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From PEKN 4P22 D02 2012 Group 07

Contents 1 Group 7 Members 2 Initial consultation 2.1 Questions to Ask Client 2.1.1 Medications List 2.1.2 Notes 3 Client's Goals 4 Program Goals 5 Thursday, October 11 Client Assessment 5.1 Warm up 5.2 Strength 5.3 Muscular Endurance 5.4 Cardiovascular 5.5 Flexibility 5.6 Cool-Down 5.7 Notes 6 Tuesday, October 16 Workout Plan 6.1 NOTES 7 Thursday, October 18 Workout Plan 7.1 Warm Up 7.2 Circuit 7.2.1 Upper Body 7.2.2 Core 7.2.3 Cardio 7.2.4 Organization of Circuit 7.3 Cool-Down 7.4 Notes 8 Tuesday, October 23 Workout Plan 8.1 Warm up 8.2 Circuit 8.2.1 Lower Body 8.2.2 Core 8.2.3 Cardio 8.2.4 Organization of Circuit 8.3 Cool-Down 8.4 Notes 9 Thursday, October 25 Workout Plan 9.1 Warm up 9.2 Circuit 9.2.1 Upper Body 9.2.2 Core 9.2.3 Cardio 9.2.4 Organization of the Circuit 9.3 Cool-Down 9.4 Notes 10 Tuesday, October 30 Workout Plan 10.1 Warm up 10.2 Circuit 10.2.1 Upper Body 10.2.2 Lower Body 10.2.3 Core 10.2.4 Cardio 10.2.5 Organization of Circuit 10.3 Cool-Down 10.4 Notes 11 Thursday, November 1 Workout Plan 11.1 Warm Up 11.2 Circuit 11.2.1 Upper body 11.2.2 Lower body 11.2.3 Core 11.2.4 Cardio 11.2.5 Organization of Circuit 11.3 Cool-Down 11.4 Notes 12 Wednesday, November 7 Workout Plan 12.1 Warm up 12.2 Circuit 12.2.1 Upper body 12.2.2 Lower Body 12.2.3 Core 12.2.4 Cardio 12.2.5 Organization of Circuit 12.3 Cool-Down 12.4 Notes 13 Friday, November 9 Workout Plan 13.1 Warm up 13.2 Circuit 13.2.1 Upper Body 13.2.2 Lower body 13.2.3 Core 13.2.4 Cardio 13.2.5 Organization of Circuit 13.3 Cool-Down 13.4 Notes 14 Tuesday, November 13 Post-Assessment 14.1 Warm up 14.2 Cardiovascular Assessment 14.3 Flexibility Assessment 14.4 Cool-Down 14.5 Notes 15 Thursday, November 15 Post-Assessment 15.1 Warm up 15.2 Strength Assessment 15.3 Muscular Endurance Assessment 15.4 Cool-Down 15.5 Results and Notes 16 Success of Program and Completion of Program Goals 17 Program Continuation

[edit] Group 7 Members

• Jenessa Bellmay
• Michio Clark
• Jessica Miotto
• Casey O'Dwyer

[edit] Initial consultation

Students: Casey and Jenessa

Date: Tuesday, October 2nd @ 3:05 pm

Location: Walker Complex custodial lunch room

[edit] Questions to Ask Client

• FILL OUT PAR-Q
• DO YOU HAVE ANY MEDICAL HISTORY WE SHOULD KNOW ABOUT?
  • Type 2 Diabetes
• ANY PREVIOUS INJURIES OR SURGERIES?
  • Arthritis in both knees, more severe in left than right, left knee locks from time to time, needed surgery for cartilage in knee but didn't get it
• ANY MEDICAL CONDITIONS?
  • Diabetes; high BP but normalized now
• DO YOU TAKE ANY MEDICATION?
  • Yes
• IF YES, WHAT MEDICATION?
  • Medformin, Genuvia, Acctack, Dimachrome, Victoza
  • Patient will provide us with more detailed description of medications, doses, etc. at our next meeting
• HOW OLD ARE YOU?
  • 55 on November 1st
• WHAT IS YOUR OCCUPATION?
  • Custodial Cleaner at Brock: Walker Complex
• WHAT DOES THIS INVOLVE?
  • lifting, cleaning, scrubbing, scraping, walking to cover large distance of walker complex, fairly physically demanding job
• ANY PHYSICAL ACTIVITY?
  • Custodial duties, feeding animals/ farm work at home
• WHAT ARE YOUR EXPECTED GOALS FROM THIS EXERCISE PROGRAM?
  • lose 10 pounds (not within our scope of practice, but has a bet with a co-worker to lose 10 lbs), increase in muscle tone/ definition, flatten stomach
• WHAT DO YOU EXPECT FROM US?
  • creativity- willing and open to trying various types of exercise, build muscle definition in arms and legs lose weight (not within our scope of practice)
• WHEN AND HOW OFTEN ARE YOU AVAILABLE?
  • 2 times a week for an hour per session, preferably Tuesday/ Thursday from 1:30-2:30
• HOW MUCH TIME ARE YOU WISHING TO PUT TOWARDS THIS EXERCISE PROGRAM?
  • 2-3 sessions a week for an hour per session
• ANY PREVIOUS PHYSICAL ACTIVITY OR EXERCISE EXPERIENCE?
  • Yes- was a part of the 4p22 client group last year
• IF YES, HOW DID IT GO?
  • challenging, pushed her to the limit, saw results of her hard work and was motivated to keep at the program
• WAS IT A POSITIVE OR NEGATIVE EXPERIENCE?
  • Positive
• WHAT WERE THE REASONS FOR IT BEING POSITIVE OR NEGATIVE?
  • more energy for performing everyday activities, saw results over time and was therefore motivated to keep going
• DO YOU HAVE ANY PREFERRED METHODS OF EXERCISES?
  • would like to use elliptical and begin a weight training program
• IS THERE A CERTAIN SPORT YOU PLAY AND ENJOY?
  • Doesn’t play any sports; can't do much running because of knees
• DO YOU HAVE ANY EXERCISES OR FORMS OF PHYSICAL ACTIVITY THAT YOU DISLIKE?
  • knees limit ability to run and lift heavy loads
• WHAT IS YOUR CURRENT LIFESTYLE LIKE?
  • lives in the country, lots of land and animals to maintain

• HOW OFTEN ARE YOU PHYSICALLY ACTIVE?
  • IF PHYSICALLY ACTIVE, WHAT DO YOU DO?
  • 8:30-11:30AM taking care of horses- very physical- lifting and throwing hay bails
• ANY CHILDREN?
  • 2 children, 5 grandkids
  • wants to be able to keep up with the grandchildren, visit on weekends
• DO YOU HAVE A DOG?
  • horses, 6 dogs, 1 cat
• IS THE PHONE NUMBER WE REACHED YOU ON YOUR PREFERRED WAY FOR US TO GET A HOLD OF YOU?
  • Yes
• MAKE SURE THEY HAVE PHYSICIANS APPROVAL TO BE PART OF AN EXERCISE PROGRAM
  • Yes, physicians approval granted
  • Make sure she gets a pass to the zone

[edit] Medications List

• METFORMIN (500mg): 2 tablets taken at breakfast and 2 tablets taken with dinner
• DIAMICRON MR (60mg): 1 tab with breakfast
• JANUVIA (100mg): 1 tablet once daily
• FUROSEMIDE (20mg): 1 tablet every morning
• ASA DAILY LOW DOSE (81mg): 1 tablet daily
• CENTRUM: 1 tablet a day
• CRESTOR (20mg): 1 tablet before bed
• VICTOZA (6mg/ml): taken before bed
• ACCUSITIC (20mg): 1 tablet every morning

[edit] Notes

• Used to have body issues and therefore was afraid to go to the gym
• Fears and anxieties have decreased and she is now willing and ready to try new things at the gym
• Looking to try variety of resistant type exercises
• Really enjoyed working with her PEKN 4P22 group from last year
• They mainly focused on a cardio based program with her so she is looking to gain knowledge in resistance training exercises, and mainly wants to tone her muscles
• Is looking forward to starting the new program!

[edit] Client's Goals

• To increase muscle definition in arms and legs
• To have creativity and variety incorporated into program
• To begin a resistance training program
• To keep up with grandkids
• Weight loss of 10lbs (however out of our scope of practice)

[edit] Program Goals

1. Flexibility Goal

• Improve sit and reach test score by 7 cm to bring her to zero and get her out of the negative values thereby improving her flexibility.This will be completed through incorporating static and dynamic stretches that target each of the major body areas during the 10 minute cool down 2x a week. The stretches included will be static modified sit and reach, dynamic stretches of kicking up to their hands, standing toe touch, etc.

2. Muscular Endurance Goal

• Increase muscular endurance by increasing her push up test score to the next category (from fair to good). Push up test will be redone and muscular endurance reassessed at the end of work out session with client. We will continue to increase muscular endurance through incorporating upper body resistance exercises into our full body circuits 2x a week, at least 15 reps for a minimum of 2 sets, goal being 3 sets each dependent on limited time. We include upper body exercises such as, seated row, lat pulldown, chest press with dumbbells, bicep curls, tricep kickback, etc.

3. Cardiovascular Goal

• Maintain time of Rockport walking test through including cardiovascular exercises into our circuit for 1 minute intervals (due to time constraints) between major muscle group sets. This will be achieved through completing a total of 3 minutes on the stationary bike, walking on track or working on elliptical at higher intensity (RPE at a 5-7 out of 10) plus warm up of 5 minutes and cool down of 2 minutes at lower intensity. Cardiovascular exercises will range from stationary bike, walking the track, to the elliptical to include variability in our work out plans.

[edit] Thursday, October 11 Client Assessment

Students: Michio and Jessica

Time 1:30-2:30

Location: Zone

[edit] Warm up

Elliptical 5-10mins

• Dynamic Stretching
  • hip abduction and adduction, straight leg kicks forward and back, arm circles
    • complete 10 repetitions for each side

• Description:
  • Swing the leg left and right while keeping it straight. Repeat for a certain number of repetitions. Switch leg and repeat. A wall or other support is recommended to keep the body stable during this movement.

• Description:
  • Swing the leg forward and back while keeping leg straight. Repeat for a certain number of repetitions. Switch leg and repeat. A wall or other support is recommended to keep the body stable during this movement.

[edit] Strength

6RM Bench Press

• 70lbs
• Estimated 1RM = 80lbs
• 90th percentile

• • Description:
    • Begin by lying flat on the bench, with your body in a natural and relaxed position. Put your arms straight out to either side of you, and then bend your elbows, bringing your hands up to touch the bar. Lower the bar by bending the arms until the bar is touching your chest. Push bar back up to starting position.

6RM Leg Press

• 120lbs
• Estimated 1RM = 140lbs
• 20th percentile

• • Description:
    • Sit in maching with back and head against the padded support. Place the feet on the foot plate, hip width apart. Push the platform away from the body by extending the legs, then bend the legs back to the starting position to finish the movement.

[edit] Muscular Endurance

• Push up Test
  • Scored 13
    • Average for females 50-59

• • Description:
    • Lie prone on the floor with hands slightly wider than shoulder width. Bend knees and raise body up off floor by extend arms with body straight. lower body to floor by bending arms. Push body up until arms are extended.

• Partial Curl-up Test
  • Scored 23
    • Very good for ages 50-59

• • Description:
    • Lie supine on a mat with knees bent and feet flat on the ground. Place hands facing down by your side. Slowly raise head and shoulders off the ground, keeping back flat on the ground. Lower head and shoulders back down.

• Prone Double Straight Leg Test
  • 10s
  • Below 25 percentile for females ages 50-59

• Description:
  • Lie down on stomach. Rest your head on your hands on the floor. Raise legs off the floor and hold for as long as you can. Clearance off the ground can be checked my placing a hand under the knees. Squeeze your legs as straight as you can hold them.

[edit] Cardiovascular

• Rockport Walking Test
  • Weight: 158lbs
  • Time: 17:25 = 17.42mins
    • Fair for ages 30-69
  • 32beats/15s = 128beats/min
  • VO2max= 22.5 mL/kgmin

[edit] Flexibility

Note: was not completed on Thursday October 11th due to time. Was completed on Tuesday October 16th

• Sit and Reach
• Functional Movement Screen
  • Active Straight Leg Raise
  • Shoulder Mobility

[edit] Cool-Down

• 5-10 minutes elliptical at low intensity to bring down heart rate
• Static Stretches
  • Cross Arm
    • Hold for 30s
  • Toe Touch
    • Hold for 30s
  • Static quad stretch
    • Hold for 30s
  • Back extension
    • Hold for 30s

[edit] Notes

Dynamic stretches

• The leg kicks were low and therefore show inflexibility in the hamstrings
• Slight instability during dynamic stretching
  • Therefore modified one of the stretches to use support of the wall
    • As a result in the future it might be a good idea to modify dynamics stretches to use a support
    • May also want to work on stability in the future

Strength Testing

• Leg Press
  • Exercise was taken with some caution do to the condition of the client's knees
  • No problems with this exercise
    • client like this exercise
      • Therefore this type of exercise may not prove to be a problem for this client and could be a good choice of exercise in the future
• Push up Test
  • client made a comment on how they do not like push-ups
    • Therefore in the client's exercise program we should find other ways to strengthen this area
• Prone Double Straight Leg Test
  • Client commented that she has done similar exercise and does not really like them
    • Therefore possible alternative methods to strength this area could be looked at
    • However the dislike of this exercise could be due the the weakness which is noted in the results of the assessment
      • Training in this area and improvements may lead the client to like this type of exercises more

Flexibility

• Ran out of time to test must be assessed next session

[edit] Tuesday, October 16 Workout Plan

Location: The Zone

Time: 1:30pm-2:30pm

Trainers: Casey and Jenessa

Warm up walking around track for 5 minutes

stretching the upper body while walking. Dynamic stretching on the track

Weights core exercises to work main muscle groups

• Bench Press: 40 lbs (1/2 of 1RM), 15 repetitions

• Leg Press: 80 lbs (1/2 1RM), 15 repetitions ** IF THIS IS TOO PAINFUL BECAUSE OF HER ARTHRITIS, A HAMSTRING CURL CAN BE SUBSTITUTED**

• Seated Row: Going to have to figure out how much weight she is able to lift, since she didn’t do them in analysis. Using the information provided, a rough estimate can be determined. Since the back muscles are antagonists to the chest, we can assume that she will be able to lift a similar amount of weight, therefore 40 lbs. If too much or too little, we can modify.

• Description:
  • Sit on the platform with knees bent and grasp the cable attachment. Position yourself with knees slighlty bent and so that you have to reach to grab the handle with outstretched arms yet without curling the lower back over. keep a straight back.Pull the handle and weight back toward the lower abdomen while trying not to use the momentum of the row too much by moving the torso backward with the arms. Target the middle to upper back by keeping the back straight and squeezing the shoulder blades together as you row, chest out. Return the handle forward under tension to full stretch remembering to keep that back straight even though flexed at the hips.

• Seated Quadriceps Extension: similar to the antagonist of the leg press (or hamstring curl), but weight will probably be a bit less, as she is only using quadriceps muscle as opposed to glutes and hamstrings in leg press. Will have to estimate her capabilities.

• Description:
  • Sit on the seat provided. Hook the feet under the bar. Adjust the bar so that it rests comfortably at the lower end of the leg. Extend the legs forward and back down in a slow, controlled movement.

• Lat pulldown: Start with 30 pounds, see how client feels. Increase or decrease weight accordingly

• Description:
  • Sit on the seat and adjust the thigh pads so that the quads above the knees sit comfortably under the support. •Grasp the cable bar with a wide overhand grip, knuckles up and sit on the seat with thighs under the support. Keeping the back straight, pull the bar down to about chin level or a little lower while squeezing the shoulder blades together. Return the bar to full height and repeat.

• Shoulder press above head (dumbbells): We will also have to estimate this also.

• Description:
  • Stand upright or sit on a bench with the back straight. Hold a dumbbell in each hand at the shoulders with an overhand grip. thumbs on the inside and knuckles facing up. Raise the weights above the head in a controlled motion, ensuring that you do not slam the arms upward and stress the elbow joint. Return dumbbells to the shoulders.

Abdominals

• Planks on elbows hold for 30 seconds

• Description:
  • Lie face down on the floor. Raise the body up with the forearms while balancing the lower body on the toes. Do not sag around the abdominal region. Keep the body as rigid as possible. Hold this position by bracing and contracting the abdominal muscles.

• Partial curl ups: 12 repetitions

(2 sets of each exercise)

Cardio Elliptical trainer for 25 minutes. Working at an intensity of 40-50% of VO2 max

Cool Down 5 minutes of low intensity exercise on the elliptical, followed by static stretching held for 30 seconds of all the main muscle groups.

[edit] NOTES

Warm up: walked around track for 10 minutes Static stretching in the stretching area of the zone- shoulders, triceps, quadriceps, hamstrings, calves, obliques. Each exercise held for about 30 seconds.

Weights (core exercises to work main muscle groups)

Leg Press: 80 lbs (1/2 1RM), 15 repetitions, 1 set. She felt 80 pounds to be too easy. Next set we added 10 pounds and she did 15 repetitions at 90 pounds. She said she could feel it in her legs but it was not very challenging.

Seated Row: Started with 30 pounds and did 15 repetitions. She said it felt too easy. She did her next set with 40 pounds and 15 repetitions and liked the harder resistance better.

Seated Quadriceps Extension: Client completed 2 sets of 15 repetitions at 50 pounds. She said the resistance felt good and was optimally challenged.

Lat pulldown: Started with 30 pounds, client did 15 repetitions and was not challenged enough at all. Let her feel what 40 pounds felt like, and she still wanted more resistance. She completed her seconds set of 15 repetitions with 50 pounds and was a better workload.

Shoulder press with dumbbells: Started initially with 15 repetitions with 5 pound dumbbells but was too light for her. Increased weight to 8 pound dumbells. This was a better challenge for her.

Cardio: Elliptical trainer for 10 minutes. Working at an intensity of 40-50% of VO2 max. Client worked up a sweat but was still able to talk and have a conversation while working, indicating she was working at an optimal level.

Cool Down: 5 minutes of lower intensity exercise on the elliptical, followed by static stretching held for 30 seconds of all the main muscle groups.

Also completed flexibility assessment due to lack of time during initial pre-assessment

---

Sit and Reach Test

• Client obtained a score of -7.
  • This indicates that her flexibility is poor and improvement is necessary

• Description:
  • Sit on the floor, legs flat and straight, and attempt to reach beyond the upright toes.

FMS Active Straight Leg Raise

• Client obtained a score of 2
• Her leg being raised was not perfectly perpendicular to the ground, and her leg on the ground did not stay straight
• Her right leg was slightly more flexible than the left
  • This indicates poor hamstring flexibility and/or inadequate hip mobility.

• Description:
  • Lay on back with arms at the side and the whole body flat against the ground. Keeping the body against the groud, raise one leg up with foot flexed and leg straight. raise it as far up as possible.

FMS Shoulder Mobility

• Client obtained a score of 2
  • Her arms were within one and half hand lengths

• Description:
  • Stand and raise your right arm straight up overhead. Bend your right elbow and let your right palm rest on the back of your neck and slide it down your back and between your shoulder blades. Reach behind you with your left hand so the back of your hand rests on the middle of your back. Now slide your right hand down and your left hand up to try to touch the fingers of both hands. Measure the minimum distance between the fingertips of the right and left hand.

• Client did not like the bench press exercise that was done in the weight room. A more comfortable exercise to do with her could be with dumbells and in the stretch area of the zone. She can lay down on her back and do the bench press exercise here.
• Leg press: 90 pounds was too easy. Start with 2 sets of 15 reps of 100 pounds next session.
• Due to the client's hectic schedule, she is now only able to meet on Tuesdays and Thursdays at 7pm for 30 minutes. Because of the limited time she will now have, the previous exercise plan we have been doing will not work. We need to come up with a more efficient exercise regime that will give her a good workout in a short amount of time.
• Circuits incorporating cardiovascular and muscle toning exercises together may be the best plan for our client.

[edit] Thursday, October 18 Workout Plan

Location: The Zone

Time: 7:00pm - 7:30pm

Trainers: Michio and Jenessa

Because our client now has limited time and wants to improve aerobic and muscular endurance, we have decided that circuit training would be best for her.

[edit] Warm Up

• Pedaling on stationary bicycle for 5 minutes
• Stretch the upper body while pedaling (shoulders, triceps, neck, back)
• After 5 minutes of pedaling, static leg stretches will be done on the major muscle groups of the lower body (hamstrings, quads, calves, glutes)
  • hold stretches for 10s

[edit] Circuit

Today we will work the upper body and core in the circuit.

[edit] Upper Body

Exercises that will be done are:

• biceps curl

• Description:
  • Start with two dumbbells at your sides with your palms facing out and arms extended. Keep you elbows at your sides and bend your arms up towards the shoulders to contract the biceps muscles. Lower to the starting position by extending your arms. Repeat

• tricep kickbacks

• Description:
  • Bend your knees slightly and bend over with your back straight. Position your arm so it is tucked in on your side. Extend your arm until it is straight. Flex your arm to return to the starting position. Repeat

• shoulder press

• bent over row

• Description:
  • Bend your knees slightly and bend over with your back straight. Hold the dumbbells about shoulder width apart with your arms extended. Pull the dumbbells to your lower chest with your elbows pointing out to the sides. Then slowly lower the dumbbells to the starting position. Repeat

• bench press, laying on the mat

[edit] Core

• basic crunch
• standing oblique crunch

• Description
  • Start by standing straight up with your feet shoulder width apart. Hold dumbbells in your hands. Keeping your back straightt, bend to one side as far as possible. Then return to the starting position. Repeat for a certain number of repetitions. Repeat for opposite side.

[edit] Cardio

• Brisk walk one lap of track

[edit] Organization of Circuit

Warm-Up

2 sets of bicep curl, tricep kickbacks, basic crunch

Cardio

2 sets of shoulder press, bent over row, bench press, standing oblique crunch

Cardio

Cool-Down

Each exercise will be done for a total of 45 seconds, so a stopwatch will be required. For exercises that must be completed seperately for each side of the body (standing oblique crunch and tricep kickback), we will do a total of 30 seconds on each side of the body.

Both 8 pound and 5 pound dumbells will be available, depending on the weight the client is able to handle.

Since our exercise is a circuit today, I think it is best for our client to do as many repetitions as she can of each exercise within a given period of time, rather than do a set amount that may work her too hard or not enough. This way she can work at her own pace and what feels best for her. Also, since we have a limited time, this will keep the circuit moving quickly.

Between each exercise, we will walk one lap of the track BRISKLY. The goal is to keep her heart rate up for aerobic gains, and since running will be too hard on her knees, we will walk.

[edit] Cool-Down

After the completion of the last exercise, we will walk one more lap of the track at a decreased pace to bring her heart rate back down. Two laps may be required to recover more fully. Static stretching will then be completed to increase client's flexibility. Specifically her leg flexibility, stretching the hamstrings, hip flexors and quads.

• Hold stretches for 30s

[edit] Notes

• Circuit training seemed to provide a good method to get a workout in 30mins
• Client seemed to enjoy the workout
• Client performed about 15-17 reps for all the exercises in the 30s time limit for each exercise
• Client used the 8lbs dumbell for every exercise expect the tricep kickbacks were the 5lbs dumbell

Improving the workout

• number of times walking laps around the track could be limited to a fewer number
  • It might be of more benefit for the client to perform more than one strength exercise before a walk or other form of cardio is used
    • In doing so may want to try and increase the intensity of the cardio
    • Due to the client not being able to run suggesting using other modalities for cardio can be used
      • This would consist of using the elliptical or bike and instructing the client to exercise at a higher pace than a walk

[edit] Tuesday, October 23 Workout Plan

This session was rescheduled to WEDNESDAY, OCTOBER 24 due to client being unavailable

Location: The Zone

Time: 7-7:30pm

Trainers: Casey and Jenessa

Plan today: circuit training is the best mode of exercise for the limited time that we will have. Thursday’s exercise session worked the upper body. Today we will focus on the lower body and abdominal muscles. To increase the intensity of her cardio workout, we will put her on the stationary bicycle.

Materials: exercise ball, 8 pound dumbbells, stop watch

[edit] Warm up

• Stationary bicycle with dynamic stretching for 5-10 minutes.
• Taking legs out of the pedals after pedaling for 10 minutes- swing legs back and forth, calf stretches with feet
  • complete 10 repeptitions for each

[edit] Circuit

[edit] Lower Body

• Exercise ball squat
  • Since her knees cause her some pain, she does not need to perform a full squat- just enough to feel it in her leg muscles.

• Description
  • Posistion the exercise ball between you and the wall, on the lower back. Stand with your feet wider than shoulder width apart and position your feet slightily infront of you. Lean back against the ball and then lower down into a partical squat by bending at your knees and hips. The ball should roll between your back and the wall as you lower. The return to the starting point. Repeat

• Glute exercise on hands and knees

• Description
  • Start in the hands and knees position. Lift one leg and bend it forming a 90-degree angle. Flex the foot so the sole is pointing upwards. Raise your leg as high as you can without arching your back, and then lower your leg to the ground. Repeat for a certain number of repetitions and then switch legs and repeat for the other leg completing the same amount of repetitions.

• Standing oblique crunch with 8 pound dumbbells

• Calf Raises on a step

• Description
  • Start by standing in front of a step with your feet shoulder width apart. Step up on the step with both feet holding a railing or other support and let the heels hang off the edge. Then raise up onto your toes. Then lower the heels as far as possible below the level of the step. Repeat

[edit] Core

• Basic Crunch

• Exercise Ball Abdominal Exercise
  • Laying on back, put exercise ball in between the legs with legs at a 90 degree angle from the torso
  • Slowly lower legs down to just a few inches above the ground and then back up

[edit] Cardio

• Stationary bike for 3 minutes at RPE of 5/10 on 10 point scale

[edit] Organization of Circuit

Warm-up

2 sets of exercise ball squat, glute exercise on hands and knees, basic crunch

Cardio

2 sets of standing oblique crunch, calf raises, exercise ball abdominal exercise

Cardio

Each exercise at 45 seconds each or if exercise is done on both sides of the body do it for 30 seconds on each side.

[edit] Cool-Down

• Exercise on the stationary bike at a low intensity to decrease heart rate
• Static Stretches
  • Cross Arm
    • Hold for 30s
  • Toe Touch
    • Hold for 30s
  • Static quad stretch
    • Hold for 30s
  • Back extension
    • Hold for 30s

[edit] Notes

• For warm up, client completed 3 minutes at level 5 and 6 minutes at level 3 because she found level 5 resistance was really working her legs and we did not want to push her too hard
• Dynamic exercises completed: swinging legs front to back, swinging legs medially and laterally in front of body, shoulder circles and crossing arms horizontally across body to cross in front of chest multiple times
• For exercise ball squat, our client completed 21 reps in the 45 second period for both the 2 sets
• First set for standing oblique crunch, on both sides, client completed 21 reps on each side
  • Second set for standing oblique crunch, on both sides, client completed 20 reps on each side
• Client had excellent form when completing the plank and completed the plank for the goal of 45 seconds for both sets
• 2 sets of all the above exercises were completed, then client went on stationary bike for 3 minutes at level two
• Unable to complete 2 sets of the last 3 exercises, therefore only 1 set of the last 3 exercises was completed
• Exercise ball abdominal exercise:completed 10 reps in 30 seconds of the correct prescribed exercise, completed the last 15 seconds doing modified exercise where the knees were bent
• Completed 20 calf raises with a 8 pound dumbbell in hand in the 45 seconds
• Completed glute exercise on hands and knees successfully for the 30 seconds on either leg
• Personal comments of client:
  • Client enjoyed all exercises prescribed to her in this workout, did not complain or make comment of not liking any of them
  • Felt her muscles working, but noted it was never painful
  • Felt that "muscles woke up" during routine, thereby assuming her muscles did get an efficient work out and were working at a suitable level (not too easy or not too difficult/aggressive for her to handle)
  • Felt sluggish prior to starting work out sessions, now feels like has more energy

[edit] Thursday, October 25 Workout Plan

Location: The Zone

Time: 7:00-7:30pm

Trainers: Michio and Jessica

Plan today Circuit training will be used as it is the best mode of exercise based on the limited time we have with the client. Wednesday's workout focused on lower body and abdominal muscles. Today we will focus on upper body and abdominal muscles. We will be using the stationary bike today to allow for an increase in intensity from a walk. Materials: exercise ball, 8 pound dumbbells, stop watch

[edit] Warm up

Elliptical 5mins

Dynamic Stretches

• Arm Swings
  • 10 repetitions

• Description:
  • Strart with your arms by your side. Swing the arms forward and up to an overhead position. Next, swing your arms forward and down to the starting position. Repeat

• Arm Circles
  • 10 repetitions in both directions
• Leg Kicks
  • 10 repetitions for each leg
• Butt Kicks
  • 10 repetitions for each leg

• Description
  • Jog while kicking the heels to the butt and back down quickly

[edit] Circuit

[edit] Upper Body

(1 exercise per set, alternating exercises in each set of the circuit)

• Lat Pulls
  • 30s
  • 50lbs
• Shoulder Press
  • 30s
  • 8lbs or 10lbs dumbells
• Chest Press
  • 30s
  • 40lbs

• Description
  • Sit on the seat with the upper chest above the horzonital handles. Grasp the handle with a wide over hand grip and elbows out to the sides just below the shoulders. Push until arms are are extended and then return to start poststion. Repeat

• Seated Row
  • 30s
  • 40lbs

[edit] Core

(1 exercise per set, alternating exercises in each set of the circuit)

• Planks
  • held for 30s on elbows
• Curl-ups
  • 30s

[edit] Cardio

• Bike
  • on a scale of 1 to 10, 10 being perceived maximal excursion, pedal at a 7
  • 30s

Rest

• 30s

[edit] Organization of the Circuit

For above the workout will then look like so

Set 1

• Lat pulls
• Planks
• Chest Press
• Bike
• Rest

Set 2

• Shoulder Press
• Curl-ups
• Seat Row
• Bike
• Rest

This will be completed for a total of 6 sets. The client will be instructed to walk briskly between work stations.

[edit] Cool-Down

Bike at a low intensity to decrease heart rate

Static Stretches

• Stability Ball Lat Stretch
  • 5 repetitions held for 10s

• Description:
  • Kneel behind a stability ball, sitting on the heels with arms extened in front of you with plams on the stability ball. Roll the ball forward, keeping the butt on the heels and lowering the chest. Hold for 10s and return to starting postion. Repeat

• Cross Arm
  • Hold for 30s
  • Hold for 30s
• Toe Touch
  • Hold for 30s
• Static quad Stretch
  • Hold for 30s
• Back Extension
  • Hold for 30s

• Description:
  • Lie prone, placing hands on the floor. Lift the upper body off the ground by extending arms upward and stretching the back. Hold for 30s

[edit] Notes

• Client mention some muscle soreness in her legs from the previous day's workout
  • Noted she felt it the most when she bent her legs
  • However there was no pain in her legs
• we were able to start a little bit earlier today
  • as a result we were able to have time to complete all 6 of the circuit
    • however when we have a the normal time frame to workout this means we will have to decrease the number of sets due to time
• In terms of the exercises in the circuit the following was performed in the 30s time frame:
  • Lat Pulls
    • Set 1: 15 reps, 50lbs
    • Set 3: 16 reps, 50lbs
    • Set 5: 16 reps, 50lbs
• Shoulder Press
  • Set 1: 22 reps, 8lbs
    • was completed in set 1 instead of 2 as someone was on the chest press machine at the time
  • Set 4: 15 rep, 10lbs
    • Increased weight for this set as the 8lbs in set 1 seemed to easy
  • Set 6: 17 reps, 8lbs
    • Client choose to decrease weight has her arms were feeling tired
    • This seemed to be a good choice based on the number of reps completed in the 30s set
    • Therefore from this we can possibly start with the 10lbs next time and then decrease the weight in the later stages of the workout as the client gets tired
• Chest Press
  • Set 2: 15 reps, 40lbs
  • Set 3: 16 reps, 40lbs
  • Set 5: 17 reps, 40lbs
• Seated Row
  • Set 2: 20 reps, 40lbs
  • Set 4: 18 reps, 40lbs
  • Set 6: 16 reps, 40lbs
• Curl-ups
  • Set 2: 17 reps
  • Set 4: 16 reps
  • Set 6: 16 reps
• Planks
  • was able to complete all sets
• Bike
  • was able to complete all sets
• Rest
  • Mentioned she liked the rest station
• Client did say "You are killing me"
• therefore we know we pushed her today
• When asked if the workout was too hard today she said "I will let you know tomorrow"
  • Therefore based on what she tells us we will be able to know if it was too intense for her or if it was good for her
• Client was instructed that stretches will help her if she feels muscle soreness the next day

[edit] Tuesday, October 30 Workout Plan

Location: The Zone

Time: 7:00-7:30pm

Trainers: Jenessa and Casey

• Today we will be working the client's whole body. This will be the plan for all exercise sessions from now on in order to get the most benefit out of our client's limited time. Last week, client was only able to workout on Wednesday and Thursday, so we had to separate upper and lower body because she was exercising 2 days in a row. We could do not do full body circuits two days in a row because her muscles would not have enough time to recover.

[edit] Warm up

Walk track briskly for 5 minutes

Dynamic Stretches

• Arm Swings
  • 10 repetitions
• Arm Circles
  • 10 repetitions in both directions
• Leg Kicks
  • 10 repetitions for both legs
• Butt Kicks
  • 10 repetitions for both legs

[edit] Circuit

[edit] Upper Body

• Dumbbell bench press- 10 pound dumbbells
• Seated Row- 40 pounds as determined before as a sufficient weight for exercise
• Cardio
• Rest

[edit] Lower Body

• Ball Squat against wall
• Hand and knees glut exercise
• Cardio
• Rest

[edit] Core

• Oblique crunches with dumbbells
• Planks
• Cardio
• Stretch

[edit] Cardio

• Stationary bicycle

• • Each exercise will be done for 45 seconds, and in between each muscle group, cardio will be done on the stationary bicycle for 2 minutes with the resistance being set to 5 (since we increased the time spent doing cardio as compared to the last work out date, we decreased the resistance. We increased cardio time because we did not feel 30s of cardio between resistance exercise sets was sufficient.) In exercises which require each side to be worked seperately, client will exercise each side for 30 seconds.

[edit] Organization of Circuit

• We will follow this order for the body of the exercise:

• Warm up
• 2 sets of upper body followed by the cardio
• 2 sets of lower body followed by the cardio
• 2 sets of core followed by the cardio
• Cool down

[edit] Cool-Down

• Bike at a low intensity to decrease heart rate
  • RPE 5/10 on 10 point scale

Static Stretches

• Stability Ball Lat Stretch
  • 5 repeptions held for 10s
• Cross Arm
  • Hold for 30s
• Toe Touch
  • Hold for 30s
• Static quad Stretch
  • Hold for 30s
• Back Extension
  • Hold for 30s

[edit] Notes

• walking the track briskly warmed the client up well, said she felt warm and was sweating slightly.

• • Upper Body:
• After warming up, client completed a dumbbell bench press lying on a mat. She used 10 pound weights in each hand.
  • Set 1: 24 reps
  • Set 2: 24 reps
• Seated Row: Done on the pully machine, using 40 pounds which was a good weight for the client.
  • Set 1: 22 reps
  • Set 2: 27 reps
• After these 2 exercises were completed, client pedaled on the stationary bicycle for 2 minutes. The 2 minute limit was for time management purposes, as 3 minutes caused us to run out of time last week.
• On a scale of 1-10, client was told to work at about a 5
• She said she was working hard and could feel her muscles working and fatiguing.
  • Lower Body:
• After finishing the 2 minute bicycle session, client moved on to lower body exercises after a 30 second rest period.
  • Squat using exercise ball against a wall
  • Set 1: 23 reps
  • Set 2: 24 reps
• Glut exercise on the hands and knees, done 1 leg at a time
  • Set 1: 19 reps on right leg, 20 reps on the left leg
  • Set 2: 23 reps on left, 22 reps on right
    • Client said she really felt her lower body working in these exercises and enjoyed the way it has been transforming her body.
• After 2 sets of each exercise was completed, client pedaled at a resisance of 5 for 2 minutes again
  • Abdominals
• After finishing the 2 minute bicycle session, client moved on to abdominal/core exercises after a 30 second rest period.
  • Standing oblique crunches with dumbbells
  • Set 1: 19 reps on the right, 19 sets on the left
  • Set 2: 22 reps on the right, 22 reps on the left
• After 2 sets of each exercise was completed, client pedaled on the stationary bike one last time for 2 minutes at an exertion level of 5 out of a possible 10.
  • Cool Down
• After the last bicycle session was completed, client walked the track for two laps to cool down and slow down her heart rate.
• Static stretched were completed to stretch the muscled worked: Cross arm stretch, standing and touching toes, static quad stretch, sit and reach (1 leg at a time), cobra stretch for abdominals as well as childs pose.
  • • Client said she is very happy with her exercise progress and says she feels tight and strong, as well as less "flabby"
    • It is important to continue to give her pointers on her technique, sometimes she forgets how things are supposed to properly be done, but she takes pointers well once reminded

[edit] Thursday, November 1 Workout Plan

Location: The Zone

Time: 7:00-7:30pm

Trainers: Michio and Jessica

The client was ill on this date due to external causes and therefore was unable to come in for a workout. This work out was rescheduled and took place on MONDAY, NOVEMBER 5th, 2012.

[edit] Warm Up

• Elliptical 5mins
• Dynamic Stretches
  • Scissor Stretch
    • 10 repetitions

• Description:
  • Start with the arms extended out sideways at shoulder height. Move both arms horizontally in front of your chest, crossing one over the other. Then return back to the starting position and beyond moving your arms behind your shoulders. Then move your arms back in front of your chest again alternating the arm which crosses over top. Spread your arms out again. Repeat

• • Triceps Stretch
    • 10 repetitions for each arm
  • Leg Kicks
    • 10 repetitions for each leg
  • Butt Kicks
    • 10 repetitions for each leg

[edit] Circuit

[edit] Upper body

• Triceps Pull down
  • 30s
  • 20lbs
• Biceps Curl
  • 30s
  • 8lbs dumbbells

[edit] Lower body

• Seated quad extension
  • 30s
  • 50lbs
• Hamstring Curl
  • 30s
  • (start with 40lbs)

[edit] Core

• Hyperextensions
  • 30s

• Description:
  • Position thighs prone on a large pad and lower legs under a padded brace. Raise the upper body until the hips are fully extented. Lower the upper body by flexing the hips until fully flexed. Repeat

• Curl-ups
  • 30s

[edit] Cardio

• Elliptical
  • on a scale of 1 to 10, 10 being perceived maximal exertion, compete at a 6
  • 60s

Rest

• 30s

We will be aiming to complete this circuit for a total of 3 times

[edit] Organization of Circuit

• We will follow this order for the body of the exercise:

• Warm up
• 2 sets of upper body followed by the cardio
• 2 sets of lower body followed by the cardio
• 2 sets of core followed by the cardio
• Cool down

[edit] Cool-Down

Exercise on the elliptical at a low intensity to decrease heart rate

Static Stretches

• Seated Bent-Knee Biceps Stretch
  • Hold for 30s
• Overhead Triceps Extension Stretch
  • Hold for 30s
• Toe touch
  • Hold for 30s
• Static quad stretch
  • Hold for 30s
• Back extension
  • Hold for 30s

[edit] Notes

• The client says she can see results from the workout program
• The client feels her body is feeling "tighter"
  • She is happy to be able to see such results
• Client was unable to do use the weight machine to perform the hamstring curl
  • The client felt the machine was too big for her and as a result felt too stretched out to use the machine
  • Therefore we must come up with alternative methods to strengthen the hamstrings
    • Such methods could include using an exercise ball or ankle weights
• The zone was very busy
• it made it very hard to do the workout which was planned
• Therefore to avoid this problem we should avoid using machines and use more body weight and free weight exercises
  • This way we can have all the equipment which we need available to use when we need it
• An increases in the flexibility of the hamstrings was seen in this workout
  • The client was able to touch her toes in the static hamstring stretch which she was not able to do before
    • In terms of this we should be able to see an increase in flexibility in the final assessment when using the sit and reach test

[edit] Wednesday, November 7 Workout Plan

Location: The Zone

Time: 7:00-7:30pm

Trainers: Jenessa and Casey

We are going to repeat the work out plan from Tuesday, October 30th in order to work the opposing upper, lower and core muscles that were worked on Monday. For example, Monday the upper body focused on triceps and biceps, and today the upper body sets will focus on chest (primarily the pectoralis major) and back (primarily the trapezius). This adds variability to our work out for our client is doing different exercises on the two sessions that she is with us and this allows us to really work her full body every week.

The weights we are using currently were sufficient for Jane last work out, therefore this work out we will assess as to whether or not we can increase the weight she lifts for the next work out.

[edit] Warm up

Stationary bike at a resistance level of 5/10 for 5 minutes

Dynamic Stretches

• Arm Swings
  • 10 repetitions
• Arm Circles
  • 10 repetitions in both directions
• Leg Kicks
  • 10 repetitions for each leg
• Butt Kicks
  • 10 repetitions for each leg

[edit] Circuit

[edit] Upper body

• Dumbbell bench press - 10 pound dumbbells
• Seated Row- 40 pounds as determined before as a sufficient weight for exercise
• Cardio
• Rest

[edit] Lower Body

• Ball Squat against wall (two hand hold on a 10 pound dumbbell outstretched in front of her)
• Hand and knees glut exercise
• Cardio
• Rest

[edit] Core

• Oblique crunches with twist holding 10 pound dumbbells
• Planks
• Cardio
• Stretch

[edit] Cardio

• Stationary bicycle

[edit] Organization of Circuit

• Each exercise will be done for 45 seconds, and in between each muscle group, cardio will be done on the stationary bicycle for 2 minutes with the resistance being set to 5. In exercises which require each side to be worked seperately, client will exercise each side for 30 seconds. We will follow this order for the body of the exercise (excluding warm up and cool down):

• 2 sets of upper body followed by the cardio
• 2 sets of lower body followed by the cardio
• 2 sets of core followed by the cardio

[edit] Cool-Down

Bike at a low intensity to decrease heart rate

Static Stretches

• Stability Ball Lat Stretch
  • 5 repeptitions held for 10s
• Cross Arm
  • Hold for 30s
• Toe Touch
  • hold for 30s
• Static quad Stretch
  • • Hold for 30s
• Back Extension
  • Hold for 30s

[edit] Notes

• Weight was increased to 12.5 pound dumbbells for all free weight exercises , as client was completing over 20 repetitions of each exercise.
• Bench Press:
  • Set 1: 19 reps
  • Set 2: 22 reps
• Seated row machine was occupied so a standing dumbbell row was completed insead
  • Set 1: 18 reps
  • Set 2: 20 reps
• Ball squat:
  • Set 1: 22 reps
  • Set 2 (with a 12 pound dumbbell in front of the body): 18 reps
• Hand and knees glut exercise (with a 5 pound dumbbell in the knees):
  • Set 1: 20 reps on left and right leg
  • Set 2: 20 reps on left and right leg
• Standing oblique crunch:
  • Set 1: 22 repetitions on the right and left side
  • Set 2: 20 repetitions on the right and left side
• Plank: held twice for 45 seconds each time. Completed with good form and successfully

• • Client was clearly working harder than the last exercise session, indicating that the increase in weight was sufficient for resistance training.
  • Said she could feel a difference in how hard she was working, but said the increase in weight was manageable

[edit] Friday, November 9 Workout Plan

Location: The Zone

Time: 7:00-7:30

Trainers: Michio and Casey

Today we will do a similar workout to the one which we did on Monday. We will be making some changes to the upper body portion of this workout as we will focus on the shoulders. This will allow us to have some variation in our workout and exercise some difference muscle groups.

[edit] Warm up

• Bike 5mins
• Dynamic Stretches
  • Scissor Stretch
    • 10 repetitions
  • Arm Circles
    • 10 repetitions in both direction
  • Leg Kicks
    • 10 repetitions for each leg
  • Butt Kicks
    • 10 repetitions for each leg

[edit] Circuit

[edit] Upper Body

• Shoulder Press
  • 30s, 12.5 lbs dumbbells
• Butterflies
  • 30s, start with 8lbs dumbbells

• Description:
  • Lie supine on a flat bench. Lift the dumbbells so they are in front of you at shoulder width apart with your arms extended and your palms facing inwards. Lower your arms with a slight bend in the elbow making a wide arc motion. Lift your arms in the same wide arc motion to return to the starting position. Repeat

[edit] Lower body

• Seated quad extension
  • 30s, 50bls
• Leg Curls with exercise ball
  • 30s

• • Description:
    • Lie supine on the floor with your lower legs on the exercise ball. Have the arms on the floor extended out to the sides. Lift hips so that the only body part touching the ground is the shoulders and arms. Flex the knees, bring the heels towards you and allow your feet to roll on top of the ball. Lower to the original postion by extending the knees. Repeat

[edit] Core

• Hyperextensions
  • 30s
• Curl-ups
  • 30s

[edit] Cardio

• Elliptical
  • on a scale of 1 to 10, 10 being perceived maximal exertion, exercise at a 7
  • 60s

Rest

• 30s

[edit] Organization of Circuit

• We will follow this order for the body of the exercise:

• Warm up
• 2 sets of upper body followed by the cardio
• 2 sets of lower body followed by the cardio
• 2 sets of core followed by the cardio
• Cool down

[edit] Cool-Down

• Exercise on the elliptical at a low intensity to decrease heart rate
• Static Stretches
  • Cross Arm
    • Hold for 30s
  • Toe Touch
    • Hold for 30s
  • Static quad stretch
    • Hold for 30s
  • Back extension
    • Hold for 30s

[edit] Notes

• Upper Body

• Shoulder Press
  • 1st set: 15
  • 2nd set: 16
• Butterflies
  • 1st set: 16
  • 2nd set: 15

• Lower Body

• Seated quad extension
  • 1st set: 17
  • 2nd set: 16
• Leg curls with an exercise ball
  • 1st set: 24
  • 2nd set: 21

• Core

• Hyperextensions
  • 1st set: 20
  • 2nd set: 20
• Curl ups
  • 1st set: 19
  • 2nd set: 19

• Cardio - completed 60s of cardio after the 2 sets

• Difficulty with butterflies due to lower back pain when laying on the bench therefore we modified the exercise to laying on a raised bench that was at a 45 degrees angle. This helped with the back pain and she was comfortably able to complete the 2 sets
• After the 1st set she said she felt sweaty and warmed up but good and ready for the next set
• Comments made by the client:
  • Her muscles feel all toned and tighter
  • Her level of energy continues to increase
  • She has lost a total of 6 lbs so far since beginning the work out (along with her own modification of her diet)
  • She has gotten all the things she has wanted out of this work out so far and she is satisfied with what we have developed for her and done with her so far
  • Next week we will move on to post-assessment because she is going on vacation the following week

[edit] Tuesday, November 13 Post-Assessment

Location: The Zone

Time: 7:00-7:30 pm

Trainers: Jessica and Casey

• Due to our client leaving for vacation, she is not available next week so the remaining two sessions she has left with us will be used for her post-assessment

• Today will be used to complete the cardiovascular post-assessment and the flexibility post-assessment then Thursday will be used to complete the strength post-assessments

Today's Plan:

[edit] Warm up

• Elliptical 5-10mins

• Dynamic Stretching
  • high knees to chest, butt kicks, straight leg kicks, lunge, arm circles
    • 10 repetitions for each side

[edit] Cardiovascular Assessment

• Equipment
  • Stopwatch
  • Track

• Rockport Walking Test - briskly walk 8 laps of the track at the zone and time how long it takes client, then get HR and follow calculations for determining VO2max

PRE-ASSESSMENT RESULTS

• Rockport Walking Test
  • Weight: 158lbs
  • Time: 17:25 = 17.42mins
    • FAIR for ages 30-69
  • HR: 32beats/15s = 128beats/min
  • VO2max= 22.5 mL/kgmin
  • just below the 10th percentile

POST-ASSESSMENT RESULTS

• Rockport Walking Test
  • Weight:151lbs
  • Time:16:05 = 16.08mins
    • FAIR (however only one second off improving to low average)
      • FAIR=16:05-17:31
      • LOW AVERAGE=14:37-16:04
  • HR: 37 beats/15s= 148 beats/min
  • VO2max = 24.256mL/kgmin
  • just below the 20th percentile

[edit] Flexibility Assessment

• Sit and Reach Test
• Functional Movement Screen
  • Active Straight Leg Raise
  • Shoulder Mobility

PRE-ASSESSMENT RESULTS

• Sit and reach test
  • Client obtained a score of -7.
    • This indicates that her flexibility is poor and improvement is necessary

• FMS Active Straight Leg Raise
  • Client obtained a score of 2
    • Her leg being raised was not perfectly perpendicular to the ground, and her leg on the ground did not stay straight
    • Her right leg was slightly more flexible than the left

• FMS Shoulder Mobility
  • Client obtained a score of 2

POST-ASSESSMENT RESULTS

• Sit and Reach
  • client obtained a score of -2
  • 5cm improvement but still did not surpass the baseline value of 38cm (reached 36cm)
    • flexibility is still poor, but client continues to stretch at home and will continue improving

• FMS Active Straight Leg Raise
  • Improved but still scored a 2: knee on ground is still slightly bent, mild compensation with opposite hip, therefore she cannot score a 3
  • right leg still slightly more flexible than left

• FMS Shoulder Mobility
  • Client maintained a score of 2

[edit] Cool-Down

• Exercise on the elliptical at a low intensity to decrease heart rate
• Static Stretches
  • Cross Arm
    • Hold for 30s
  • Toe Touch
    • Hold for 30s
  • Static quad stretch
    • Hold for 30s
  • Back extension
    • Hold for 30s

[edit] Notes

• Said she has higher energy levels during day to day activities and was extremely high energy and ready for session today
• Claimed after 2 laps of the Rockport test in pre-assessment she was tired and legs 'felt like jello' but now had ample energy to complete the Rockport Test and was even eager to jog lightly
• Reported again on how toned her muscles feel, no longer feel 'flabby'
• Client said she is going to miss working with all of us and will stay in touch to keep us updated on her progress
• Client has been stretching at home and wants weights and exercise ball for christmas so the take home plan we will create for her will be beneficial and will take into account the equipment she is requesting for Christmas
• Client satisfied with program and happy with the success she has made
• Client took all group members contact information to keep in touch and let us know about her final results (such as her total weight loss according to her diabetic doctor)
• Client did not report anything being uncomfortable or painful today
• She had a noticeable increase in energy and positivity and happiness

[edit] Thursday, November 15 Post-Assessment

Location: The Zone

Time: 7:00-7:30 pm

Trainers: Jenessa and Michio

• Today will be used to determine the strength post assessment.

Today's Plan:

[edit] Warm up

• Elliptical trainer for 5 minutes
  • Dynamic stretching of all the major muscles: arm circles, high knees to chest, leg kicks forward and back as well as to the sides.
    • 10 repetitions for each side

[edit] Strength Assessment

• 6 RM Testing
  • Bench Press
  • Leg Press

[edit] Muscular Endurance Assessment

• Push up Test
• Partial Curl-up Test
• Prone Double Straight Leg Test

[edit] Cool-Down

• Brisk walk around the track for about 5 minutes
• Static stretching:
  • Sit and reach
    • hold for 30s
  • Shoulder stretch- arm across chest
    • hold for 30s
  • Upward dog stretch for abdominals
    • hold for 30s
  • Standing quadriceps stretch
    • hold for 30s

[edit] Results and Notes

Strength Testing

• Unable to complete 6RM for bench press due to all the machines being occupied and client felt intimidated by the large machine and preferred not doing it
• 6RM for Leg Press
  • 160 pounds
  • 40 pound improvement
  • Moved up to 60th percentile from the 20th percentile

Muscular Endurance Testing

• Push up Test
  • 15 repetitions
  • Increase by 2 repetitions
  • Went from average to good category
• Partial Curl Up test
  • 23 repetitions
  • No change
• Prone Double Straight Leg Test
  • 59 seconds
  • 49 second improvement
  • Went from below 25th percentile to about 50th percentile for her age

• Despite not being able to complete the 6RM bench press, clearly her upper body strength has improved as shown by the push up test
• Client was extremely happy with her improvements and the way she feels and looks

[edit] Success of Program and Completion of Program Goals

Re-stated program goals:

---

1. Flexibility Goal

• Improve sit and reach test score by 7 cm to bring her to zero and get her out of the negative values thereby improving her flexibility.This will be completed through incorporating static and dynamic stretches that target each of the major body areas during the 10 minute cool down 2x a week. The stretches included will be static modified sit and reach, dynamic stretches of kicking up to their hands, standing toe touch, etc.

2. Muscular Endurance Goal

• Increase muscular endurance by increasing her push up test score to the next category (from fair to good). Push up test will be redone and muscular endurance reassessed at the end of work out session with client. We will continue to increase muscular endurance through incorporating upper body resistance exercises into our full body circuits 2x a week, at least 15 reps for a minimum of 2 sets, goal being 3 sets each dependent on limited time. We include upper body exercises such as, seated row, lat pulldown, chest press with dumbbells, bicep curls, tricep kickback, etc.

3. Cardiovascular Goal

• Maintain time of Rockport walking test through including cardiovascular exercises into our circuit for 1 minute intervals (due to time constraints) between major muscle group sets. This will be achieved through completing a total of 3 minutes on the stationary bike, walking on track or working on elliptical at higher intensity (RPE at a 5-7 out of 10) plus warm up of 5 minutes and cool down of 2 minutes at lower intensity. Cardiovascular exercises will range from stationary bike, walking the track, to the elliptical to include variability in our work out plans.

Were program goals met?

---

1. Flexibility Goal - VERY CLOSE

• Although our client was 2cm off meeting this goal, she did still make an improvement in her sit and reach flexibility score by 5cm. For only 5 weeks of training and only 2 half hour sessions per week, this is a remarkable improvement. She scored a -2cm on her post-assessment in comparison to a -7cm on the pre-assessment. This increase in her flexibility was achieved, as stated in the outlined program goal, mainly through static stretching during the 5-10 minute cool-downs of every session, as well as some dynamic stretching may have helped her with flexibility.

2. Muscular Endurance Goal - GOAL MET

• Our client achieved this goal by scoring a 15 on her post-assessment push up test and therefore moved up to the 'good' category. This was achieved through muscular endurance being the main focus of our client's circuit exercise plan and having her complete upper body resistance exercises in the majority of workouts. Some exercises completed to improve the push up test score were push ups, bicep curls, tricep kickbacks, seated row, and chest press with dumbbells.

3. Cardiovascular Goal - CLIENT EXCEEDED GOAL

• Our client exceeded this goal because not only did she maintain her Rockport walking test score, she actually improved it, and improved by a significant amount. She was only one second off improving up to the next category of 'low average' from the 'fair' category her pre-assessment score put her in. Her pre-assessment score was 17:25 and her post-assessment score was 16:05, therefore she decreased her time by 1:20 and went from being just below the 10th percentile to just below the 20th percentile for her VO2MAX score. This improvement in cardiovascular health was improved through the cardio taking place during the warm up, circuit, and the cool down and the cardio activity ranged from the elliptical machine to the stationary bike to the track.

• Our client overall did very well with our program and exceeded our expectations. Her overall health improved and her main goal, which was to improve muscular endurance and tone her muscles, was achieved.

[edit] Program Continuation

Our client has asked her family to support her by buying her small free weights for Christmas. We want to incorporate these into a home program that she can complete 3 times per week for approximately half an hour (2 days of weights and 1 of cardio). This will allow her to work her program into her busy schedule and requires little extra equipment so she can do the training comfortably in her own home.

We wanted to maintain the same goals from our previous sessions. The program will focus on improving muscular endurance, improving cardio, and improving flexibility. The program will include:

• A stretching routine to continue to improve her flexibility. It will focus on improving the flexibility of her shoulders, back, quads, and hamstrings, which were all tight at the beginning of our programming. This routine can be performed at the end of her exercise sessions and can also be performed on off days to further improvements.
• A cardio session consisting of a 30-minute brisk walk once a week. This can be performed outside on a nice day or on the indoor track at Brock.
• A circuit of exercises using free weights and body weight resistance.

Diagrams will be provided to the client with the workout, as well as a description of each activity. As we are no longer there to give demonstrations, these will provide comprehensive instructions on how to perform the exercises properly and where the exercises and stretches should be felt.