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PEKN 4P22 client Meeting:

In attendance: Katie Moore, Stacie Bengts, Stephanie Durk Absent: Jeremy Hall

General personal information: -58 years old -Kids and grand kids -Likes reading and crafts -has a 1 year old puppy (Rottweiler) -Likes walking and doing aerobics -likes hiking

Personal Goals: -Strengthen her back because she has osteopenia in her lumbar spine -strengthen her knees for walking up stairs -increase her lifespan -Number one goal from this is to be able to do a push up! It is the only thing in her program that she can’t do for her aerobics class. -core strength

-No zone membership -No pool membership -Has a current track membership -Aerobics class 40-45 minutes, 5 times a week -favourite part of the class is the “step” part (but her knees stop her from going all out -Hates to do push ups in the class because she can’t do one

-Her time limits are her lunch hours, 40 minutes long -She spends a lot of time at her desk (too much time in her eyes) and she thinks she has very bad posture

Medical History: -Osteopenia in her lumbar spine -Arthritis in fingers and ankles (she uses and ergonomic keyboard at her desk to account for this) -has had no operations -regular blood pressure and heart rate (from her Dr. Visit last month) -No known heart problems

-No vacation this term -best mode of contact is email -Best days to meet are Wednesday or Thursdays. She has very limited time.



CLIENT ASSESSMENT TESTS:


1. 1 mile Rockport walk test


Objective: To assess cardiovascular ability.


Equipment: Stop watch


Procedure: Take heart rate measure immediately prior to beginning walking for 1 minute. Record value. Begin walking when the timer says "go". Once completed the walking, immediately take heart rate measure for 1 minute. Record value.


2.A Complete a Manual Muscle Test for the Upper trunk and shoulders/arms if she is having trouble with the push ups or doesn't want to do them.


3. Sit and reach Objective: Test the flexibility of the hip and lower back Equipment: Yard stick and tape Procedure:


 1.Remove shoes
 2. have client reach forward slightly with both hands and hold final position, put tape down on the yard stick where she reached
 3. best of 3 trials keeping legs straight
 4. Range of motion Objective: To measure the range of motion of flexion and extension (and abduction and adduction) the knees and hips 


5. Manual Muscle Screen Objective: measure the range of motion of the knee and hip flexors and extensers

6. Posture Assessment.


CLIENT ASSESSMENT RESULTS:


October 18th 2011

Present: Jeremy, Steph and Stacie;

Absent: Katie (who made up assessment protocol)

Assessment outcomes: Rockport 1 mile walk test: 8 laps of track in Brock’s Walker Complex Heart rate prior to test: 76bpm Heart rate post test: 120 bpm Time to complete: 15:30

Sit and reach test: Attempt 1: 8cm Attempt 2: 8cm Attempt 3: 7cm

Muscle screen test: Hip flexors: 5 Hip abductors: 5 Hip adductors: 5 Shoulder adductors: 5 Shoulder flexors: 4 Shoulder extensor: 5 Shoulder horizontal abductors: 4 Rhomboids, middle trapezius, posterior deltoid: 5 Hip, back, neck and shoulder extensors: 5

Posture assessment: In the frontal plane, everything seemed in correct alignment. The only note we took was that the medial border of the right scapula seemed to protrude more than the left side. In the sagittal plane, we noticed a slightly forward chin, trunk inclined to rear slightly but everything else was in correct alignment.



CLIENT PROGRAM:


Stacie, Stephanie and Jermey:

Warm up: 3 laps of brisk walking around track

Stretch: dynamic stretch – front lunges, knee grabs (straight up and down), foot pull/knee push, Frankenstein walks

Workout:

Chest fly on stability ball:

Purpose: strengthen pectoralis major and bicep brachii

Technique: using a stability ball lean back and rest your shoulder blades in the middle of the ball while resting both feet flat on the floor making a 90 degree angle with your knees. Keep head in a neutral position trying not to strain the neck. Have your arms abducted laterally palms facing up with weights in hand and adduct arms keeping elbows locked until your hands meet in the middle of your body weights weights over your face.

Upright row with weights:

Purpose: Strengthen the trapezius, deltoids and biceps.

Technique: Stand up straight with a weight in each hand at your side. Palms facing down put your hands and weights together in front of you and pull up until the weights are level just above your chest. Make sure to not tilt your wrist to either side and keep your elbows bent above your hands.

Bicep curl hammer down:

Purpose: Strengthen bicep brachii and brachioradialis

Technique: Stand up straight hands at sides palms facing up with weights in hands. Flex your elbows to bring weights towards shoulders. Rotate your palms to face inward and slowly extend the elbow down back to the initial position.

Tricep Kickback:

Purpose: Strengthen the triceps

Technique: start by standing one foot slightly in front of the other torso facing forward flexed at the hips. Extend arms backward keeping them in line with your back. Make a right angle with your arm and extend backwards until in line with your back. Keep the elbow from moving.

Rear support hold:

Purpose: Strengthen the abdominal muscles, biceps and triceps

Technique: keeping straight legs from sitting position hold body up using arms positioned behind you. Keep body in a straight line and hands flat on ground pointing forward.

Back extension:

Purpose: Strengthen latissimus dorsi and erector spinae

Technique: lying stomach ground on the floor lift/ extend torso up while keep legs on ground. Hands on head bent elbows pointed outward.

Knee pulls with stability ball:

Purpose: Strengthen abdominals

Technique: start with ankles resting on ball and your arms supporting you hands directly beneath your shoulders, back should be flat. Bend your legs toward your upper body keeping your ankles on the ball as the ball rolls toward you.


Gluteus pushes:

Purpose: to strengthen the Gluteus maximus and hamstrings

Starting position: On elbows and knees

Technique: Lift left knee from ground, bend knee in to chest then extend straight out behind body. Repeat 15 times. On 15th one, hold foot at top for 2 seconds. Lower left leg over the right leg and extend up. X 12. Stretch back. Switch legs. Repeat once.


CLIENT MEETING


October 20, 2011 Present: Steph and Stacie

Today we went to meet with E.D. and she didn't show up. We later discovered that she had sent us an email a couple hours prior explaining why she would have to miss today's session.


CLIENT MEETING


October 25, 2011

Present: Steph and Stacie

Today we met with E.D. and went through the program with her for the first time. This was to familiarize her to the new exercises, demonstrate proper technique for each, determine weight to be used, appropriate amount of repetitions and sets and to hear any concerns, complaints or impressions about the program from E.D. Four main points can be concluded from this meeting:

  1. The tricep overhead extension was changed to tricep kickback for client preference. Her arm movement during this exercise needs to be monitored.
  2. There was only one stability ball available at the time and was not the adequate size to be performing the knee pull exercise (ball was too large)
  3. E.D. looked discomforted and perturbed during the rear support hold exercise and this exercise might have to be altered or omitted from the program.
  4. After the program was over we asked about her impressions and comments and she had a complaint that her right hip was having pain from one of the exercises. This issue will need to be discussed and decided what needs to be changed in the program to ensure no pain in the hips.


CLIENT MEETING


October 27, 2011

Present: Katie and Jermey

Warm up -3 laps around the track

workout -shoulder fly (front and side) 2x10 with 5lb weights

-preacher (bicep) curl - 2x15 20lb

-tricep pull down - 3x15 15lb

-Lat pull down - 2x15 30lb

-back extension - 2x15 80lb

-tricep dips on ball - 15 dips - 8 dip

Flexibility - static streches of shoulders arms and back Push ups - 8


Shoulder fly Purpose: To strengthen the deltoid muscles.

1. In a standing position and holding a dumbbell in each hand.

2. Raise your arms to the sides slowly until your arms are even with your shoulders. 3. Slowly return the weight back to the starting point.

Note: this exercise can also be done with the weights lifted in front of the body until they are even with the shoulders. REPS: SETS:

Preacher Curl (Bicep Curl)

Pupose: Strengthen your biceps muscle group

1. Using a machine adjust seat height so that arms can reach over the bench

2. Lift the weight towards your body until your arms meet your chest

3. Slowly return the weight to its starting position REPS: SETS:


Tricep bench push up

Purpose: Strengthen your triceps muscle group.

1. Sit on the edge or a bench or chair.

2. Put your hands beside you and life yourself off the seat.

3. Lower your body until your elbow is at a 90 degree angle.

4. Raise your body back up to the bench.

REPS: SETS:

Seated Row

Purpose: Strengthen your latissimus dorsi and rhomboids.

1. Adjust seat height so that chest pad rests on centre of chest.

2. Adjust chest pad so that arms are able to reach handles with a slight bend.

3. Pull weight towards your body into your chest.

4. Slowly return weight back to normal position.

REPS: SETS:

Deadbug

Purpose: Strengthen core muscles.

1. Laying on your back.

2. Hold an exercise ball in your hands above your head.

3. Pass the ball to your feet by only moving hands and legs.

REPS: SETS:


CLIENT MEETING:


November 1, 2011

Present: Katie and Stacie

Warm up: 3 laps around track

Gluteal pushes, altered:

Purpose: to strengthen the Gluteus maximus and hamstrings Starting position: On elbows and knees

Technique: Lift left knee from ground, bend knee in to chest then extend straight out behind body. Repeat 15 times. On 15th one, hold at bottom of pose. Keeping knee bent at 90 degrees, externally rotate at the hip x12. Stretch back. Switch legs. Repeat once.

Butterfly:

Purpose: Strengthen the rhomboids Starting position: Standing erect.

Technique: Make fists and raise arms to side until shoulder height. Concentrate on pinching shoulder blades together throughout the whole movement.

Reps: 10 Sets: 2 * At the end of second set, do military press x 10.

Military press: With arms abducted at 90˚ angle, flex elbows to 90˚ and raise arms above head until fully extended. Roll shoulders to stretch.

Knee pulls with stability ball:

Purpose: Strengthen abdominals

Starting position: Ankles resting on ball and arms supporting your body directly under shoulders. Ensure back is flat.

Technique: Bend your legs toward your upper body keeping your ankles on the ball as the ball rolls toward you. Reps: 8 Sets: 2

Chest fly on stability ball:

Purpose: strengthen pectoralis major and bicep brachii

Starting position: lay with your shoulder blades resting in the middle of the ball. Lay both feet flat on the floor, ensuring a 90 degree angle with knees. Keep head in neutral position.

Technique: Have your arms abducted laterally palms facing up with weights in hand. Adduct arms keeping elbows locked until your hands meet in the middle of your body weights weights over your face. Reps: 15 Sets: 2

Supine 5 - 10's:

Purpose: Strengthen rectus abdominis and hip flexors

Starting position: Lay supine on floor, for beginners, start with hands by thighs.

Technique: Perform 5 seconds of holding a hollow shape - legs off ground, shoulders and head off ground. Perform 5 knee tucks - bring knees into chest and bring chest toward knees. Perform 5 rocks - with knees and hips extended, rock. Rest

Prone 5-10's:

Purpose: Strengthen erector spinae, latissimus dorsi and gluteus maximus

Starting position: Lay prone on floor, for beginners, start either with hands by legs or arms bent, hands in front of face.

Technique: Perform 5 seconds of holding a hollow shape - legs and chest off ground.

Perform 5 flutters - lay flat on ground, then bring legs and chest of ground for a second, return to laying flat. Perfrom 5 rocks - with hips extended, rock. Rest.


CLIENT MEETING:


November 3, 2011

Present: Stephanie and Jeremy

Today there the fire alarm was pulled in the Zone so we couldn't do our workout in there so we improvised. Our client walked for 10 minutes outside to warm up. We then grabbed a mat and a 5 pound weight and a spot in the hallway to do the rest of the workout. For all exercises we used the 5 pound weight and did 2 sets of 15 reps. The exercises we were able to do were: shoulder flys, front flys, bicep curl, tricep kickback, shoulder press and bicep curl hands prone. We then went through tricep stretches and bicep stretches. On the mat we did the deadbug exercise without the ball 2 sets of 15 reps. We also had E.D. try and do as many push-ups as she could do all at once and she did 7 again.



CLIENT MEETING


November 8, 2011

Present: Katie and Stephanie

Warm up: 3 lap walk around the track

Main work out:


Glteal pushes: Sets:2, Reps: 8

Knee pull with stability ball: Sets: 3, Reps: 8

Back Extensions: Sets 2, Reps: 8

Chest Fly (standing): Sets; 3, Reps 8

Supine 5-10s: Sets:2

Prone 5-10's: Sets: 2

Stretching: 10 minutes of static and dynamic stretching for flexability



CLIENT MEETING


November 10th, 2011

Present: Jeremy and Stacie

Warm up: 3 laps of brisk walking around track Stretch: Roughly 4 minutes of stretching hip flexors, gluteus maximus, hip adductors.

Tic Tocks: Purpose: Strengthen obliques, abdominis rectus and stretch the lower back. Starting position: Lay supine, flex hips and knees to 90 degrees. Keep knees and ankles together. Straighten arms out to either side of body, at shoulder height.

Technique: Bring both legs to right side until you feel a slight stretch in the back. Bring legs back to the starting position, ensure back touches the ground. Bring both legs to left side until you feel a slight stretch in the back.

Notes: Control of the movement is key. Slow, controlled movements give best results. Reps: 12 Set:1

Front support rollers:

Purpose: Strengthen the deltoids, rectus abdominis, erector spinae, shoulder flexors and extensors. Starting position: On hands and knees with a Swiss ball placed directly behind you. Lift one leg and place shin on ball, lift other leg and place shin on ball. Keep shoulders directly over the wrists. Keep arms straight and keep body parallel to the floor.

Technique: Keep arms and body straight. Don't move hands. Put more weight over the shoulders, lean forward until you feel you can't go any further. Push your weight back until your thighs roll on the ball.

Reps: 10 Sets: 2

Hip tucks on Swiss ball:

Purpose: Strengthen lower abdominis rectus and gluteus maximus

Starting position: lay with your lower back resting in the middle of the ball. Lay both feet flat on the floor, ensuring a 90 degree angle with knees. Place hands behind head but do not strain neck. Keep head in neutral position.

Technique: Lift hips. Curl chest and upper body to the point of being unable to contract your abdominals any further. Return to the starting position.

Reps: 10 Sets: 2

Butterflies:

Purpose: Strengthen the rhomboids

Starting position: Standing erect.

Technique: Make fists and raise arms to side until shoulder height. Concentrate on pinching shoulder blades together throughout the whole movement. At the end of the 10th repetition, keep arms raised at shoulder height. Open hands, bend elbows, bring hands toward shoulders. Make fists, extend elbows and straighten arms. Repeat this 10 times.

Reps: 10 Sets: 2

Roll shoulders to stretch.

Stretches: Focus on Gluteals and lower back

Chest flys on stability ball 3x10 10lb dumbells Tricep dips on stability ball 2x12 pushups: 10


CLIENT MEETING


November 15, 2011

Present: Katie and Jeremy Warm up: 3 lap walk around the track

Main work out:


Gluteal pushes: Sets:3, Reps: 8

Knee pull with stability ball: Sets: 3, Reps: 8

Back Extensions: Sets: 3, Reps: 8

Chest Fly (standing): Sets; 3, Reps 8

Supine 5-10s: Sets:3

Prone 5-10's: Sets: 3

Lat Pull Downs: Sets: 3 Reps: 8

Tricep Pull Downs: Sets: 3 Reps: 8

Stretching: 10 minutes of static and dynamic stretching for flexibility


CLIENT MEETING


November 17, 2011

Present: Stacie and Stephanie

Warm up: 3 laps of brisk walking around the track

Main work out:

Circuit #1:

Shoulder roll pulls: Reps:12 Sets:2 Tick tocks: Reps: 6 Sets: 2 Push ups with stretch back: Reps: 5 Sets: 2


Circuit #2:

Gluteal pushes, altered (knee abducted) Gluteal pushes, altered (knee to chest, extended back)

Stretching


CLIENT MEETING


November 20, 2011

Present: Stacie and Katie

Warm Up: 3 Laps around the Gym

3 Circuits Of: Gluteal pushes, Knee pull with stability ball, Back Extensions, Chest Fly (standing), Supine 5-10s, Prone 5-10's

Finished with stretches focusing on hip flexors, IT band, gluteals, hip abductors and hamstrings


CLIENT MEETING


November 22 2011

Present: Stephanie and Jeremy

Warm up: 3 lap walk around the track Main work out:

Chest Flys: 3x12 10lb dumbells

Shoulder Fly: 3x10 5lb dumbells

preacher curl: 3x10 20lb (machine)

Tricep pulldown: 3x10 30lb (machine)

Abdominal crunches on ball: 2x25

Pushups: 5, 5, 3.


POST PROGRAM ASSESSMENT


November 29, 2011 Present: Stacie, Stephanie and Katie

1. 1 mile Rockport walk test

2. Sit and reach

3.A Complete a Manual Muscle Test for the Upper trunk and shoulders/arms if she is having trouble with the push ups or doesn't want to do them.

4. Posture Assessment.

5. We also asked if she would like to try to do push ups that would mimic the number found in her aerobics class, though we have no comparable data for this.


RESULTS

1. Heart Rate Before: 84bpm

Heart Rate After: 112bpm

Time to completion: 15 minutes 39seconds

2. Attempt #1: 10cm

Attempt #2: 14cm

Attempts #3: 16cm

3. Hip flexors: 5

Hip abductors: 5

Hip adductors: 5 Shoulder adductors: 5

Shoulder flexors: 4

Shoulder extensor: 5

Shoulder horizontal abductors: 4

Rhomboids, middle trapezius, posterior deltoid: 5

Hip, back, neck and shoulder extensors: 5

4. Frontal Plane: Left Shoulder Slightly Lower than right shoulder Saggital Plane: Neck Slightly Forward

5. 8 till exhaustion, 4 tilll exhaustion


THE END

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