PED 025: Movement Enhancement

Name: _____________________________________________ Class number: _______

Section: ____________ Schedule: _______________________ Date: ________________

Course Code: PED 025 Generic Course Title: Movement Enhancement Credit: 2 units
Course Title: Individualized Fitness Program Tagline: Becoming Fit

Description: This deals with the self-application of the self-designed fitness program that comprises of
cardiopulmonary conditioning and musculoskeletal strength and endurance training in the context of
Prochaska, DiClemente, and Norcross’ model of change

Outcomes: Upon completion of this course, the students shall have achieved their physical fitness level in
terms of cardiopulmonary conditioning and musculoskeletal strength and endurance required to maintain
healthy status and to engage in advanced conditioning and sports training, and have achieved skills as a
demonstration of their readiness to train other individuals to become fit.

Skills: The students will be honed on screening their readiness for physical activity, formulating exercise
prescription, designing a fitness program, assessing the progress of their training, and applying
Prochaska, DiClemente, and Norcross’ model of change by implicit self-motivation and explicit self-
actualization.

Assessment: The students will compile their outputs and other documents in a portfolio (print or
electronic) including the accomplished forms that show records of their serial anthropometric girth
measurements, body mass index, and peak heart rate.

Certification: The manifestation of the outcomes set for this course at the start of the semester makes
the students qualified to receive the Fitness Training Completion Certificate.

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 PED 025: Movement Enhancement

Name: _____________________________________________ Class number: _______

Section: ____________ Schedule: _______________________ Date: ________________

Module 1 – Pre-contemplation Stage

Outcomes: Upon completion of this module, the student shall have:

1. Defined one’s own life’s success and happiness.
2. Identified tangible and non-tangible things that make him happy.
3. Recognized stumbling blocks in the pursuit of his happiness and success.
4. Determined situations in his present lives that need to be changed.
5. Found ways to effect the changes.
6. Established readiness to apply ways to effect the changes.

Estimated Duration: Two weeks

STUDENT’S PLATFORM:
Teaching-Learning Activities:
1. Interview two persons – one closed relative and one not related by blood line, both should be
suffering from any chronic or debilitating disease requiring maintenance medications and
limitations in the performance of his activities of daily living. A written narrative report from this
interview shall be submitted. The report shall contain the answers to but not limited to the
following questions:
a. How did you draw your road map to success in life? What did you consider as essential factors
that lead to the fruition of your life’s success? What did you perceive as determinants of
success that will make you happy? Had you made your loved ones, your family collateral
contributors of your success?
b. How does your present condition affect the road map you charted a long time ago? Have you
thought of attaining or not attaining anymore what you had drawn before?
c. Can you narrate the history of your present medical condition from onset until at present? Do
you have family members or relatives who are also suffering from, or somewhat similar or
related to what you have right now? What are the diseases common in your family?
d. Prior to the onset of the present condition, did you indulge in the use of illicit drugs, excessive
consumption of alcoholic beverages, chain smoking, skipping adequate sleep over work, and
spending time for too much worrying?
e. Prior to the onset of the present condition, had you been into any form of physical activity like
indoor and outdoor individual or team sports, fitness exercise programs and recreational
activities like trekking, leisure walking? If so, at what age did you start and end your
participation? How regular had you done it? How many days a week? How much time you
spent for this activity every session? Less than or more than 30 minutes?
f. What were your doctor’s advice now on dieting, compliance to medications, and physical
activity? What medications did your doctor prescribe? Can you tell me what these are for?
How long you have been taking all of these?
g. If you were to look back, what lifestyle practices you would have changed to prevent the onset
of your present medical condition, to reach the realm of success and happiness in life you
dreamt of way back then? Is physical inactivity like lack of exercise one of those you would
consider worth changing so as not to succumb to what you have now?

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 PED 025: Movement Enhancement

Name: _____________________________________________ Class number: _______

Section: ____________ Schedule: _______________________ Date: ________________

2. Write an essay on the Pursuit of His or Her Success and Happiness with emphasis on:
a. defining one’s own life’s success and happiness;
b. identifying tangible and non-tangible things that make him happy and successful;
c. recognizing stumbling blocks in the pursuit of his happiness and success;
d. determining situations in their present lives that need to be changed;
e. finding ways to effect the changes
f. establishing readiness to apply ways to effect the changes.

3. Accomplish the table below. For each question below, please fill in the square Yes or No. Please be
sure to follow the instructions carefully. With the supervision of your PE instructor, interpret your
answer and draw conclusion.
Questions Yes No

1. I am currently physically active.

2. I intend to become more physically active in the next 6 months. For activity to
be regular, it must add up to a total of 30 or more minutes per day and be
done at least 5 days per week. For example, you could take one 30-minute
walk or three 10-minute walks each day.

3. I currently engage in regular physical activity.

4. I have been regularly physically active for the past 6 months.

Basic Concept: The students read these notes after completion of the three activities above.
Physical inactivity is a fast-growing public health problem and contributes to a variety of chronic
diseases and health complications, including obesity, heart disease, diabetes, hypertension, cancer,
depression and anxiety, arthritis, and osteoporosis. The 2008 National Nutrition Survey of the Food and
Nutrition Research Institute (FNRI-DOST) found very high prevalence of physical inactivity among adults.
The prevalence of low physical activity for work- and non-work-related physical activity was more than
85%, particularly among females, while that of leisure-related physical activity was 83%. In fact the
prevalence of low physical activity increased significantly from 2003 to 2008, particularly for work-related
and travel-related physical activity.

In addition to improving a student’s overall health, increasing physical activity has proven effective
in the treatment and prevention of chronic diseases.
Regular physical activity at the correct intensity:
• Reduces the risk of death by 40%
• Lowers the risk of stroke by 27%
• Reduces the incidence of diabetes by almost 40%
• Reduces the incidence of high blood pressure by almost 50%
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Name: _____________________________________________ Class number: _______

Section: ____________ Schedule: _______________________ Date: ________________

• Can reduce mortality and the risk of recurrent breast cancer by almost 50% • Can lower
the risk of colon cancer by 60%
• Can reduce the risk of developing of Alzheimer’s disease by one-third • Can decrease
depression as effectively as medications or behavioral therapy.
Exercise is indeed medicine!

Benefits of Exercise
There is overwhelming scientific evidence to support the positive relationship between regular
physical activity and health. The overall health benefits of physical activity can be summarized in the table
below:

Over-all Benefits of Physical Activity

Strong Evidence Moderate to Strong Evidence Moderate Evidence

Lower risk of early death Better functional health for Lower risk of hip fracture
Lower risk of coronary older adults Lower risk of lung cancer
heart disease Reduced abdominal obesity Lower risk of endometrial
cancer

Lower risk of stroke Weight maintenance after Increased bone density

Lower risk of high blood weight loss Improved sleep quality
pressure Better cognitive function
Lower risk of adverse lipid for older adults
profile
Lower risk of type 2 diabetes
Lower risk of metabolic
syndrome
Lower risk of colon cancer
Lower risk of breast cancer
Prevention of weight gain
Weight loss
Improved cardiorespiratory
and muscular fitness
Prevention of falls
Reduced depression

Source: The evidence rating was reported based on the 2008 review by the Office of Disease Prevention
and Health Promotion of US Department of Health and Human Services. Over 8000 articles reporting the
health benefits of exercise were reviewed in preparation for the report. These evidence ratings were also
adopted in the recently released 2011 National Physical Activity Guidelines by the Health Promotion
Board.

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 PED 025: Movement Enhancement

Name: _____________________________________________ Class number: _______

Section: ____________ Schedule: _______________________ Date: ________________

The following sections will elaborate further on the health benefits of exercise for common chronic
conditions and the optimum level of physical activity that is needed to achieve them.

Premature death
• Individuals who are physically active for approximately 7 hours a week have a 40% lower risk of dying
early from leading cause of death than those who are active for less than 30 minutes a week.
• The Risk of Dying Prematurely Declines as People Become Physically Active

• High amounts of activity or vigorous-intensity activity are not necessary to reduce the risk of premature
death. Studies show substantially lower risk when people do 150 minutes of at least moderate-
intensity aerobic physical activity a week.
• The most dramatic difference in risk is seen between those who are inactive (30 minutes a week) and
those with low levels of activity 90 minutes or 1 hour and 30 minutes a week).
• The relative risk of dying prematurely continues to be lower with higher levels of reported moderate
or vigorous-intensity leisure-time physical activity.

Cardiorespiratory health
• Significant reductions in risk of cardiovascular disease occur at activity levels equivalent to 150 minutes
a week of moderate-intensity physical activity. Even greater benefits are seen with 200 minutes (3
hours and 20 minutes) a week.
• In hypertension, blood pressure lowering effects of exercise are most pronounced in people with
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 PED 025: Movement Enhancement

Name: _____________________________________________ Class number: _______

Section: ____________ Schedule: _______________________ Date: ________________

hypertension who engage in moderate-intensity exercise 30 minutes on most days; with systolic blood
pressure decreasing approximately 5-7 mm Hg after an isolated exercise session (acute) or following
exercise training (chronic).
• It has been estimated that as little as 2 mm Hg reduction in population average systolic BP can reduce
mortality from coronary heart disease and stroke, and all causes by 6% and 10% respectively
(Lewington et al. 2002).

Metabolic health
• Regular physical activity strongly reduces the risk of developing type 2 Diabetes and also aids in the
control of blood sugar for those already with diabetes.
• The Da Qing study in China included an exercise only treatment arm and reported that even modest
changes in exercise (20 min of mild or moderate, 10 min of strenuous, or 5 min of very strenuous
exercise one to two times a day) reduced diabetes risk by 46% (compared with 42% for diet plus
exercise and 31% for diet alone).
• The Finnish Diabetes Prevention Study and the US Diabetes Prevention Program (DPP) included
intensive, lifestyle modifications with both diet and increased physical activity. In the former, 522
middle-aged, overweight adults with impaired glucose tolerance (IGT) completed either lifestyle
modifications of at least 30 min of daily, moderate physical activity, or no change in behaviour. The
DPP randomized 3234 men and women with IGT or impaired fasting glycemia (IFG) into control,
medication (metformin), or lifestyle modification groups, composed of dietary and weight loss goals
and 150 min of weekly aerobic activity. Lifestyle modification in both studies reduced incident
diabetes by 58% and, in the DPP, had a greater effect than metformin (31%).
• Both aerobic and resistance training improve insulin action, blood glucose control and fat oxidation and
storage in muscle. Physical activity/exercise can result in acute improvements in systemic insulin
action lasting from 2 to 72 hours. Hence, the benefits of regular exercise in clients with type 2 diabetes
mellitus include improved glucose tolerance, increased insulin sensitivity, decreased HbA1c and
decreased insulin requirements.
• Regular participation in aerobic physical activity and exercise results in beneficial changes in lipid
profile of patients with dyslipidaemia. These changes include
reductions in triglyceride levels and an increase in HDL (good cholesterol) concentrations. The
reductions in LDL levels in clinical trials have been inconsistent.
• Good evidence exists that physical activity reduces the risk of metabolic syndrome. Lower rates of these
conditions are seen with 120 to 150 minutes (2 hours to 2 hours and 30 minutes) a week of at least
moderate-intensity aerobic activity.

Overweight and obesity

• A minimum of 150 minutes per week of moderate intensity physical activity for overweight and obese
adults improve health; however, greater amounts of physical activity of > 250 minutes per week is
necessary to achieve clinically significant weight loss.
• There is strong evidence that regular physical activity between 150 and 250 minutes per week reduces
the risk of weight gain and is most effective when combined with a balanced diet.

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 PED 025: Movement Enhancement

Name: _____________________________________________ Class number: _______

Section: ____________ Schedule: _______________________ Date: ________________

Musculoskeletal health
• Regular physical activity slows the decline in bone density especially in individuals participating in weight
bearing aerobic and resistance programs using moderate or vigorous intensity. These changes are
significant when exercising at 90 minutes a week and continue up to 300 minutes a week.
• Physically active individuals, especially females, have lowered risk of hip fracture than do inactive
individuals. There is moderate evidence that 120-300 minutes per week of regular physical activity at
moderate intensity is associated with a reduced risk of hip fractures.

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 PED 025: Movement Enhancement

Name: _____________________________________________ Class number: _______

Section: ____________ Schedule: _______________________ Date: ________________

Module 2 – Contemplation Stage

Outcomes: Upon completion of this module, the student shall have:
1. Assessed his readiness to indulge in regular physical activity particularly, exercise.
2. Defined the success of his engagement in exercise with set goals and established priorities.
3. Identified ways of controlling his life for the success of his exercise engagement.
4. Screened himself with the end goal of classifying himself according to the risk stratification for
participation in exercise.
Estimated Duration: Two weeks

STUDENT’S PLATFORM:
Teaching-Learning Activities:
1. Answer the following questions:
a. Where am I now in my life? How did I get here?
b. What do I like about myself, my body? What do I not like?
c. What is it about my body and mind that I am unhappy with that could be positively affected by exercising regularly?
d. What would I like to change, if anything, and why?
e. What is going on in my life that would facilitate behavior change? Inhibit it? f. Where am I now in my physical
activity level?
g. Have I tried regular exercise before and failed to stick with it? h. Currently, what do I estimate my potential to
stick with an exercise program to be?
i. What unmet personal needs am I thinking of attempting to meet? j. Am I ready, really ready, to try it? Would I
really like to change, even if it means giving up something I am accustomed to?
k. Do I think that I can mobilize the mental strength if that is what I want or need to do?
l. What has my previous experience with personal health behaviour change been? Good? Bad? Some success?
None? Will that help me this time around?
m. What can I learn from experience that will help this time? Am I being realistic about this?
n. What is my self- image?
o. Do I think of myself as good-looking? Attractive? Not attractive? Healthy? Unhealthy?
p. What do I see when I look in the mirror?
q. What kinds of feelings do those images elicit?
r. If I am planning to exercise to help in weight loss or simply to shape up a currently out of shape body, will I be able to
use the facts that smaller size clothing now fits and that my waist is getting smaller as measures of success, rather than
scale weight (which might or might not change much, even as I am redistributing body mass)?
s. And further, if I am going to exercise primarily for weight loss, is my true goal to become really ‘‘thin,’’ rather than
somewhat thinner?

2. Based on your answers to the questions above, write an essay about your readiness to engage in
exercises indicating the following:
a. SMART (Specific, Measurable, Achievable, Realistic, and Timely) Goals
b. Daily or weekly prioritized activities including its schedule
c. Ways to control factors that hamper your goals

3. Accomplish the Physical Activity Readiness Questionnaire below. Your PE instructor will help you
interpret the answers to the questions below.

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 PED 025: Movement Enhancement

Name: _____________________________________________ Class number: _______

Section: ____________ Schedule: _______________________ Date: ________________

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Name: _____________________________________________ Class number: _______

Section: ____________ Schedule: _______________________ Date: ________________

Basic Concept: The student shall read these notes prior to accomplishing the PAR-Q form.

Risks of exercising -- Putting it in perspective

Before discussing the risk of exercising, it is important to begin by asking the question, ’’Is the person
safe to remain sedentary?’’ Physical inactivity has been identified by the World Health Organization as
the fourth leading risk factor for global mortality (6% of deaths globally).
The risks of participation in exercise range from the most common – muscle soreness and
musculoskeletal injury to the most serious – myocardial infarctions and sudden cardiac death, which will
be discussed here. Vigorous physical activity has been shown to transiently increase the risk of sudden
cardiac death and myocardial infarction (heart attack) among individuals with both diagnosed and occult
cardiac conditions. The absolute risk of sudden cardiac death during vigorous physical activity has been
estimated at one per year for every 15,000 - 18,000 people. Although these rates are low, the risk is
relatively higher in sedentary unscreened individuals who engage in unaccustomed vigorous activity. As
such, sedentary individuals who intend to exercise should begin with low to moderate intensity exercises.
For these individuals, an appropriate pre participation screening process should be administered to further
lower the risk.
The important points on risk of exercising can be summarized below:
• Exercise generally does not provoke cardiovascular events in healthy individuals with normal
cardiovascular systems.
• Risk of sudden cardiac arrest or myocardial infarction is very low in healthy individuals
performing moderate intensity activities.
• Risk of sudden cardiac death and/or myocardial infarction increases transiently and acutely in
individuals performing vigorous exercise with diagnosed or occult cardiovascular disease.

Even in patients with known cardiac disease undergoing a supervised rehabilitation programs, the
incidence of adverse cardiac events are rare: cardiac arrest = 1 in 117,000; non-fatal myocardial infarction
= 1 in 220,000; and death = 1 in 750,000 patient-hours of participation.

Considering the overwhelming benefits of physical activity, the risk of inactivity and the relatively rare
serious side effects of exercise, almost all patients will benefit from physical activity; with some of them
needing modifications or restrictions on their exercise program. For patients with chronic diseases, it is
important that the clinician performs a risk stratification and exercise screening prior to initiating an
exercise prescription.

Aims of Pre-Participation Health Screening

• Identify individuals with medical contraindications for exclusion from exercise programs until these
conditions have been addressed and optimized. • Identify individuals with clinically significant disease(s)
who should participate in a medically supervised exercise programs.
• Identify individuals who are at increased risk for disease because of age, symptoms and risk factors who
should undergo further medical evaluation and exercise testing before initiating an exercise program
or increasing the frequency, intensity or the duration of the current program.
• Identify individuals with special needs e.g. Elderly or disabled population etc. that may affect exercise
testing and programming.

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 PED 025: Movement Enhancement

Name: _____________________________________________ Class number: _______

Section: ____________ Schedule: _______________________ Date: ________________

A self-guided questionnaire such as the Physical Activity Readiness Questionnaire is the recommended
entry level for screening. This self-guided question screening tool is able to quickly identify conditions or
risk factors that require further assessment before commencing exercise. If the student answers no to all
7 questions, he is at a LOW RISK for health complications, and is generally safe to begin an exercise
program without supervision at any intensity. PE instructors can expect to receive the New PAR-Q from
students that require exercise clearance.

However, for most patients with chronic disease, the PAR-Q typically produces a positive response for
at least one of the questions. With that in mind, the algorithm presented in the figure below outlines the
screening process that the PE instructor and the student can go through to determine the student’s risk
level. This is called risk stratification. This assessment process is based on ACSM’s recommendation
available in the eighth edition of ACSM’s Guidelines for Exercise Testing and Prescription.

Risk Stratification
The process of risk stratification is based on:
• Identifying the presence or absence of known cardiovascular, pulmonary and/or metabolic
disease.
• Identifying the presence or absence of signs and symptoms suggestive of cardiovascular, pulmonary
and/or metabolic disease. (see Table 1.1) for definition of major signs and symptoms)
• Identifying the presence or absence of cardiovascular risk factors. (see Table 1.2 for Cardiovascular
Risk Factors Threshold)

ACSM Risk Stratification Categories

Low risk:
• No signs/symptoms of or no diagnosed cardiovascular, pulmonary and/or metabolic disease.
• No more than one cardiovascular risk factor.
• Low risk of acute cardiovascular event.
Physical activity/exercise program may be pursued safely without the necessity of medical
examination and clearance
Moderate risk:
• No signs/symptoms of or no diagnosed cardiovascular, pulmonary and/or metabolic disease.
• Two or more cardiovascular risk factors.
• Increased risk of acute cardiovascular event.
• Individuals at moderate risk may safely engage in low to moderate intensity physical activities
while awaiting medical clearance.
• Medical clearance and exercise testing prior to participation in vigorous intensity exercise is
recommended.
High risk:
• One or more signs and symptoms of or diagnosed cardiovascular, pulmonary and/or metabolic
disease.
• High risk of acute cardiovascular event.
• Thorough medical examination and clearance must be sought prior to initiation of physical activity
or exercise at any intensity.

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 PED 025: Movement Enhancement

Name: _____________________________________________ Class number: _______

Section: ____________ Schedule: _______________________ Date: ________________

Placement of your student in the HIGH, MODERATE, or LOW RISK categories helps the PE instructor
determine the need for further testing and supervision during exercise.
HIGH RISK: Students should undergo further medical testing before starting an exercise program.
Clinical supervision is recommended during exercise and stress testing.
* Clinical supervision = under the direct supervision of a health/fitness professional possessing a
combination of advanced college training and certification equivalent to the ACSM Registered Clinical
Exercise Physiologist and Exercise Specialist or above
MODERATE RISK: Student is safe to begin light- or moderate-intensity exercise (should undergo
further medical assessment before partaking in vigorous-intensity exercise) Supervision by a fitness
professional during exercise is often recommended (depends on the reason for falling into this category)
* Professional supervision = under the supervision of a health/fitness Professional possessing a
combination of academic training and certification equivalent to the EIMP Clinical Fitness Professional or
above.
LOW RISK: Student is safe to begin exercising without further assessment. Exercise supervision is
not necessary.
It is also important to note that students may require supervision for reasons other than a medical
condition. These may include learning to use the exercise equipment, familiarization with exercise
technique and if either the PE instructor or the student feels that exercising under supervision will
motivate student to continue regular exercise.
Algorithm for the screening process:

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 PED 025: Movement Enhancement

Name: _____________________________________________ Class number: _______

Section: ____________ Schedule: _______________________ Date: ________________

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Name: _____________________________________________ Class number: _______

Section: ____________ Schedule: _______________________ Date: ________________

Important considerations for risk stratification

The algorithm serves as a guide that may be modified at the discretion of the PE instructor. Some of
the information may not be available to the PE instructor at the screening to assess the risk level
accurately. Under these circumstances, PE instructors are encouraged to use existing information and
make a conservative estimate of the student’s risk level.
• If the student’s disease is well controlled e.g. metabolic or pulmonary disease such as thyroid and
asthma and other stable chronic diseases or conditions) the student will remain at HIGH RISK;
however, the intensity of his exercise may be increased at the discretion of the relevant specialist
or cardiologist.
• A student in the moderate risk category based on cardiac risk factors may be progressed to LOW
RISK if the risk factors resolve (e. g. quitting smoking, losing weight, or no longer sedentary).
• Hypertensive students with resting SBP ≥ 200 mm Hg or DBP ≥ 110 mm Hg should not undergo
exercise testing nor be allowed to exercise. It is important to establish blood pressure control and
assess for presence of end organ disease before initiating exercise. For asymptomatic
hypertensive students with BP < 180/110 mm Hg and no evidence of end organ disease, they may
begin low to moderate intensity aerobic exercises without the need for exercise testing.
• For individuals with type 2 Diabetes (T2DM) desiring to participate in low-intensity physical activity
like walking, physicians should use clinical judgment in deciding whether to recommend pre
exercise testing. Conducting exercise stress testing before walking is unnecessary. No evidence
suggests that it is routinely necessary and requiring it may create barriers to participation.
• To avoid automatic inclusion of lower-risk individuals with T2DM, exercise stress testing is
recommended primarily for previously sedentary T2DM students who want to undertake activity
more intense than brisk walking. The goal is to more effectively target individuals at higher risk
for underlying cardiovascular disease. In general, ECG stress testing may be indicated for
individuals matching one or more of these criteria in the Table 1.3 below.

For a more in-depth look at pre-participation screening, please see the National Sports Safety
Committee’s report 2007 which can be downloaded from the website below:
http://www.ssc.gov.sg/publish/etc/medialib/sports_web_uploads/gc/media_releases_enc
losures/sports_safety_committee.Par.0005.File.tmp/Sports_Safety
_Committee_26SEPO7.pdf

In this module, we have outlined both the health risks that students face if they remain inactive, as
well as the risks of exercising. Although most students will benefit from participating in regular exercise,
students should be screened prior to initiating an exercise program. For many, this will consist of the short
PAR-Q, in which they are able to answer NO to each of the questions. These students are safe to begin an
exercise program of any intensity without supervision.
For students who answer YES to at least one of the New PAR-Q questions, the screening process needs
to continue to assess their level of risk. The risk level (low, moderate, or high) that the student is assessed
at will determine:
a. Whether he needs further medical assessment prior to beginning an exercise program.
b. The intensity at which he is safe to exercise.
c. Whether he needs supervision during his physical activity.
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 PED 025: Movement Enhancement

Name: _____________________________________________ Class number: _______

Section: ____________ Schedule: _______________________ Date: ________________

Module 3 – Preparation/Planning Stage

Outcomes: Upon completion of this module, the student shall have:
1. Been cleared medically to engage in physical activity particularly, exercise.
2. Designed for himself an exercise program for strengthening and cardiovascular conditioning.
Estimated Duration: Two weeks

STUDENT’S PLATFORM:
Teaching-Learning Activities:
1. Write an essay explaining your risk stratification and the exercise intensity that fits your
classification.
2. Record your baseline anthropometric measurements that include: a. Weight in
kilogram
b. Height in meter
c. Body mass index = weight in kg divided by the square of the height in meter d. Waist
circumference in centimeter
3. Make an exercise prescription using the FITT format for both cardiovascular conditioning and
strengthening. The format is found at the end of this module.

Basic Concept: Read the notes below before accomplishing the second and third activities above.
Every exercise prescription should be tailored to meet individual health and physical fitness goals.
The principles of exercise prescription are based on the psychological, physiological and health benefits
of exercise training, and are generally intended for a healthy adult. Modifications are however, necessary
to accommodate the individual characteristics such as health status, physical ability, age or athletic and
performance goals.

Components of Exercise Training Sessions

• Warm up
➢ Transitional phase that allows the body to adjust to the changing physiological, biomechanical
and bioenergetic demands during the conditioning phase of the exercise session.
➢ Minimum of 5-10 minutes of low to moderate intensity cardiovascular and muscular
endurance activities.
➢ Increases body temperature.
➢ Decreases the potential for post-exercise muscle soreness.
• Conditioning
➢ 20-60 minutes of aerobic, resistance, neuromuscular and/or sports activities (exercise bouts of
10 minutes are acceptable if the individual accumulates at least 20-60 minutes each day of
daily exercise).
• Cool down
➢ Allows gradual recovery of heart rate and blood pressure, and removal of metabolic end-
products from the muscles used during the more intense conditioning phase.
➢ Minimum of 5-10 minutes of low to moderate intensity cardiovascular and muscular
endurance activities.
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Name: _____________________________________________ Class number: _______

Section: ____________ Schedule: _______________________ Date: ________________

• Stretching
➢ Minimum of 10 minutes of stretching performed after the warm up or cool down phases.

Components of an Exercise Prescription

The components of a prescription for medication include the name of the medication, strength or
dose, frequency of administration, route, refills, and precautions. The components of an exercise
prescription follow a similar format, using the FITT principle: Frequency, Intensity, Time (or duration)
and Type. An important element to consider in exercise prescription is exercise progression.
Frequency refers to the number of times the activity is performed each week. There is a positive dose-
response relationship between the amounts of exercise performed -- as the amount (frequency and time
or duration) of exercise performed increases, so do the benefits received.
Intensity of the physical activity is the level of vigour at which the activity is performed. There are a
number of ways in which intensity can be measured. Some methods are easier to use but are generally
less objective, while others are more objective but may require additional equipment or simple
calculations. The Table 2.1 provides an overview of some ways to measure exercise intensity.
In general, we recommend using a simple, though less objective, measure of intensity, such as the
talk test or the Rating of Perceived Exertion (RPE). Objective measures of intensity are more accurate and
often used in formal exercise testing.
• Subjective Measures of Intensity
The least objective but easiest measure of intensity is the ‘‘talk test.’’ When performing physical
activity at a low intensity, an individual should be able to talk or sing while exercising. At a moderate
intensity, talking is comfortable, but singing, which requires a longer breath, becomes more difficult. At
vigorous intensity, neither singing nor prolonged talking is possible. A similarly easy but more robust
measure of intensity is ‘perceived exertion.’
The original perceived exertion scale, the Borg Rate of Perceived Exertion (RPE) Scale ran from a
minimum of 6 to a maximum of 20. This scale has been simplified to a10- point scale in which intensity
increases from a minimum (level 0) to a maximum (level 10). Both are shown below. The talk test and
RPE Scale are practical measures for sedentary patients without significant cardiovascular risk factors.

• Physiological/ Relative Physiological/Relative Measures of Intensity

Other more objective measures include percentages of maximal oxygen consumption (VO2 max),
oxygen consumption reserve (VO2 R), heart rate reserve (HRR) and maximal heart rate (HRmax). Some of
these more objective measures are used in
formal exercise testing. Perhaps the easiest but not the most accurate measure is calculated using a
percentage of the patient’s HRmax.
For example, exercising at a moderate intensity would be quantified as 64%-76% of HRmax. You
estimate your student’s HRmax using the formula 220 minus the student’s age (220 - age).
Although this method is simple, it has a high degree of variability and tends to underestimate
HRmax in persons under the age of 40 and overestimate it in individuals over the age of 40. This is generally
true for both genders. A more accurate but more complicated formula is 206.9 - (0.67 ◊ age). Depending
on the situation, the clinician will need to decide whether ease or accuracy is more important.
• Absolute Measures of Intensity Metabolic Equivalents
METs represent the absolute expenditure of energy needed to accomplish a given task such as
walking up two flights of stairs. One MET is defined as 1 kcal/kg/hour and is roughly equivalent to the
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 PED 025: Movement Enhancement

Name: _____________________________________________ Class number: _______

Section: ____________ Schedule: _______________________ Date: ________________

energy cost of sitting quietly. A MET is also defined as oxygen uptake in ml/kg/min with one MET equal
to the oxygen cost of sitting quietly, equivalent to 3.5 ml/kg/min. METs are a useful and convenient way
to describe the intensity of a variety of physical activities and are helpful in describing the work of different
tasks; however, the intensity of the exercise needed to achieve that task is relative to the individual’s
reserve. A simple way of converting METs to calorie cost of physical activity makes use of the following
equation:
Calories expended/hr = *METs Rating X BW (kg)
* 2000 Compendium:?Ainsworth BE, Haskell WL, Whitt MC, Irwin ML, Swartz AM, Strath SJ, O’Brien WL,
Bassett DR Jr, Schmitz KH, Emplaincourt PO, Jacobs DR Jr, Leon AS. Compendium of Physical Activities: An
update of activity codes and MET intensities. Medicine and Science in Sports and Exercise, 2000;32
(Suppl):S498-S516.1993 Compendium:?Ainsworth BE, Haskell WL, Leon AS, Jacobs DR Jr, Montoye HJ, Sallis
JF, Paffenbarger RS Jr. Compendium of physical activities: Classification of energy costs of human physical
activities. Medicine and Science in Sports and Exercise, 1993; 25:71-80.
For example, a healthy, active person may report that climbing the two flights of stairs as light-
intensity, while an inactive, chronically ill person may report that the same task requires vigorous effort.
Light physical activity is defined as requiring less than 3 METs, moderate activities 3-6 METs, and vigorous
activities greater than 6 METs. Table 2.2 illustrates common physical activities with the associated
intensity in METs.
35
As with other aspects of this module, you and the student are offered choices. Here, again, the choice of
measure for intensity is used is up to the student and you. For persons at risk for cardiac events, more
objective measures may be necessary; while for otherwise healthy, sedentary individuals, the easier,
more subjective measures will likely suffice.
Table 2.2. Common physical activities with the associated intensity in METs

Time, or duration of the activity, refers to the length of time that the activity is performed. Generally,
bouts of exercise that last for at least 10 minutes are added together to give a total time or duration for a
given day. For example, a student who brisk walks 10 minutes in the morning, and 10 minutes in the
evening, can count a total time or duration of 20 minutes for the day. Note that the exercise
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recommendations are dosed in terms of minutes of activity.

Type of physical activity: Walking is the most common form of physical activity that sedentary
individuals can begin. Walking is a very familiar activity, and one that can easily be incorporated into daily
life. The main types of exercise are:
• Cardiovascular / Aerobic exercise
• Resistance Exercise Aerobic (Cardiovascular) Exercise
• Aerobic (cardiovascular) exercise: Continuous rhythmic exercise that uses a large amount of
muscle mass; require aerobic metabolic pathways to sustain activity. • Use of large amount of
muscle? Sufficient? In total body oxygen consumption? Central cardiopulmonary adaptations
e.g.: Walking, jogging, cycling, swimming, rowing, dancing, in-line skating
The quantity or volume of exercise is a function of the frequency (F), intensity (I) and the duration/time
(T) as well as the type of the exercise performed (T). The exact composition of FITT varies depending on
the characteristics and goals of the individual. The FITT exercise prescription will need to be revised
according to the individual’s response, need, limitation and adaptation to exercise as well as the evolution
of goals and objectives of the exercise program.

Frequency
➢ 3-5 days a week of a combination of moderate and vigorous aerobic exercise. Intensity
➢ Relative (physiologic) difficulty of the exercise (how hard the exertion feels).
➢ Exercise of at least moderate intensity that noticeably increases heart rate and breathing is
recommended as the minimum exercise intensity for adults to achieve health benefits.
➢ A combination of moderate and vigorous intensity exercises that substantially increases heart rate
and breathing is recommended and ideal for attainment of health improvements in most adults.
➢ The risk of exercise, which includes cardiac and musculoskeletal complications, increases with
higher intensity.
➢ Higher intensity interval training is time-efficient, especially for individuals who have less time
available for physical activity.
➢ Intensity and duration interact and are inversely related.
➢ Improvements in aerobic fitness from low intensity, longer duration exercise (easy run for 90 min)
are similar to those with higher intensity interval training (various quantities of intervals between
30 sec and 4 min)
➢ Exercise intensity may be estimated by various methods, the easiest objective measure being
Peak HR method:
Target HR = HRmax x % intensity desired
where predicted maximal heart rate (HRmax): 220 - age
➢ Less objective but practical methods for sedentary subjects like the talk test and RPE have been
discussed above.
Other methods are:
➢ HR reserve (HRR) method:
Target HR = [(HRmax - HRrest) x % intensity desired] + HRrest
(HRmax is calculated by prediction equation).

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➢ VO2 reserve method:

Target VO2 R = [(VO2 max - VO2 rest) x % intensity desired] + VO2 rest (VO2 max is estimated by
maximal or submaximal testing).
➢ Peak VO2 method:
Target VO2 = VO2 max x % intensity desired.
➢ Peak METs x (% METs) method:
Target METs = [(VO2 max)/3.5ml/kg/min] x % intensity desired. (Activities at the target VO2 and
METs can be determined using a compendium of physical activity or metabolic equations).
HR reserve and VO2 reserve reflect the rate of energy expenditure during physical activity more
accurately than other exercise intensity prescription methods but require more complex
calculations and exercise testing.

Exercise quantity and duration (Time)

➢ Measure of amount of time physical activity is performed i.e. per session, day or week, or by the
total caloric expenditure.
➢ The quantity of physical activity may be performed continuously or intermittently and accumulated
over the course of a day through one or more sessions of physical activity of at least 10 minutes
in duration.
➢ A total of 150 minutes of moderate intensity aerobic exercise or vigorous intensity aerobic exercise
done for a total of 75 minutes is recommended for most adults. Both moderate and vigorous
intensity exercises can be accumulated over a week with 1 minute of vigorous intensity aerobic
exercise equivalent to 2 minutes of moderate intensity aerobic exercise.
➢ To promote or maintain weight loss, 50-60 minutes a day (to total 300 minutes per week of
moderate exercise), or 150 minutes per week of vigorous exercise (or an equivalent combination
of daily exercise) is recommended.
➢ Performing intermittent sessions of 10 minutes of exercise to accumulate the minimum duration
recommendations is an effective alternative to continuous exercise.
➢ Total caloric expenditure and step counts may be used as surrogate measures of exercise
duration.
➢ A minimum caloric expenditure of 1000 kcal a week through physical activity and exercise, as well
as 3000-4000 steps per day of walking at moderate to vigorous intensity is recommended.

Aerobic (Cardiovascular) exercise mode (Type)

➢ Rhythmic, aerobic type exercises of at least moderate intensity involving large muscle groups and
requiring little skill to perform are recommended for improving cardiovascular fitness.
➢ Other exercise and sports requiring skill to perform or higher levels of fitness are recommended
only for individuals with adequate skill and fitness to perform the activity.
➢ Exercise can be classified into different groups according to exercise intensity and energy
expenditure (see Table 2.3)
➢ Group A & B - useful to regulate and maintain intensity of effort ➢ Provide predictable levels of
energy expenditure - not affected by sex, age, skill ➢ As individuals progress to higher fitness levels,
group C & D exercises provide more variation. Rely on heart rate response or subjective RPE
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➢ Cardiovascular exercises can also be classified by body-weight dependency

Southwestern University will follow the FITT format using the training design of the European
Association of Preventive Cardiology, European Society of Cardiology as shown below. In the absence of
the results of the cardiopulmonary exercise test, the intensity
discussed above will be used: <64% for light intensity, 64 – 76% for moderate intensity, and >74% for high
intensity. The Karvonen’s formula will be used to determine the target heart rate: [(HRmax - HRrest) x %
intensity desired] + HRrest; HRmax is 220 – age.

Muscular Fitness and Resistance Training

Resistance training is an essential component of any exercise training program. It improves all
components of muscular fitness including strength, endurance and power. The aims of resistance training
include reducing the physiological stress during activities of daily living, preventing muscular
deconditioning, and for effective management and prevention of chronic diseases.
• Frequency
➢ For general muscular fitness, and for adults who are untrained or recreationally trained, resistance
training of each major muscle group is recommended for 2 or more days a week with at least 48
hours separating the exercise training sessions for the same muscle group.
➢ All muscle groups to be trained may be done so in the same session, or each session may focus on
selected muscle groups so that only a few of them are trained in any one session. (split routine)
• Type
➢ Multi joint or compound exercises affecting more than one muscle group and focusing on agonist
and antagonist muscle groups are recommended for all adults, to avoid creating muscle
imbalances that may lead to injury.
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➢ Single joint exercises targeting major muscle groups may also be included in a resistance training
program.
• Volume of resistance exercise (Repetitions and sets)
➢ Adults are encouraged to train each muscle group for a total of 2-4 sets, derived from the same
exercise or from a combination of exercises affecting the same muscle group, with 8-12 repetitions
per set i.e. 60-80% of one-repetition maximum (1-RM), with a rest interval of 2-3 minutes between
sets to improve muscular fitness. 1-RM is the maximum amount of weight one can lift in a single
repetition for a given exercise.
➢ Having different exercises training the same muscle group adds variety and improves adherence
to the training program.
➢ Resistance training intensity and number of repetitions performed each set are inversely related.
➢ A higher number of repetitions with lower intensity not exceeding 50% 1-RM should be performed
per set along with shorter rest intervals and fewer sets if the objective of the resistance training
program is mainly to improve muscular endurance.
➢ For older adults and deconditioned individuals who are more susceptible to musculotendinous
injuries, 1 or more sets of 10-15 repetitions of moderate intensity i.e. 60-70% 1-RM resistance
exercises are recommended.
• Technique
➢ Each exercise should be performed with proper technique and include both lifting (concentric
contractions) and lowering (eccentric contractions) phases of the repetition. Each repetition
should be completed in a controlled deliberate fashion throughout the full range of motion.
➢ Maintain a regular breathing pattern i.e. exhaling during lifting phase and inhaling during the
lowering phase.
Flexibility Exercises (Stretching)
➢ Stretching exercise is recommended in any exercise training program for all adults.
➢ Stretching exercise is most effective when the muscles are warm and should be performed
before and/or after the conditioning phase.
➢ Stretching should be performed to the limits of discomfort within the range of motion, perceived
as the point of mild tightness without discomfort.
➢ Stretching following exercise may be more preferable for sport activities where muscular strength,
power and endurance are important for performance, rather than during the warm up period.
➢ Stretching following warm up is still recommended for adults exercising for overall physical
fitness or athletes performing activities in which flexibility is important.
➢ There is minimal scientific evidence to demonstrate the efficacy of stretching for injury prevention
though limited evidence seems to suggest that it may be beneficial in sports in which flexibility is
an important part of performance.
➢ Stretching exercises improve the joint range of motion and physical function, especially in the
elderly.
➢ Stretching should be performed at least 2-3 times a week, for at least 10 minutes in duration.
➢ Stretching exercises should involve the major muscle tendon groups of the body. ➢ Four or
more repetitions per group are recommended.
➢ Static stretches should be held for 20-30 seconds.
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Neuromuscular Exercise
➢ Neuromuscular exercise is recommended for the elderly population who are frequent fallers or
with mobility impairment, and suggested for all adults.
➢ Frequency: 2-3 days a week.
➢ Examples include core conditioning, balance & gait exercises, and taijiquan.

SWU Exercise Prescription Format (See Annex A for Tabular Format) • Cardiovascular
Conditioning
Warm-up:
Static Stretch 1: _______________ Duration: _____ sec Reps: ______ Set: ____ Static
Stretch 2: _______________ Duration: _____ sec Reps: ______ Set: ____ Static Stretch
3: _______________ Duration: _____ sec Reps: ______ Set: ____ Static Stretch 4:
_______________ Duration: _____ sec Reps: ______ Set: ____
Conditioning:
Frequency: _____ x a week
Intensity: Target Heart Rate (THR) = ______ beats/min %HRR + _______ RHR = _______

For Light Intensity Interval Training:

30 30 30 sec 60s 60s 12
sec sec 30 30 THR
60s 60s sec sec Borg 11-
5 min sec n sec n sec n sec n 3 min ½ HRR
For Moderate Intensity THR
Continuous Exercise: Borg 11-14
20 - 30 min
5 min 3 min For High ½ HRR
Intensity Interval Training:
4 4 min 3 min 3 ½ HRR
min min 4 min 3 min Borg >15
5 min 3 min 4 min THR
Time: ______ min/session _______ min/week
Type (check): _____ Jogging _____ Treadmill _____ Ergo bike _____ Rope skipping _____
Swimming _____ Rowing _____ Stair climbing _____ Star jumps _____ Walking Others:
_______________________________________________________
Cool Down:
Static Stretch 1: _______________ Duration: _____ sec Reps: ______ Set: ____ Static
Stretch 2: _______________ Duration: _____ sec Reps: ______ Set: ____ Static Stretch
3: _______________ Duration: _____ sec Reps: ______ Set: ____ Static Stretch 4:
_______________ Duration: _____ sec Reps: ______ Set: ____
• Muscular Resistance Training
Frequency: _____ x a week
Type: ___ compound exercises ___ single joint exercises

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Section: ____________ Schedule: _______________________ Date: ________________

Target muscles or class/Type of Exercise: For split routine, group the exercises.
_____________________________ ______________________________
_____________________________ ______________________________
_____________________________ ______________________________
_____________________________ ______________________________
Volume (for each exercise above):
1 RM: ___ Load: ___ (kg) %1RM: ___ Reps: ___ Sets: ___

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Section: ____________ Schedule: _______________________ Date: ________________

Module 4 – Action Stage

Outcomes: Upon completion of this module, the student shall have:
1. Implemented regularly upon himself the cardiovascular conditioning and muscular resistance training
program he designed.
2. Demonstrated improvement in the parameters or achieved the target parameters of the
cardiovascular conditioning and muscular resistance training.
Estimated Duration: Four to six weeks

STUDENT’S PLATFORM:
Teaching-Learning Activities:
1. Document randomly the activities by video or photograph the activities involved in the
implementation of your designed cardiovascular conditioning and muscular resistance training
program.
2. Tabulate the parameters obtained in each session as shown in Annexes B and C.

Basic Concept:
Prerequisites:
▪ Exercise is better performed early in the morning or in the evening. ▪ It should
not be done on a full stomach.
▪ People who have followed a sedentary or quiet lifestyle should begin an exercise program slowly.
▪ It is not important how quickly one advances to a higher level of fitness. Becoming fit eventually
and maintaining that fitness is what matters.
▪ A slow and easy start can avoid musculoskeletal injuries. Be sure to thoroughly warm up before
beginning and cool down gradually by stretching, appropriate to the exercise. This is very important
to prevent cramping and other discomforts. ▪ Choose activities that you like.
▪ Be realistic about what you can do.
▪ Exercising in a group is better than doing it alone because it makes it a social event and encourages
continuous participation.
▪ One has to consult a doctor before starting an exercise program. Also stop and check with your
doctor right away if you develop sudden pain, shortness of breath, or feel ill.
▪ Choose your method of exercise carefully! Make sure it is suitable for your body type. Avoid high-
impact events. Certain exercises should not be performed when people have certain diseases.
▪ People with diabetic retinopathy should not perform exercises that involve bending forward too
much or standing on their head.
▪ People with weak heart should not perform strenuous exercise. Those who have had a heart attack
cannot perform any exercise other than walking for a certain period after recovery.
▪ Be very certain to remain hydrated by continuously drinking water supplemented with vitamin C
and electrolytes while exercising.
▪ Even those confined to bed should have some kind of physical activity or at least physiotherapy to
avoid bedsores, chest infection, and loss of strength of bones, constipation and depression.

▪ Observe physical distancing, proper donning and doffing of mask and hand washing when exercising in
areas at risk for droplet or airborne infection. ▪ The mask does not compromise breathing. It is an
effective way to prevent viral transmission in a community context, provided that compliance is high.
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Equipment, Gear and Environmental Considerations:

• Wear light clothing and sports shoes with medial arch support.
• Avoid exercising under the heat of the sun or in a humid environment. • Exercise on
even ground of floor.
• Be mindful of the surrounding when exercising in the park while listening to music on your head
phone or earphone as you may hit or may be hit by others. • Exercise with somebody so he can call
for help when necessary.
• If equipment is needed for cardiovascular conditioning:
- Set the speed of motorized treadmill that stimulates your heart to beat within the target heart
rate. Maintain such a speed for your designed duration. - Observe the speed of manual treadmill
or ergo bike that corresponds to your target heart rate. Maintain such a speed for your designed
duration.
- Set the resistance of your ergo bike that would give you the target heart rate and maintain it
for your designed duration.
• If you are not using an equipment but instead running, jogging, hopping and other aerobic exercises,
maintain the intensity of your activity that would give you the target heart rate within the
designed duration.
• Bottle filled with water and your body weight can be used for your muscular resistance training.
Other elastic materials at home may be used.
• Your heart rate can be monitored while exercising by:

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- Counting your radial pulse (https://www.youtube.com/watch?v=m8tzO_nreb0) - Hooking a

pulse oximeter to your finger
- Holding the pulse counter on the treadmill or ergo bike
- Downloading the measurement of HR application to your android phone

Normal Response to Exercise:

• Increased heart rate
• Increased breathing rate
• Mild to moderate sweating, depending on your exercise level
• Feeling or hearing your heart beat
• Muscle aches and tenderness that might last a day or two as you get started
Abnormal Response
• Severe shortness of breath
• Wheezing, coughing, or other difficulty in breathing
• Cramps, severe pain or muscle aches
• Excessive perspiration
• Chest discomfort, pain, pressure or tightness felt in the chest and possibly extending to your left
arm or neck
• Light-headedness, dizziness, fainting
• Severe, prolonged fatigue, or exhaustion after exercise
• Nausea

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Section: ____________ Schedule: _______________________ Date: ________________

Module 5 – Maintenance Stage

Outcomes: Upon completion of this module, the student shall have:
1. Progressed his cardiovascular conditioning and muscular resistance training in a new exercise
prescription.
2. Achieved the target parameters of the new cardiovascular conditioning and muscular resistance
training program that requires progression to much higher levels.
Estimated Duration: Four to six weeks

STUDENT’S PLATFORM:
Teaching-Learning Activities:
1. Write an essay about your experience in implementing your designed fitness program in the past
4-6 weeks citing the reinforcing factors and the stumbling blocks.
2. Record your new anthropometric measurements that include:
a. Weight in kilogram
b. Body mass index
c. Waist circumference in centimeter
3. Revise your exercise prescription using the FITT format for both cardiovascular conditioning and
strengthening. Use the same format in Annex A.
4. Document randomly the activities by video or photograph the activities involved in the
implementation of your newly revised cardiovascular conditioning and muscular resistance
training program.
5. Tabulate the parameters obtained in each session as shown in Annexes B and C.

Basic Concept:
Rate of Progression in Cardiovascular Conditioning
The recommended rate of progression depends on the individual’s health status, exercise tolerance
and exercise program goals. Progression involves increasing any of the FITT components.
• Frequency, intensity and duration of exercise are gradually adjusted over the next 4-8 months or
longer for the elderly and deconditioned patients.
• Progression in the FITT components of the exercise prescription should be made gradually to avoid
muscle soreness and injury.
• All individuals should be monitored for any adverse effects of the increased volume, and downward
adjustments should be made if the exercise is not well tolerated.

Progression to National Physical Activity Recommendations

For sedentary students initiating an exercise program, a lower dose of exercise may be initially
recommended. It is assumed that your student will eventually set a goal to reach the recommended levels
of 150 minutes a week of moderate- intensity exercise or 75 minutes a week of vigorous-intensity exercise,
or some combination thereof. He might do this at the outset, or he might do it only after conquering the
‘‘regular’’.
This progression can occur by increasing the duration, the frequency, the intensity, or a combination
of these. There is no single correct order to progress these components, and the best option will vary
depending on each student’s preferences, health status, and lifestyle. We will describe two different paths
that your patients can choose to follow, each focusing on a different component: duration and frequency.
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Section: ____________ Schedule: _______________________ Date: ________________

In each case, it is assumed that your student is beginning his program for a duration that he is
confident of maintaining at least 3 times per week (frequency) at a low to moderate intensity. For example,
over a course of one month, he may go from walking five minutes a day three times each week, up to 20
or even 30 minutes a day three times each week. Once a duration of 30 minutes is reached, your student
can then increase the frequency of the exercise from three times each week ( see Figure 2.1, this occurs
at the end of level 6), to four, and then five times each week.

An alternative method is to progressively increase the frequency of activity. Your student can begin
their progression by first increasing the frequency of activity up to at least five days each week, while
maintaining the same duration for each session. Some students will be able to increase their frequency
directly from three to five times per week; others will want to progress more slowly first, to four times
per week, and then up to five.

This option has the advantage of helping your student establish a more regular habit of incorporating
exercise into his daily routine. The hardest part of regular exercise is the regular, not the exercise.
Following this progression pathway focusing on frequency, your student establishes the pattern of regular
exercise for a duration that is not intimidating or overwhelming. Once your student has reached a
frequency of at least five times each week, he can then consider increasing the intensity of the exercise to
a moderate level, i.e. an RPE of 3-4 out of 10, or a level at which he is able to talk but not sing. Your student
can also consider increasing the duration of the exercise sessions by 5-10 minutes per week, while still
maintaining the good habit of exercising five days each week. The order in which the intensity and duration
are increased is not important, and will depend on your student’s preference and health/fitness/age
status. Figure 2.2 illustrates this progression path.
Figure 2.2. Progression along the frequency path

Progression in Muscular Resistance Training

• If continued gains in muscular fitness and mass are desired, the individual will have to progressively
overload the muscles to present a greater training stimulus, by using a higher resistance or more
weights, performing more repetitions but not exceeding 12 repetitions, or training muscle groups
more frequently.
• If the individual is satisfied with the muscular fitness improvements made, a maintenance program
is adopted where the same regimen of sets, repetitions, resistance and frequency is performed
without the need for overloading. Muscular fitness may be maintained by training muscle groups
only 1 day each week provided the intensity remains the same.

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Module 6 – Termination Stage

Outcomes: Upon completion of this module, the student shall have:
1. Regularized his cardiovascular conditioning and muscular resistance training using the revised
prescription.
2. Achieved the target parameters of the new cardiovascular conditioning and muscular resistance
training program that requires progression to much higher levels.
Estimated Duration: Four to six weeks

STUDENT’S PLATFORM:
Teaching-Learning Activities:
1. Write an essay about:
a. Your experience derived from the implementation of your revised fitness program in the past
4-6 weeks citing the reinforcing factors and the stumbling blocks.
b. Your experience with the motivational approach of your PE instructor from the start of the
semester until at present, and how this approach would motivate also other people to follow
your footstep in this endeavour.
c. The effect of your physical education experience this semester to your pursuit for happiness
and success in life.
2. Record your new anthropometric measurements that include:
a. Weight in kilogram
b. Body mass index
c. Waist circumference in centimeter
3. Revise your exercise prescription using the FITT format for both cardiovascular conditioning and
strengthening based on your progress at the end of Module 5. Use the same format in Annex A.
4. Document randomly the activities by video or photograph the activities involved in the
implementation of your newly revised cardiovascular conditioning and muscular resistance
training program.
5. Tabulate the parameters obtained in each session as shown in Annexes B and C.

Basic Concept: The principle of progression in Module 5 still applies here. On the other hand, your
tendency to progress further may it be within the physiological bounds or not, may fire back at you. Here
are some guides in avoiding over exercising.
Health experts recommend moderate-intensity exercise on most days of the week. So, you may
be surprised to learn that you can get too much exercise. If you exercise often and find that you are often
tired, or your performance suffers, it may be time to back off for a bit. Learn the signs that you may be
exercising too much. Find out how to keep your competitive edge without overdoing it.

How too much exercise can hurt

To get stronger and faster, you need to push your body. But you also need to rest. Rest is an important
part of training. It allows your body to recover for your next workout. When you do not get enough rest,
it can lead to poor performance and health problems.
Pushing too hard for too long can backfire. Here are some symptoms of too much exercise:
• Being unable to perform at the same level
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• Needing longer periods of rest

• Feeling tired
• Being depressed
• Having mood swings or irritability
• Having trouble sleeping
• Feeling sore muscles or heavy limbs
• Getting overuse injuries
• Losing motivation
• Getting more colds
• Losing weight
• Feeling anxiety
If you have been exercising a lot and have any of these symptoms, cut back on exercise or rest
completely for 1 or 2 weeks. Often, this is all it takes to recover. If you are still tired after 1 or 2 weeks of
rest, contact or see your PE instructor. You may need to keep resting or dial back your workouts for a
month or longer. Your PE instructor can help you decide how and when it is safe to start exercising
again.

How to avoid overtraining

You can avoid overdoing it by listening to your body and getting enough rest. Here are some other
ways to make sure you are not overdoing it:
• Eat enough calories for your level of exercise.
• Decrease your workouts before a competition.
• Drink enough water when you exercise.
• Aim to get at least 8 hours of sleep each night.
• DO NOT exercise in extreme heat or cold.
• Cut back or stop exercising when you don't feel well or are under a lot of stress. • Rest for at least 6
hours in between periods of exercise. Take a full day off every week.

Compulsive exercising
For some people, exercise can become a compulsion. This is when exercise is no longer something
you choose to do, but something you feel like you have to do. Here are some signs to look for:
• You feel guilty or anxious if you do not exercise.
• You continue to exercise, even if you are injured or sick.
• Friends, family, or your provider are worried about how much you exercise. • Exercise is
no longer fun.
• You skip work, school, or social events to exercise.
• You stop having periods (women).
Compulsive exercise may be associated with eating disorders, such as anorexia and bulimia. It can
cause problems with your heart, bones, muscles, and nervous system.

When to call a medical professional

Call your PE instructor who will refer you a medical professional once you: • Have signs
of overtraining after 1 or 2 weeks of rest
• Have signs of being a compulsive exerciser
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• Feel out of control about how much you exercise

• Feel out of control about how much you eat
Your medical provider may recommend that you see a counselor who treats compulsive exercise or
eating disorders. Your provider or counselor may use cognitive behavioral therapy (CBT), antidepressants
medicines and support groups as treatments.

ASSESSMENT
At the end of the semester, the following will be evaluated: (File folder may be submitted to
Cloud, or mailed or, when health crisis is gone, hand carried)

A. Portfolio (File Folder in Cloud) must contain as shown in the table below. Absence of any of the
outputs would mean a grade of INCOMPLETE.
Module Outputs Check

1 Interview Report* (Relative)

Interview Report* (Non-Relative)

Essay* on Pursuit of Happiness and Success in life

Accomplished Table Physical Activity States of Change Questionnaire

Interpretation of the Table

2 Answers to Self-Assessment Questions

Essay* on Readiness for Exercise, Goals Setting, Prioritizing, Controlling

Accomplished 2020 PAR-Q

Interpretation of 2020 PAR-Q

3 Essay* on Risk Stratification and Exercise Intensity

Baseline Anthropometric Measurements

Exercise Prescription for Cardiovascular Conditioning

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 PED 025: Movement Enhancement

Name: _____________________________________________ Class number: _______

Section: ____________ Schedule: _______________________ Date: ________________

Exercise Prescription for Muscular Resistance Training

4 Compilation of videos or photos each session

Cardiovascular Conditioning Monitoring Chart

Muscular Resistance Training Monitoring Chart

5 Essay* on experience derived from training using the first prescription

New Anthropometric Measurements

Progressed Exercise Prescription for Cardiovascular Conditioning

Progressed Exercise Prescription for Muscular Resistance Training

Compilation of videos or photos each session

Cardiovascular Conditioning Monitoring Chart

Muscular Resistance Training Monitoring Chart

6 Essay* on experience derived from training using the 2nd prescription

Essay* on the motivational approach of the PE instructor

Essay* on effects of PE 1 to the pursuit of one’s happiness/success

New Anthropometric Measurements

Progressed Exercise Prescription for Cardiovascular Conditioning

Progressed Exercise Prescription for Muscular Resistance Training

Compilation of videos or photos each session

Cardiovascular Conditioning Monitoring Chart

Muscular Resistance Training Monitoring Chart

32
 PED 025: Movement Enhancement

Name: _____________________________________________ Class number: _______

Section: ____________ Schedule: _______________________ Date: ________________

*Minimum for all essay and narrative reports = 1,500 words

B. Progression in Cardiovascular Conditioning and Muscular Strength and Endurance: The rating for these
outcomes will be based on the mean of the target and the baseline. The mean is the passing mark.
Cardiovascular Conditioning
Parameters Baseline 2nd 4th week 6th week 8th week nth week
week

Waist Circumference

Weight

BMI

Target Heart Rate

58
Peak Exercise Heart
Rate

Borg RPE

Muscular Strength and Endurance

Parameters Baseline 2nd 4th week 6th week 8th week nth week
week

Volume

Load, % 1RM

Exercise 1

Exercise 2

Exercise 3

33
 PED 025: Movement Enhancement

Name: _____________________________________________ Class number: _______

Section: ____________ Schedule: _______________________ Date: ________________

Exercise 4

RPE

Exercise 1

Exercise 2

Exercise 3

Exercise 4

REFERENCES
A. Most of the content of these modules were lifted from the Exercise is Medicine, Philippines Pre-
Course Book 2017 with the following references:
➢ ACSM’s Guidelines for Exercise Testing and Prescription 8th Edition ➢ ACSM’s Resource Manual
for Guidelines for Exercise Testing and Prescription Sixth Edition
➢ ACSM’s Exercise Management for Persons with Chronic Diseases and Disabilities; J. Larry Dustine,
Geoffrey E. Moore, Patricia L. Painter and Scott O. Roberts ➢ ACSM’s Exercise is Medicine; A
Clinician’s Guide to Exercise Prescription by Steven Jonas and Edward Phillips
➢ ACSM’s Exercise is Medicine; A quick guide to Exercise Prescription by Technogym Medical
Scientific Department
➢ 2011 National Physical Activity Guidelines Health Promotion Board Singapore ➢ Exercise and
Type 2 Diabetes: American College of Sports Medicine and the American Diabetes Association: Joint
Position Statement by the American College of Sports Medicine and the American Diabetes
Association; approved by Executive Committee of the American Diabetes Association Medicine &
Science in Sports & ExerciseR and Diabetes Care; July 2010
➢ Appropriate Physical Activity Intervention Strategies for Weight Loss and Prevention of Weight
Regain for Adults; ACSM Position Stand ; Donnelly, Joseph E. Ed.D (Chair); Blair, Steven N. Ped;
Jakicic, John M. Ph.D.; Manore, Melinda M. Ph.D., R.D.; Rankin, Janet W. Ph.D.; Smith, Bryan K.
Ph.D.; Med Sci Sports Exerc. 2009; 41(2):459-71
➢ Exercise and Hypertension; ACSM Position Stand by; Pescatello, Linda S. Ph.D., FACSM, (Co-Chair);
Franklin, Barry A. Ph.D., FACSM, (Co-Chair); Fagard, Robert M.D., Ph.D. FACSM; Farquhar, William
B. Ph.D.; Kelley, George A. D.A., FACSM; Ray, Chester A. Ph.D., FACSM; Medicine & Science in
Sports & Exercise: March 2004 -
Volume 36 - Issue 3 - pp 533-553
➢ Harmonizing the Metabolic Syndrome: A Joint Interim Statement of the International Diabetes
Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute;
American Heart Association; World Heart Federation; International Atherosclerosis Society; and
International Association for the Study of Obesity; K.G.M.M. Alberti, FRCP; Robert H. Eckel, MD,
FAHA; Scott M. Grundy, MD, PhD, FAHA; Paul Z. Zimmet, MD, PhD, FRACP; James I. Cleeman, MD;
34
 PED 025: Movement Enhancement

Name: _____________________________________________ Class number: _______

Section: ____________ Schedule: _______________________ Date: ________________

Karen A. Donato, SM; Jean-Charles Fruchart, PharmD, PhD; W. Philip T. James, MD; Catherine M.
Loria, PhD, MS, MA, FAHA; Sidney C. Smith, Jr, MD, FAHA; Circulation 2009, 120:1640-1645
➢ National Physical Activity Guidelines for Americans 2008: Office of Disease Prevention and Health
Promotion of US Department of Health and Human Services ➢ Ministry of Health Clinical Practice
Guidelines, Management of Asthma 1/2008
➢ Australian Association for Exercise and Sports Science position statement on exercise and asthma
Alan R. Morton, Kenneth D. Fitch Journal of Science and Medicine in Sport 14 (2011) 312-316
➢ Department of Health (2010, March-April). Philippine National Guidelines on Physical Activity:
Galaw-galaw baka pumanaw. Healthbeat, 58, 6-8 Retrieved from: http://www.
doh.gov.ph/node/1025.html
➢ Department of Health, National Epidemiological Center. (2009). ‘‘The 2009 Philippine Health
Statistics’’. Retrieved from http://www.doh.gov.ph/sites/default/files/ PHILIPPINE%20HEALTH
%20STATISTICS%202009_0.pdf
➢ Department of Health (2013, April 26). ‘‘Leading causes of Mortality.’’ Retrieved from
http://www.doh.gov.ph/node/198.html
➢ Masoli, M., Fabian, D.; Holt , S. , Richard, B. (2004, May) ‘‘Global Burden of Asthma’’. Retrieved
from: http://www.ginasthma.org/local/uploads/files/GINABurdenReport_1. Pdf
➢ National Statistics Office & ICF Macro. (2009, December) ìPhilippines -National Demographic and
Health Survey 2008î. Retrieved from: http://dhsprogram.com /pubs/pdf/FR224/FR224.pdf
➢ Philippine Statistics Authority (2012, August 30). The Age and Sex Structure of the Philippine
Population: (Facts from the 2010 Census). Retrieved from
http://www.census.gov.ph/content/age-and-sex-structure-philippine-population facts-2010-
census
➢ The Problem of Mental Health in the Philippines (n.d.) Retrieved on May 15, 2014) from
wikispaces: http://mentalhealthph.wikispaces.com/2.%09The+Problem+of+Mental+
Health+in+the+Philippines
B. American Council on Exercise website. 9 signs of overtraining. www.acefitness.org/ education-and-
resources/lifestyle/blog/6466/9-signs-of-overtraining?pageID=634. Accessed August 8, 2018.
C. Carfagno DG, Hendrix JC 3rd. Overtraining syndrome in the athlete: current clinical practice. Curr Sports
Med Rep. 2014;13(1):45-51. PMID: 24412891 www.ncbi.nlm.nih.gov/ pubmed/24412891.
D. Meeusen R, Duclos M, Foster C, et al. Prevention, diagnosis, and treatment of the overtraining
syndrome: joint consensus statement of the European College of Sport Science and the American
College of Sports Medicine. Med Sci Sports Exerc. 2013;45(1):186-205. PMID: 23247672
www.ncbi.nlm.nih.gov/pubmed/23247672.
61
E. Rothmier JD, Harmon KG, O'Kane JW. Sports medicine. In: Rakel RE, Rakel DP, eds. Textbook of Family
Medicine. 9th ed. Philadelphia, PA: Elsevier Saunders; 2016: chap 29.
F. Preventive Cardiology, Cardiac Rehabilitation and Sports Cardiology Course: From Set up to Frontiers,
European Society of Cardiology and European Association of Sports Cardiology, Inselspital Bern
University Hospital, Switzerland.

35
 PED 025: Movement Enhancement

Name: _____________________________________________ Class number: _______

Section: ____________ Schedule: _______________________ Date: ________________

ANNEX A
EXERCISE PRESCRIPTION
Cardiovascular Conditioning Prescription
Name ______________________________________________________ Age: ______________ Date of
1st Day of Training: _________________ Initial Prescription/No. of Progression: _______
Components Target

Frequency

Intensity

Resting Heart Rate

Heart Rate Reserve

Target Heart Rate

HR @ High Interval

HR @ Low Interval

Borg Rate of Perceived Exertion

Time

Warm up

Stimulus

Cool down

Number of cycles

Type

36
 PED 025: Movement Enhancement

Name: _____________________________________________ Class number: _______

Section: ____________ Schedule: _______________________ Date: ________________

For Light Intensity Interval Training:

30 30 30 sec 60s 60s 12
sec sec 30 30 THR
60s 60s sec sec Borg 11-
5 min sec n sec n sec n sec n 3 min ½ HRR
For Moderate Intensity THR
Continuous Exercise: Borg 11-14
20 - 30 min
5 min 3 min For High ½ HRR
Intensity Interval Training:
4 4 min 3 min 3 ½ HRR
min min 4 min 3 min Borg >15
5 min 3 min 4 min THR

Example: A 25 year-old male medically cleared to engage in high intensity interval training.
Components Target

Frequency 5 x a week

Intensity

Resting Heart Rate 88 beats/min

Heart Rate Reserve 76%

Target Heart Rate (220-25-88)0.76 + 88 = 169

HR @ High Interval 169 beats/min

HR @ Low Interval (220-25-88)0.38 + 88 = 128 beats/min

Borg Rate of Perceived Exertion 15

Time

Warm up 5 min @ low interval

Stimulus 23 min

Cool down 3 min @ low interval

37
 PED 025: Movement Enhancement

Name: _____________________________________________ Class number: _______

Section: ____________ Schedule: _______________________ Date: ________________

Number of cycles 4

Type HIIT on Motorized Treadmill

For High Intensity Interval Training:

4 min
4 Borg >15
4 3
4 3
min 3
min 3
min THR = 169 beats/min
5 min min min beats/min
min min ½ HRR = 128

Muscular Resistance Training Prescription

Name ______________________________________________________ Age:
______________ Date of 1st Day of Training: _________________ Initial Prescription/No. of
Progression: _______
Training Age

Goal

Volume

Frequency

Session/Duration

Warm up Duration Sets Reps

Stretch

Exercise Sets Reps Rest Load RPE

38
 PED 025: Movement Enhancement

Name: _____________________________________________ Class number: _______

Section: ____________ Schedule: _______________________ Date: ________________

Cool down Duration Sets Reps

Stretch

Name of PE Instructor:
___________________________________________________________ Date
Submitted/Finished:
________________________________________________________
Example:
Training Age 28

Goal Increase strength

Volume Moderate

Frequency 2x week

Session/Duration 80 min including warm up and cool down

Warm up Duration Sets Reps

Stretch

Arms across 30 sec 2 1

chest

Prone quad 30 sec 2 1

stretch

39
 PED 025: Movement Enhancement

Name: _____________________________________________ Class number: _______

Section: ____________ Schedule: _______________________ Date: ________________

Hams stretch 30 sec 2 1

Exercise Sets Reps Rest Load RPE

Squat 5 4 2-3 min 85% 1RM 17

Bench press 3 5 2-3 min 80% 1 RM 17

Power clean 3 4 2-3 min 70% 1 RM 15

Deadlift 5 4 2-3 min 85% 1RM 17

Bench pull 3 8 1-2 min 75% 1RM 14

DB Split squat 3 8 1-2 min 75% 1RM 14

Military Press 3 8 1-2 min 75% 1RM 14

Cool down Duration Sets Reps

Stretch

Arms across 30 sec 2 1

chest

Prone quad 30 sec 2 1

stretch

Hams stretch 30 sec 2 1

40
 PED 025: Movement Enhancement

Name: _____________________________________________ Class number: _______

Section: ____________ Schedule: _______________________ Date: ________________

ANNEX B
CARDIOVASCULAR CONDITIONING MONITORING CHART
Name ______________________________________________________________________________
Age: ____________________ PE Instructor:
________________________________________________________________________ Section:
_________________
Parameters Basel Day Day Day Day Day Day Day Day
ine 1 2 3 4 5 6 7 8

Date
Measured

Initial or
Progressi
on No.

Waist
Circumfer
ence, cm

Height, m

Weight, kg

BMI

Target Heart
Rate

Peak
Exercise
Heart
Rate

Borg RPE

*5 days a week
Parameters Day 9 Day Day Day Day Day 5 Day Day Day
10 11 12 13 14 15 16

Date
Measured

41
 PED 025: Movement Enhancement

Name: _____________________________________________ Class number: _______

Section: ____________ Schedule: _______________________ Date: ________________

Initial or
Progressi
on No.

Waist
Circumfer
ence, cm

Height, m

Weight, kg

BMI

Target Heart
Rate

Peak
Exercise
Heart
Rate

Borg RPE

*5 days a week
ANNEX C
MUSCULAR RESISTANCE TRAINING MONITORING CHART
Name ______________________________________________________________________________
Age: ____________________ PE Instructor:
________________________________________________________________________ Section:
_________________
Parameters Baseli Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7 Day 8
ne

Date
Measured

Volume/Inten
sity

Load, % 1RM

42
 PED 025: Movement Enhancement

Name: _____________________________________________ Class number: _______

Section: ____________ Schedule: _______________________ Date: ________________

Exercise 1

Exercise 2

Exercise 3

RPE

Exercise 1

69 Exercise 2

Exercise 3

Parameters Day 9 Day Day Day Day Day Day Day Day
10 11 12 13 14 15 16 17

Date
Measured

Volume/Inten
sity

Load, % 1RM

Exercise 1

Exercise 2

Exercise 3

RPE

Exercise 1

Exercise 2

Exercise 3

*With 48 hours interval

43