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Name: PATANI, ISAIAH SHALOM A.

Date:
Section: BSA1-14 Schedule:

Exercise Prescription Form


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

• Cardiovascular Conditioning
✓ Warm-Up:
Exercise 1: Dancing________________ Duration :___2__mins. Reps:__1___ Sets:___1__
Exercise 2:_Biking_________________ Duration :_3.5__mins. Reps:___1__ Sets:__1___
Exercise 3:_Running_______________ Duration :__2.5_mins. Reps:___1__ Sets:__1___
Exercise 4:_Walking________________ Duration :__2__mins. Reps:___1__ Sets:___1__

• Muscular Resistance Training


✓ Conditioning:
Exercise 1:Push-ups_______________ Duration :_3___mins. Reps:__10__ Sets:___3__
Exercise 2:Wall push-ups. Duration :__3___mins. Reps:10-15_ Sets:_3 ___
Exercise 3:Wall sit. Duration : 3.5__mins. Reps:__10__ Sets:__2___
Exercise 4:Squats. Duration :_3.5__mins. Reps:_12-15_ Sets:__3 _
Exercise 5:Planks________________ Duration :___2_mins. Reps:__1___ Sets:_3-5__
Exercise 6:Lunge Duration :__3__mins. Reps:__24__ Sets:__3-4_
Exercise 7:Pull-up. Duration :_2.5_mins. Reps:_6-10 _ Sets:__3-4_
Exercise 8: Crunches. Duration :__2__mins. Reps:_10-12_ Sets:___3__
Exercise 9:Calf raises. Duration :_3.5__mins. Reps:__10__ Sets:__2___
Exercise 10: Triceps dips. Duration :_4 _mins. Reps: 10 _ Sets:__3 _

a. Frequency: ___3___x a week (put check on the day/s below)


Days Monday Tuesday Wednesday Thursday Friday Saturday Sunday
3 ✓ ✓ ✓

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Name: Date:
Section: Schedule:

b. Intensity: (check your risk stratification)


___✓_ Low Risk -> Moderate to High Intensity
______Moderate Risk -> Low to Moderate Intensity
______High Risk -> Low Intensity

c. Time: _30__min/session ___90_min/week

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


Cardiovascular __✓__Push Ups
__✓__Walking __ __Curl Up
_____Brisk Walking __✓__Lunges
__✓__Running __✓__Squat
__✓__Biking _____Lifting Weights
__✓__Dancing

Muscular Strength
Others: Planks, Pull ups, Triceps dips and calf raises.

✓ Cool Down:
Exercise 1:Child’s Pose___________ Duration :__2__mins. Reps:__2___ Sets:__1___
Exercise 2:Head-to-head Knee Forward Bend Duration :_2.5__mins. Reps:___3__
Sets:__2___
Exercise 3: Shoulder stretch_______ Duration :_2.5__mins. Reps:__2___ Sets:__2___
Exercise 4:Body Shakes__________ Duration :___3_mins. Reps:_1____ Sets:___2__

This document is the property of PHINMA EDUCATION


Name: Date:
Section: Schedule:

B. EXPLAIN YOUR FITNESS PLAN AT LEAST 2 OR 3 PARAGRAPHS.

First of all i need to perform cardio vascular conditioning which is warm up to


First Iimprove
need to perform cardiovascular
the circulation andconditioning
improves(warm-up)
my heart,solungs,
my body wouldn’t
and blood experience
vessels fatigue.
by I
chose to have at least 3x a week exercise so that my body has time to rest and recover. Since I’m a low
increasing
risk the blood
I chose moderate flow
to high in my muscle.
exercises it see
that you will alsoinhelp reduce
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I do in the upper
lessen my of
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thisof injury.
file.

I chose to have a three times a week exercise so my body have a time to rest
and recover and i must not use all of my time in exercising my physical body, i
also need to improve my mental health in my recovery time.

Since im a low risk so i chose moderate to high exercise as you can see it in my
fitness program.

This document is the property of PHINMA EDUCATION

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