Module 3 - Exercise Prescription Sample 1

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Name: Christian Franco, Steven De Guzman, Rhine Louis Gawat, Jhon Kenneth

Juguilon, Alyssa Mae Serra, Jhaslie Rhazel Soy Date: 09-20-2022


Section: UP-FA2-BSN1-22 Schedule:

Exercise Prescription Form


Instruction: Design your own fitness plan by filling out this form.
Eg. Exercise 1: Push Ups Duration : 3 mins. Reps: 4 Sets: 4

 Cardiovascular Conditioning
 Warm-Up:

CARDIOVASCULAR CONDITIONING: WARM UP



EXERCISE DURATION REPS SETS
Jumping Jacks 1 min. 3 1
Hips circle 45secs. 5 1

Arm circle 1 min. 5 1


Torso twist 45secs. 5 1
Brisk walking 1 min. 3 1

Muscular Resistance Training


 Conditioning:
Exercise 1: Plank Duration: 45 secs. Reps:2 Sets:2
Exercise 2: Curl-Ups Duration: 1min. Reps:4 Sets:2
Exercise 3: Russian twist Duration: 40 secs. Reps: 5 (both side) Sets:2
Exercise 4: Crunches Duration: 30 secs. Reps:6 Sets:2
Exercise 5: Wall sit Duration: 30 secs. Reps:1 Sets:2
Exercise 6: Wall push-ups Duration: 30 secs. Reps:4 Sets:2
Exercise 7: Step-Up Duration: 40 secs. Reps:8 Sets:2
Exercise 8: Burpees Duration: 20 secs. Reps:4 Sets:2
Exercise 9: Lunges Duration : 30 secs Reps:5(both sides) Sets:2
Exercise 10: Squats Duration: 30 secs. Reps:5 Sets:2

This document is the property of PHINMA


EDUCATION
Name: Christian Franco, Steven De Guzman, Rhine Louis Gawat, Jhon Kenneth
Juguilon, Alyssa Mae Serra, Jhaslie Rhazel Soy Date: 09-20-2022
Section: UP-FA2-BSN1-22 Schedule:
a. Frequency: 3-4 x a week (put check on the day/s below)
Day Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Monday, X X X
Wednesday,
and Friday.

b. Intensity: (check your risk stratification)

✓ Low Risk -> Moderate to High Intensity

______Moderate Risk -> Low to Moderate Intensity


______High Risk -> Low Intensity

c. Time: 26 min/session 78 min/week

d. Type: (check the exercises you will include in your program)


Cardiovascular
_Walking Muscular Strength
✓ Brisk Walking ✓ Curl Up
_Running ✓ Lunges
_Biking ✓ Squat
_Dancing __Lifting Weights
Others: Jumping jacks, Hips circle, Arm circle, Torso twist (Warm up)
Planking, Russian twist, Crunches, Wall sit, Wall pushups, Step up, Burpees (Conditioning)
Knee to chest pose, Corpse pose, Seated Forward bend, Reclining Butterfly pose (Cooldown)

 Cool Down:
Exercise 1: Knee to chest pose Duration : 1:30 mins. Reps: 2 Sets:1
Exercise 2: Corpse pose Duration : 1:30 mins. Reps:1 Sets:1
Exercise 3: Seated Forward Bend Duration : 1:30 mins. Reps:5 Sets:1
Exercise 4: Reclining Butterfly pose Duration : 1:30 mins. Reps:1 Sets:1

This document is the property of PHINMA


EDUCATION
Name: Christian Franco, Steven De Guzman, Rhine Louis Gawat, Jhon Kenneth
Juguilon, Alyssa Mae Serra, Jhaslie Rhazel Soy Date: 09-20-2022
Section: UP-FA2-BSN1-22 Schedule:

This document is the property of PHINMA


EDUCATION

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