body on top of it. Lean down towards the floor for a better stretch. The other leg should be extended backwards. Repeat on the other leg and hold the stretch.
5.Semi straddle (hand to foot stretch). Hold 15-20 seconds 
- Begin in a seated position with your legs crossed. Next, extend one of your legs angled out to the side wherever is comfortable. Then reach towards your toes and move the chest towards the leg for a deeper stretch. Hold and repeat on the opposite leg.
6.Butterfly. Hold 15-20 seconds 
- Sit with your knees bent and the soles of the feet against each other. Bring the feet close to the body. Then press your elbows against your knees to increase the stretch. Hold the stretch.
7.Wall stretch. Hold 15-20 seconds 
- Stand facing a wall. Place both hands flat against the wall. Place one leg bent at the knee near the wall and the other leg extended out farther away from the wall. both feet should be flat on the ground. Lean in closer to the wall for the deeper stretch. Hold and repeat with the other leg.
[edit] Thursday, October 11, 2012
Who was present: Amy C., Amber P., Stephanie P.
Warm up
- Completed
Leg Exercises
- 1. 2/3 of the track was done in lunges and 1/3 of the track was walking
- 2. 3 sets of 30
- 3. Hurt lower back, modified position and felt better
- 4. They were too easy, she did 30 in a row (do more next time)
- 5. Didn't have time - cut it out for next time
- 6. Didn't have time but will try to do next time
Core
- 1. Crunches hurt neck, so we modify it for her to do sit-ups with no weight
- 3. Did 30 seconds, too painful for right shoulder (maybe should do something different for next time)
- 5. & 6. Completed but said it was very challenging
- 7. She did 15 straight, and 10 on each side (less then what we had, something we should work on)
- 8. Couldn't complete one full one (goal: to be able to complete a set)
- 9. Completed with rests in between, no weight, and feet on the ground
Stretches
- Completed
- Added stretches:
Modified cobra for back: 
- The patient will start laying on their stomach. They will then go up on their forearms and arch their back and lean their head back as far as comfortable. Hold stretch for 15-20 seconds.
Standing quadriceps stretch: 
- The patient will be facing a wall and place one hand on the wall for support. They will then grab their ankle with their hand and pull leg up to their butt (right hand holds right ankle, left hand holds left ankle). They will hold stretch for 15-20 seconds and repeat with the other leg.
Gluts and hamstrings stretch: 
- The patient will start by laying on their back. They will then pull up their left leg so it is right against their body. They will wrap both hands around their leg in order to pull it in tighter to their body. They will hold stretch for 15-20 seconds and repreat with the other leg.
[edit] Thursday, October 25, 2012
Who was present: Amy C., Amber P., Stephanie P.
Warm up
- Completed
Shoulder Exercises
- Completed, but was noticeably stronger in her left arm
Leg Exercises
- 1. 2/3 of the track was completed by doing lunges and 1/3 of the track was completed by walking. We saw some form fatigue, but when corrected she improved
- 2. Did not do this exercise because it is not a good exercise for planters fascia (eliminated exercise)
- 3. completed
- 4. This was too easy, so we decided to do a wall squat for 30sec & 40sec which she enjoyed
- 5. Did not have time - cut it out for next time
- 6. Did 10 burpees but did not walk around track first (not enough time)
Core
- 1. Did 3 sets of 10
- 2. Completed
- 3. Just did regular plank not the moving plank
- 4. Completed, but right arm started to hurt
- 5. & 6. Completed
- 7. Completed
- 8. Did not do
- 9. Completed with rests in between, but kept her feet off the ground the entire time
Stretches
- Completed
- Added stretches: Modified cobra for back, Standing quadriceps stretch, and Gluts and hamstrings stretch
[edit] Exercise Session Plan 2
- General warm up (5 minutes)
1.Walk around track
- Shoulder Exercises (10 minutes)
1.Abduction elastic resistance: 1 set of 10
2.Abduction horizontal with elastic: 1 set of 10
3.Adduction horizontal with elastic:1 set of 10
4.Adduction overhead with elastic: 1 set of 10
- Leg exercises (25 minutes)
1. Leg curl machine: 3 sets of 10 (Weight TBD) 
- The patient will lay down on the machine, and adjust the leg bar so it is on their ankles. They will then adjust the weight that will best suit them. The patient will bend at the knee, bringing the leg bar up close to their butt. This should be done in a slow and controlled manner.
2.Leg press machine: 3 sets of 10 (Weight 60lbs) 
- The patient will start by sitting at the machine, and adjusting the chair so that their knees start at 90 degrees. They will then adjust the weight that best suits them. Then they will push with their legs until they are fully extended, but making sure they do no lock their knees. They will then return to the original position.
3. Leg Adductors machine: 3 sets of 10 (Weight TBD) 
- The patient will start by sitting at the machine and adjusting the leg holders so that their legs are abducted as far as possible without being uncomfortable. They will then adjust the weight on the machine to what will suit them best. They will then adduct their legs, then return to the starting position. This should be done in a slow and controlled manner.
4.Leg Abductors machine: 3 sets of 10 (Weight TBD) 
- The patient will start by sitting at the machine, and placing their legs on the inside of the machine. They will then adjust the weight on the machine to what will suit them best. They will then abduct their legs as far as comfortable, then return to the starting position. This should be done in a slow and controlled manner.
5.Quadriceps press machine: 3 sets of 10 (Weight TBD) 
- The patient will sit at the machine and tuck their ankles behind the leg bar and adjust the leg bar so that it is on their ankles. They will then adjust the weight that best suits them. The patient will extend legs forward, then return to regular position. This should be done in a slow and controlled manner.
6.'Calf Machine: 3 sets of 10 (Weight TBD) 
- The patient will sit on an inclined machine with their feet resting against the bottom bar. They will then adjust the weight that best suits them. Then they will extend their legs without locking their knees. While holding on to the handles on the side of the machine, the client will lower their feet into dorsiflexion and then raise them into plantarflexion, by flexing the calve. They will do this in a controlled manner.
- Core (10 minutes)
1.Plank - hold as long as you can
2.Bicycles- slow- 20
3.Bicycles- fast- 10
4.Assisted abdominal leg pushes
5.Oblique twists- 50
- Cool down (10 minutes)
**Stretching**all for both sides
1.Hands behind the back. Hold for 15-20 seconds
2.Behind neck stretch. Hold 15-20 seconds
3.Arm circles while walking
4.Knee to chest stretch. Hold 15-20 seconds
5.Semi straddle (hand to foot stretch). Hold 15-20 seconds
5.Butterfly. Hold 15-20 seconds
6.Wall stretch. Hold 15-20 seconds
- Added stretches: Modified cobra for back, Standing quadriceps stretch, and Gluts and hamstrings stretch
[edit] Thursday, October 18, 2012
Who was present: Amy C., Amber P., Stephanie P.
Warm up
- Completed
Shoulder Exercises
- Completed
Leg Exercises
- 1. Did not do because the machine was not free
- 2. Completed 30 sets all at once - next time increase weight
- 3. 1st set-60lbs, 2nd set- 50lbs, 3rd set- 60lbs - Lower back hurt with 60lbs set so we decreased it to 50lbs, but that was too easy so we increased it back up to 60lbs (she focused on keeping her back straight to help with lower back pain).
- 4. 1st set-50lbs, 2nd & 3rd set- 60lbs
- 5. 1st & 2nd set- 50lbs, 3rd set- 40lbs (due to muscle fatigue)
- 6. Added this in: 20lbs, did 10 reps with feet angled each way (inside, middle, outside) - she liked this one
Core
- 1. Held for 2:15 - had to stop because right shoulder was sore
- 4. 20 to each side, 20 down the middle
- 5. Feet off ground for 17 reps and then put feet on ground for the remainder
Stretches
- Completed
[edit] Thursday, November 1, 2012
Who was present: Amy C., Amber P., Stephanie P.
Warm up
- Completed
Shoulder Exercises
- Completed
Leg Exercises
- 1. completed at 40lbs
- 2. Completed at 80lbs
- 3. Completed at 50lbs
- 4. Completed at 60lbs
- 5. Completed at 50lbs
- 6. Didn't do
Core
- 1. Held for 2:30, shoulder was on fire when finished
- 2 & 3. Completed and did a second set, will increase reps for next week
- 4. 20 to each side, 20 down the middle
- 5. Feet off ground for entire time, took break after 30 then completed the rest. Felt pinch in back when started exercise
Stretches
- Completed
[edit] Thursday, November 8, 2012
Who was present: Amy C., Amber P., Stephanie P.
Warm up
- Completed
Shoulder Exercises
- Completed
Leg Exercises
- 1. completed at 40lbs
- 2. Completed at 80lbs (1st&2nd set), 100lbs (3rd set)
- 3. Completed at 50lbs (1st&2nd set), 60lbs (3rd set)
- 4. Completed at 60lbs (1st&2nd set), 70lbs (3rd set)
- 5. Completed at 60lbs
- 6. Didn't do
*7. Added in 10 squats while waiting for machine
Core
- 1. Held for 30sec, (beak), 45sec, (break), 1min
- 2 & 3. Completed and did a second set
- 4. 25 to each side, 25 down the middle
- 5. Feet off ground for entire time, did not take a break
*6. Did one V-up-roll-up
Stretches
- Completed
[edit] Thursday, November 15, 2012
Who was present: Amy C., Amber P., Stephanie P.
Warm up
- Completed 9 minutes
Shoulder Exercises
- Couldn't complete because she had a shoulder strain.
Leg Exercises
- 1. Completed at 40lbs
- 2. Completed at 100lbs
- 3. Completed at 60lbs (1st& 2nd set), 70lbs (3rd set)
- 4. Completed at 70lbs, found this challenging today
- 5. Completed at 60lbs
- 6. Didn't do.
*7.Added in the Uni-lateral leg press: Completed 2 sets of 10 at 74lbs 
- The patient will start by sitting on the machine and adjusting the weight that best suits them. They will then place their feet on the feet plates, and push outwards. They will then return to the original position. This should be done in a slow and controlled manner.
Core
- 1. Didn't do because shoulder strained
- 2. Completed 2 sets
- 3. Completed the 1st set, didn't quite finish the last set due to muscle fatigue
- 4. Completed 20 down the middle, 10 down each side
- 5. Completed with feet off the ground
*6. Added in 50 crunches because we removed the plank: completed
Stretches
- Completed
[edit] Tuesday's Workouts
[edit] Exercise Session Plan 1
**Exercise Session Plan 1 was done only Tuesday October 16, 2012
- General Warm Up (5 minutes)
1. Walk/Job around track.
- Shoulder Exercises with Theraband (15 Minutes)
1. Shoulder Flexion (10 reps, 1 set). 
2. Shoulder Extension (10 reps, 1 set). 
3. Adduction (10 reps, 1 set). 
4. Abduction (10 reps, 1 set).
5. Medial Rotation (10 reps, 1 set). 
6. Lateral Rotation (10 reps, 1 set). 
- Upper Body Workout (15 Minutes)
1. Seated Row Machine (12 reps, 3 sets at 40lbs).
2. Chest Press Machine (12 reps, 3 sets at weight TBD). 
3. Lat Pulldown Machine (12 reps, 3 sets, at weight TBD). 
- Abs/Core (10 Minutes)
1. Crunches with no weight bearing - 2 sets X 50 reps
2. Reverse Crunches: 1 set X 20 reps
- with feet on ground, lying on back, reverse crunch by lifting legs and hips off ground, keeping upper body on matt.
3. Bicycles- slow 1 set X 10
4. Bicycles- fast 1 set X 20
5. Plank- 1 minute.
- Stretching/Cool down (10 minutes)
1. Hands behind back - hold 30 seconds
2. Pectoralis stretch against a wall - hold 30 seconds each arm 
3. Arm circles while walking - 15 seconds frontward 15 seconds backward
[edit] Tuesday, October 16, 2012
Who was present: Brittany B, Ben M.
Warm up
- Completed
Shoulder Exercises
- Completed - client found the right shoulder more challenging to complete exercises
Upper body exercises
- 1. Completed 3 sets 12 reps at 40lbs
- 2. Completed 3 sets 12 reps at 40lbs
- 3. Completed 3 sets 12 reps at 40lbs
Core
- 1. Completed - Still found it challenging for her, continued to get slower as she did more - Did not mention pain in the neck however
- 2. Completed
- 3. Completed
- 4. & 5. Did not have time to get to
Stretching
- Completed
Trainer Notes:
- Allow accurate amount of time to complete a full core workout with time for adequate static and dynamic stretching at the end
- Struggled with machine exercises near the end of each set
- Increase Weight for Lat pull down next week
- Really felt chest press, challenging but she liked the machine
[edit] Exercise Session Plan 2
**Exercise Session Plan 2 was done only on Tuesday, October 23, 2012
- Warm up
5 minute walk/run around track
- Shoulder exercises with theraband
1.Flexion/Extension 10 reps X 2 sets
2.Hyperextension 10 reps X 2 sets
3.Medial Rotation 10 reps X 2 sets
4.Lateral Rotation 10 reps X 2 sets
- Upper body exercises
1.Lat Pull Down machine 40lbs 12 reps X 3 sets
2.Chest Press machine 40lbs 12 reps X 3 sets
3.Seated Row machine 40lbs 12 reps X 3 sets
- Pilates
1.Table Top Pulse 
- hold 10 seconds, bring sternum up a tiny bit X3, once sternum lifted maximum amount client can handle, pulse upwards from that position (not coming back down) Pulse 10 times, then hold 30 seconds 1 set
- Concentrate on breathing "breath through your straw"
- keeping legs at 90 degrees
- belly button to spin, lower back glued to matt
- if neck gets sore place hands behind head for support
2.Straight Leg Pulse 
- Lying flat on back lift chest up, shoulder blades off the matt keeping legs straight and extended out, **place one ankle on top of other hold 10 seconds (not in picture), bring sternum up a tiny bit X3, once sternum lifted maximum amount client can handle, continuously pulse upwards (fast pulses) for 30 seconds, continuing to pulse uncross ankles and cross opposite ankle overtop continuing to pulse for additional 30 seconds (fast pulses) - 1 set
3.Criss Cross 
- start in table top position with shoulder blades off matt
- extend right leg out hovering off the ground and rotate right shoulder blade toward left knee hold 3 seconds, inhale and bring extended leg and arm back to table top position keeping shoulder blades off ground, and repeat on opposite side, - 2 sets each side
- speed up exercise (no holding table top position in between, rotate straight through) - 5 sets each side
4.Back extension 
- start with just upper body hovering off the floor pulse upward (10 pulses -- exhale with each pule), and then hold at top for 15 seconds - 1 set
- bring lower body to join upper body, just abdominal area touching floor, pulse upward (10 pulses -- exhale with each pulse), and then hold for 15 seconds - 1 set
5.Scissors 
- shoulder blades lifting off floor, lower back glued to the matt, "belly button to spine," perform scissor type action with straight legs, with 2 pulses on each leg then switching legs - 1 set 10 reps (each leg)
- Stretching
1.Child Pose 
- push hips back
- Hold 15 seconds, relax 3 seconds push hips further back, hold 15 seconds X 3 sets
2.Shoulder stretch with towel 
- Hold 30 seconds each arm - 1 set
- pull upwards on towel hold 30 seconds each arm - 1 set
- pull downwards on towel hold 30 seconds each arm - 1 set
3.Pectoralis stretch
- Hold 30 seconds each arm - 1 set
[edit] Tuesday, October 23, 2012
Who was present: Brittany B., Ben M.
- Warm up
- Completed
- Shoulder exercises with theraband
- 1. Completed
- 2. Completed
- 3. Completed
- 4. Completed
**Right side noticeable weaker for theraband exercises, less resistance required
- Upper body exercises
- 1. Completed
- 2. **Chest Press had to stop part way third set because shoulder was too painful to continue
- 3. **Seated row dropped down to 30 lbs for third set, able to complete set with less weight
- Pilates
- 1. Completed
- 2. Completed
- 3. Completed
- 4. Completed
- 5. Completed
**Pilates moves were challenging, but expressed how much she enjoyed them and was inspired to take up more pilates! Had to rest multiple times during sets, work towards no rests DURING sets
[edit] Exercise Session Plan 3
**Exercise Session Plan 3 was done only on Tuesday, October 30, 2012
- Warm up
1. 5 minute walk/run around track
- Upper body exercises
1. Lat Pull Down Machine 50lbs 12 reps X 3 sets
2. Chest Press Machine 40lbs 12 reps X 3 sets
3. Seated Row Machine 40lbs 12 reps X 3 sets
- Shoulder exercises
1. Flexion/Extension 10 reps X 2 sets
2. Hyperextension 10 reps X 2 sets
3. Medial Rotation 10 reps X 2 sets
4. Lateral Rotation 10 reps X 2 sets
- Pilates
1. Table Top position (lying on back sternum raised enough that shoulder blades raise off floor, lower back glued to matt, knees at 90 degree angle) Hold 15 seconds - 1 set
2. Table Top Tap: 
- Tap one leg to the ground and return to 90 degree angle, repeat on other side remaining in table top position X10 each side - 1 set
3. Table top pulse upwards while exhaling X 20 pulses - 1 set
4. "Dart" position 
- lying on stomach with neutral spine and arms by sides and chest raised off floor, pulse arms upward toward ceiling X 20 reps - 1 set
5. Back extension: bend arms bringing hands too forehead, with chest up pulse chest upward toward ceiling X 10 reps - 1 set
6. Back extension with legs: Bring legs up off floor to meet with chest, only abdominal area remaining on floor, pulse whole body upwards X 10 reps - 1 set
7. Hip extention 
*But with both legs together
- Keeping legs lifted off floor bring chest down resting on matt and continue pulse solely lower body upwards X 10 reps - 1 set and then relax
8. Child's pose 30 seconds
9. On back tuck knees in and rock gips back and forth 30 seconds 
10. Oblique Single Leg Lifts 
- Lying on side, legs straight slightly infront of body, keep hips stacked on top of each other, point top foot and raise hovering off floor, exhale and bring bottom leg up to join hovering squeezing knees and legs together, and then release bring them both to the floor X 10 reps - 1 set
11. Oblique Leg Lifts 
- Pulse both legs up together, squeezing knees and legs together X 10 reps - 1 set
12. Oblique Crunch 
- Keep legs hovering and pulse upper body using arm on floor as supporting arm, exhale as pulse upward X 5 reps - 1 set, and then relax
13. On back tuck knees in and rock hips back and forth - 30 seconds
14. Switch sides and repeat exercises on opposing side
15. On back tuck knees in and rock hips back and forth - 30 seconds
16. Scissors: (2 pulses on leg before switching, exhaling on both pulses, inhaling as switching legs) X10 reps on each leg - 1 set
Stretching
1. Lower back stretches on floor (held 30 seconds X1 set each side) 
2. Hamstring/piriformis stretch (held 30 seconds X1 set each side) 
3. Glut stretch (held 30 seconds X1 set each side) 
5. Arm/shoulder stretches (held 30 seconds X1 set) - shoulder across body and shoulder behind neck 
6. Shoulder towel stretch (held 30 seconds X1 set)
7. Pec Stretch (held 30 seconds X1 set)
[edit] Tuesday, October 30, 2012
Who was present: Brittany B., Ben M.
- Warm up
- Completed: She walked to warm up instead of running. Her planter fasciitis was acting up and her knee and lower back hurt.
- Upper body exercises
- 1. Completed: Had to decrease back down to 40lbs for the 3rd set.
- *She noted that she did not feel it in her back at all, even though she was performing the exercise correctly, when told to visualize squeezing shoulder blades together to squeeze juice out of a lemon, had a better understanding and felt the purpose of the exercise more
- 2. Could not finish third set of chest press, was experiencing too much pain in the shoulder. Could pin point exactly where pain was in shoulder
- 3. Tried seated row to see if pain subsided or remained, completed 3 set of 12 reps however really struggled to complete it.
- Shoulder exercises
- 1. Completed
- 2. Completed
- 3. Completed
- 4. Completed
*While doing the theraband exercises, she noted that she felt the difficulty of the resistance a lot more in the right shoulder.
- Pilates
- 1. to 16. Completed
- Stretching
- 1. to 7. Completed
**- Expressed how injuries starting to act up again (right shoulder, low back, plantar fasciitis)
- next week break up exercises into a circuit to give triggered areas a break between sets (especially right shoulder)
[edit] Exercise Session Plan 4
- Warm up
1. 5 minute walk/run around track
- Upper Body Circuit Training
- Upper body strength exercises all done in 45 seconds as many times as possible
- In between "active rests" all done in 20 seconds as many times as possible
1. Chest press on stability ball, 7.5lb free weights 
1a. Active rest 1 (cardio): jumping jacks (modification: step out legs instead of jump)
2. Dumb bell row, 7.5lb free weights, switch arms half way through time interval 
2a. Active rest 2 (core): knee up crunch; with 5lb medicine ball, start position lying on back flat on ground with medicine ball above head, alternating crunching up with left and right knee
3. Bicep curl on stability ball, 7.5lb free weights; *slightly forward on stability ball keeping straight back to engage core 
3a. Active rest 3 (cardio): burpees (modification: step back instead of jump back)
4. Tricep kick back, 7.5lb free weights, switch arms half way through time interval 
4a. Active rest 4 (core): Russian Twist (modification: feet on floor instead of hovering), with 5lb medicine ball 
5. Medial rotation with theraband
5a. Active rest 5 (cardio): high knees (modification: march instead of jump from side to side) 
6. Lateral rotation with theraband
6a. Active rest 6 (core): Twist plot and grab (same as Russian Twist, except set ball down on one side, twist to opposite side and back, pick ball up and place on opposite side, repeat)
7. Lateral raises with free weights on stability ball, 7.5lb free weights 
7a. Active rest 7 (cardio): jump side to side touch down on opposite sides (modification: step side to side instead of jump) 
8. Theraband pull down 
8a.active rest 8 (core): side to side; lying flat legs hip distance apart, crunch up touching floor between legs, as you come back down rotate and touch down on one side, repeat touching down on opposite side
- Pilates approx. 15 minutes
1. Table Top Pulse 1 set X20 quick pulses (exhale every pulse)
2. Pilates Hundred (Modification: legs in table top position OR on the ground)
- Pump arms up and down quickly keeping straight, exhaling for 5 seconds, inhaling for 5 seconds to make one set of 10, Repeat 10 times thus total 100.
3. Roll Ups 1 set X5
- Starting lying flat on back inhale as you start to bring your arms off to floor exhale as you crunch up, inhale as you reach for your toes, exhale crunching back down SLOWLY (placing your lower back on the ground first, then middle back, then upper, neck, and shoulder)
4. Shoulder Bridge, 20 each leg 
- Point toe and exhale as bringing foot up, flex foot and inhale bring leg down inline with bent leg (1 set)
5. Back extension with swimming motion X 50 sets 
- Keeping core on ground, bellybutton to spine, perform swimming motion with arms and legs (1 arm raised + opposite leg raised, switch to opposite= 1 set)
Stretching
1. On back knees tucked to chest rock hips back and forth (X5 each side)
2. Child's pose (30 seconds)
3. Lower back stretches on floor (held 30 seconds X1 set each side)
4. Hamstring/piriformis stretch (held 30 seconds X1 set each side)
5. Shoulder towel stretch (held 30 seconds X1 set)
6. Pec Stretch (held 30 seconds X1 set)
7. **Stretching For Plantar Fasciitis (bare foot)
7a. Point and flex foot 1 set X 10 reps each foot
7b. Calf raises 1 set X 10 reps 
7c. Grab towel using only toes 1 set X 5 reps each foot 
7d. With towel folded into tube like shape, walk bare foot across 5 times
7e. Sitting try and raise just the arch of foot off ground, hold 5 seconds X 3 sets
[edit] Tuesday, November 5, 2012
Who was present: Brittany B., Ben M.
- Warm up
- Upper Body Circuit Training
- Completed
- Client not feeling well, wasn't able to push her self fully through circuit (however completed all 3 sets), wanted to try again next week when feeling better
- Modifications for cardio aspect of circuit training used, and modification for russian twist
- Right arm noticeable less resistance for theraband exercises
- Circuit took longer than anticipated -- next week 2 sets instead of 3
- Pilates
- Pilates cut short because of time, didn't complete 3. roll ups, 4. shoulder bridge 5. back extension with swimming motion -- complete next week
- Stretching
- Completed
[edit] Tuesday, November 12, 2012
Who was present: Brittany B., Ben M.
- Completed same workout session # 4 with some modifications
Warm up
- Completed
Upper Body Circuit Training
- No modification used for cardio aspect of workout, modification for russian twist used
- Completed both sets of circuit training (no problems, said she would even like a harder cardio aspect)
- Jump side to side touch down on opposite sides (active rest #7) was hurting low back so switched it to skipping
- Right arm noticeable less resistance for theraband exercises, however not as much as previous sessions
Pilates
- Completed but with modifications to the sets and reps
- Table top pulse 1 set X 20 reps quick pulses (exhale every pulse)
- Pilates hundred (Modification: legs in table top position OR on the ground), repeat 10 times to total 100.
- Roll ups 1 set X5
- Shoulder bridge: 20 reps each leg - 1 set
- Back extension with swimming motion: 50 X - 1 set
Stretching
- Completed
[edit] Tuesday, November 20, 2012
Who was present: Brittany B., Ben M.
- Completed same workout session # 4 with modifications
Warm up
- Completed
Upper Body Circuit Training
- Completed both sets of circuit training
- Changed upper body exercise 7 and 8 to:
- 7. Flies on the exercise ball
- Keeping core muscles tight (belly button to spine), as well as keeping the gluts squeezed to prevent hips from sagging, turn dumb bells above head (see picture), keeping slight bend in the elbows create a "fly" motion with he arms, making sure shoulders stay relaxed and arms stay at chest level.
- 8. Upright row with dumb bells
- Keeping straight back, core muscles tight, raise elbows so become parallel with ceiling (don't over extend above head), bring hands to about chest level, keeping shoulders relaxed through movement (not bringing shoulders up by your ears)
- Modification used for cardio aspect of workout: Active rest #7: Football shuffle
- Staying as low as possible, alternating weight back and forth as fast as posible from one foot to opposite
- Modification for russian twist used
- Right arm noticeable less resistance for theraband exercises
- Pain in lower back during active rest #3: burpees, when entering pushup position: when advised to pull belly button to spine and squeeze abdominal area during, client expressed this alleviated the pain
Pilates
- Minor modifications made to pilates workout
1. Table top pulse 1 set X 20 reps (quick pulses upward)
2. Roll ups 1 set X 5 reps
3. Back extensions: upper and lower body raised 1 set X 10 reps (pulsing upward), then just upper body raised 1 set X 10 reps (pulsing upward)
4.Bird dog/Bird dog crunch: hold bird dog 20 seconds X 1 set, bird dog crunch same side 1 set X 5 sets (slow crunches), repeat opposing side
- Keeping trunk neutral and stable, trying not to shift weight from one side to other
- Keeping trunk stable an neutral, crunch opposite elbow to opposite knee
Stretching
- Completed
[edit] Fitness Assessment Post-Test
Tuesday, November 27, 2012
Who was present: Brittany B., Ben M.
Range Of Motion
- Completed Joint ROM assessment using goniometer to reassesses joint limitation.
- The pre-test joint range of motion results no major limitations or difference in comparison to shoulders.
- The post-test joint range of motion was done to view any improvements.
- Flexion pre-test R: 0-167 L: 0-164 post-test R: 0-158 L: 0-168 **
- Extension pre-test R: 167-0 L: 164-0 post-test R: 158-0 L: 168-0 **
- Hyperextension pre-test R: 0-35 L: 0-37 post-test R: 0-27 L: 0-38
- Abduction pre-test R: 0-160 L: 0-166 post-test R: 0-164 L: 0-167
- Lateral Rotation pre-test R: 0-76 L: 0-81 post-test R: 0-76 L: 0-81
- Medial Rotation pre-test R: 0-44 L: 0-50 post-test R: 0-68 L: 0-64 **
Manual Muscle Test
- Manual Muscle reassessment test for the arms, again specifically targeting the shoulders, to note any improvement in strength.
- In the pre-test a limitation was noted in the right shoulder when providing resistance to the shoulders (in all cases, maximum resistance applied to left side, moderate resistance applied to right side).
- Horizontal Adduction pre-test L: 5 (Normal) R: 4 (Good) post-test L: 5 R: 5
- Horizontal Abduction pre-test L: 5 (Normal) R: 4 (Good) post-test L: 5 R: 5
- Flexion pre-test L: 5 R: 4 post-test L: 5 R: 4
- Extension pre-test L: 5 R: 4 post-test L: 5 R: 5
- Medial Rotation pre-test L: 5 R: 4 post-test L: 5 R: 5
- Lateral Rotation pre-test L: 5 R: 4 post-test L: 5 R: 5
pre-test couldn't hold for 10 seconds post-test held for 12.36 seconds
Functional Movement Screening (FMS)
- Partial FMS reassessment to note if improvement in compromised positioning
- Left shoulder above: pre-test score of 1 post-test score of 2 (fists 7 inches i.e., less than 9 inches apart)
- Right shoulder above: pre-test score of 3 (fists within one hand length) post-test score of 3
- Right Leg: pre-test score of 3 post-test score of 3
- Left Leg: pre-test score of 3 post-test score of 3
- pre-test score of 2 post-test score of 2
- pre-test score of 2 post-test score of 2
CV Health
- Reassessed 12 minute run/walk to get estimated VO2 max.
- Client completed 8.125 laps measured from 200m distance equaling 1 lap. For purpose of the equation 4.06 labs at 400m distance
- 4.06 laps X 400m = 1624m
- VO2 max = (0.0268 X (distance)) - 11.3 = 32.2ml/kg/min
- 60th percentile (average to above average)
- Client completed 7.00 laps measured from 200m distance equaling 1 lap. For purpose of the equation, 3.5 labs at 400m distance
- 3.5 laps X 400m = 1400m
- VO2 max = (0.0268 X (distance)) - 11.3 = 26.22ml/kg/min
- 20th percentile (well below to below average) **
Strength
- Reassessed estimated 1 RM from 10 RM to see if improvement in upper and lower body strength.
Estimated 1RM leg press using Bryzki Equation
- 1RM=weight lifted/(1.0278-(0.0278 X reps)) = 60lbs/(1.0278-0.0278 X 10reps) = 80.02
- Estimated 1RM for leg press is 80 lbs
Estimated 1RM seated row using Bryzki Equation
- 1RM=weight lifted/(1.0278-(0.0278 X reps)) = 40lbs/(1.0278-0.0278 X 10reps) = 53.35
- Estimated 1RM for seated row is 53 lbs
Estimated 1RM leg press using Bryzki Equation
- 1RM=weight lifted/(1.0278-(0.0278 X reps)) = 80lbs/(1.0278-0.0278 X 10reps) = 106.70
- Estimated 1RM for leg press is 106.7 lbs
Estimated 1RM seated row using Bryzki Equation
- 1RM=weight lifted/(1.0278-(0.0278 X reps)) = 50lbs/(1.0278-0.0278 X 10reps) = 66.68
- Estimated 1RM for seated row is 66.7 lbs
Core muscle strength and stability test
- Reassessed plank test: plank on elbow, holding for 60 seconds (raising right arm off ground for 15sec, then left arm off ground for 15 sec, then lifting right leg off ground for 15sec, then left leg 15sec), then additional 30 seconds maintaining plank position
- Measured by completion
- Completed, however client expressed extreme difficulty doing so, with major over-compensations while lifting each base of support (leaning to opposite hip), as time went on hips began to raise and lumbar began to lag
- Completed, with much less noted difficulty doing so, remained a strong solid plank position throughout. Still over-compensation while lifting each base of support but not as much lean. Displayed no lumbar leg in remaining 30 seconds.
- Reassessed pushup test again in kneeling position with knees flexed at 90 degree angle with ankles crossed
- measured by how many pushups could be completed without rest, touching fist at bottom of flexion (had 1 fist placed on top of other at chest level)
- Client completed total number of 20 (*expressed had to stop because right shoulder starts to become painful and gives out after excess load applied)
- Client completed total number of 30
Flexibility
- Reassessed Sit and Reach Test to measure hip and low back flexibility (set up same as in pre-test)
- Client performed sit and reach 3 times, best trial taken: 26cm
- Compared with table 11.31 in textbook: 70th percentile (above average)
- Best trial taken: 26cm
- 70th percentile (above average)
[edit] SUMMARY
*1. Increase flexibility
- Increase range of motion in right shoulder over 5-6 weeks
- Will be done using theraband exercises
- This will be measured through joint range of motion in the right shoulder (goniometry)
- Increase muscle manual testing from 4 to 5
- FMS shoulder mobility increase from 1 to 3 on right side
Looking at the pre-post test results as well as the clients goals from us for the program, we did not meet all the flexibility goals we had, however we did see improvements. A huge portion of our flexibility program was out of our control, as the client was doing hot yoga, which we heavily relied on as part of the flexibility training. Flexibility training should be done at least 5 times a week to really see a large increase, and thus it was unrealistic working out twice a week (with additional goals as well) to notice a significant increase in flexibility. However through the exercises we did throughout the program we were able to successfully increase our clients manual muscle scores on the right side from 4 to 5. Although we did not manage to increase her FMS shoulder mobility score from 1 to 3, we did see improvement as she successfully completed a score of 2. Her sit and reach test score remained the same pre to post test, however although no improvement was noted we were happy with her maintenance of flexibility because of how high her original score was. One unusually finding we noticed was the seemingly decreased range of motion in the right shoulder for extension and flexion, as well as the significantly large increase in range of motion in medial rotation, we believe this to be based on inaccurate measurements. While doing to testing we didn't notice the client to have any noticeable decrease or increase in her movements, and thus we believe this may be due to inaccuracy.
*2. Increase core strength
- Increase lower abdominal strength
- This will be measured by lying straight and holding her legs straight up for 10 seconds
- This will be done by assisted abdominal leg pushes, scissors, and pilates
- This will be done over 5-6 weeks
Looking at the pre-post test results we successfully met and exceeded our expectations for improvement. The client continuously expressed how weak her core section was, in large part of fear to participate in an sort of core program because of her extreme weakness. After pushing her limits with pilates and other core exercises, the client expressed her new found love for pilates, and she couldn't believe how her favorite part of the entire program was the pilates and core portion. This new found love showed in her results as she exceeded the 10 second mark in her hip test (laying flat on back and raising just legs off floor), as well as noticeable improvement of the strength and stability in her plank test (much less compromise in positioning).
*3. Increase overall muscle tone
- Working on upper and lower body strength separately on different days
- This will be done over 5-6 weeks
- This will be measured by measuring her estimated 1RM for chest press and leg press and comparing it to the initial assessment
- For lower body exercises we will be using the machines such as the leg press, adductor/abductor machine, assisted calf raise, etc
- For upper body we will use lat pull downs, chest press, push ups, etc.
- Increase muscle manual testing from 4 to 5
Our clients injuries, and continued soreness throughout the program really posed as an issue throughout. Continuously having to alter our strength training program to adapt to these injuries has us questioning whether her goal of increased strength and muscle tone would be reached. In her post manual muscle test, limitations in resistance to the right side was no longer noted, as both the right and left side scored a 5 displaying ability to withhold maximal resistance. Us and the client were pleased to see a 10 pound increase in the 10 RM strength test in both the the upper and lower body test, significantly increasing her estimated 1 RM.
*4. Cardio
- Cardio being done on her own time
- Will be reassessed in the end to see if any improvements through the 12 min walk/run
Throughout the program our client was continuously notifying us of new found injuries as well as increased pain and inflammation from lingering injuries. Less than half way through the program our client had to stop running (which she did on her own time), as well as stick with less intense fitness classes (hot yoga) rather then high impact aerobic classes due to her plantar fasciitis and even more so because of the pain in her knees. The client no longer performing much cardiovascular training unfortunately showed in her post test results, with a significant decreased in her estimated VO2 max. Our group wasn't surprised at these results (nor was the client) because of the decreased cardio, and increased amount of soreness and injuries the client reported.
- Overall we are happy to see some of the improvements we did, and are even more pleased that we were able to break through the clients fear and introduce her to new and exciting ways to exercise. No longer afraid or intimidated of using the exercise machines (now knowing how to use them and which muscles the machines are targeting), as well as her love for pilates, we hopefully provided the client with enough exercise methods for her to shift from an exercise programs she's use to (being a former triathlete) performing, to an alternative one that allows her to maintain her fitness level being mindful of her limitations and without irritating her current injuries.
[edit] Take Home Workout
- We provided our client with a booklet that documented all of the workouts we did thus far, excluding any of the ones that she did not like or caused her pain - Outlined what we did on both tuesday's and thursday's in our hour long sessions - Exercises were accompanied with pictures and descriptions on how to do each exercise with appropriate reps sets and weight - We highlighted descriptions (especially in pilates portion) on form to keep in mind while performing exercise (cues we continuously reminded her about), so she remembers them - Also provided her with all our email's so if she has any further questions about the booklet or anything else regarding the program she can let us know through email
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