A couple of things before we get to the little project that I'm going to give you to work on. All right, so in your information, you have a folder that says exercise session material. So one of the most important things that you'll find in the exercise session material folder is the Strong Survivor Workout Manual. Now, there are two versions of this. And the first one that's on top is the...
at-home workout manual. That one we generally do not use very much. The only time that we would use that is if we had a participant who was doing purely at-home exercise and that was all that they were doing. Then we would probably make them a copy of that and get that sent out to them. But the majority of the folks that we work with either work out here at the cancer rehab lab or work out at Logan, at least initially.
So they receive a copy of the full workout. The at-home one has all of the machine exercises taken out. And so there's no confusion about that, particularly when the trainer is doing their prescription for them, planning their workout sessions.
Unless they have a home gym that has some of those pieces of equipment, which has happened a couple of times in the past. Not too often, but it has happened. And then having the machine exercises in there is a good thing.
But for the majority of our participants, they just receive the workout manual that is the full one that has everything in it. Now, is this an exhaustive workout manual that includes... every single resistance training machine that you could find on the face of the planet?
No. All the photos and all the descriptions that we wrote of the photos were taken out at Logan Fitness. So there are some pieces of equipment at Logan Fitness that do not exist in the cancer rehab lab. So for instance, you cannot do a seated leg curl machine exercise in the cancer rehab lab.
We do not have that piece of equipment down there. But there are plenty of other ways that you can exercise the hamstrings, obviously. So you just have to be a little bit more creative with that one.
I'm just going to flip through real quick and show you how the workout manual is organized. Page two has some common questions because obviously this is something that we may send to a participant. And, you know, or these common questions might be actually helpful to you to look through as a trainer because it might help you to answer questions that your participants might. might have.
Then on page three, it shifts into a warmup. And this is kind of a semi-condensed version of what is in week one of the strong survivors curriculum for the Logan class. That one has a few more details in it, but this one will still get the job that we're trying to do.
Of course, we were trying to reduce. the number of pages of the workout manual a little bit. So we cut a few things here and there, but they're largely the same information.
There's just a little bit more in what we have for the Logan class. So it talks about why we warm up, how we do it, and then there are pictures and descriptions of various dynamic movements that a participant could do in preparation for a resistance training program. I think we've talked about this a couple of times. The main thing that you have to remember is that when you're working with a participant, you don't want to use just these exercises.
You certainly could use these exercises. And there are times when you probably will use these exercises as a part of phase two of the warm-up you do with your participant. But if you have a participant who you planned out to do a... to do a standing upright row exercise with rather than doing a shoulder press exercise?
Would you want to have them do the shoulder press dynamic movement as a part of phase two or would you rather have them do this movement as a part of phase two? You want to do whatever is going to mimic the resistance activities that they're going to do during that particular workout. That's what you do as a trainer for phase two. And that's something that you want to continually, continually communicate to your participants is that we are trying to mimic the exercises that you're going to do with a little bit more intensity, with a little bit more load, more resistance during your resistance training phase of the exercise program. So what we're doing.
is in phase one, we're just gradually warming up the muscles a little bit, notifying them that they're going to be used, getting blood flow going, breathing rate going, synovial fluid, all that stuff that goes along with warmup. And then in phase two, we get more specific with it, where we're starting to target the muscles we're actually going to use during that resistance training session. And so if you have a participant who goes through all of these same exercises every single time before they do a resistance training session.
That's not the end of the world, right? Because it is going to give them a good dynamic warm-up, but it's going to be a more general dynamic warm-up, especially if they're doing exercises that aren't mimicked by these dynamic exercises. So another example of that would be the front push. And the front push mimics... a bench press, right?
With either dumbbells or barbell or if you're on a machine. But what if you're doing more of a fly exercise? Does the front push mimic that?
Well, to a limited degree, there is some crossover there, but this is more of the true dynamic exercise, dynamic movement that you want to do as a part of that warm-up. So the pictures and descriptions are very generic. Like I said, if they do those, they're going to be much better off. than if they did no dynamic movements as a part of their warm-up.
But they're not going to be as good as they would if they were mimicking the exercises that they're going to do during that resistance training phase. Now one of the things that we see frequently with anybody that continues to exercise, particularly at John A. Logan, after they've gone through the class, is I will see them warm up And they're, of course, they're exercising on their own at that point. They're not exercising under the tutelage of a trainer.
I'll see them do a warm-up, and then I'll see them going through these dynamic movements. And then I'll kind of keep my eye on them, and I'll watch what exercises they go do. And in most cases, they end up doing exercises that aren't mimicked by these.
Why do they do these? It's what they are comfortable with. It's what they've seen pictures of.
It's what we did a few times in the class as a group dynamic warm-up. Obviously, with a group dynamic warm-up, everybody is doing different resistance exercises. There's no way that you can do, you know, every single dynamic movement that everybody in the class is doing.
But for the participants that move on and continue to exercise at Logan and we can see what they're doing, they often will do that and I'll usually will stroll casually over and be like well I see you're doing a dumbbell fly exercise but I noticed when you were doing your dynamic stretches that you were doing the front push. Why didn't you do a fly movement? Like oh well I was just doing what's in the manual.
Like you know that's fine. Talked about in class is that we want you to mimic those movements because that's really going to target the muscle groups that you're using. the energy systems during that resistance training phase. So very important for that to happen. One thing to remember about the warm-up is that the dynamic movements are only necessary prior to doing resistance training exercise.
If you have someone who you know maybe comes to Logan Fitness or comes to the Cancer Rehab Lab and all you're doing with them that day, is walking on the treadmill or you're walking around campus or you're sitting on an exercise bike or elliptical machine, whatever. I mean, it's not necessary for them to do these dynamic movements that are in the pictures. Why?
Because as you're warm up, let's say you're walking on a treadmill, as you're warm up, you can do three to five minutes of slow walking, increased speed, increased grade, increased speed, increased grade, until you get to where they're going to be exercise-wise. And then just have them continue walking at that pace for however long you prescribe them to exercise. Out at Logan Fitness, they go over to a treadmill, they turn it on, and they start walking.
They walk for about four minutes. They stop the treadmill, and they get off, and they run through all of these dynamic movements that are in the workout manual. Then they get back on the treadmill, and they start walking again at a slightly higher speed. And I usually will once a week. casually stroll over and I'm not trying to make anybody look stupid.
I just wanted to make sure that they understand that they don't have to do that. And I get the same answer that I got when I asked them why they didn't do a dumbbell fly. Well, it's, you're supposed to do the dynamic movements of space too. Like they've got the answer right there. They remember why.
But I'm like, but are you going to do some resistance training activity? No, no, I'm just going to walk on the treadmill today. Well, in that case, you don't need to do those dynamic movements.
That actually works against you in that circumstance because you get that nice warm up on the treadmill and then you step off and do dynamic movements that, you know, you're moving a little bit. You're not walking on the treadmill. So you're going to lose some of that warm up effect when you get back on the treadmill after being off doing these dynamic movements.
So. Important to remember that they don't have to do that. All right.
There's also a section on aerobic activity that takes you through how to calculate a target heart rate range. This is also in the week one material for the Logan class. If you do want to use a different calculation for their max heart rate, Rather than 220 minus your age, that is perfectly fine.
I know that there are other ones that are out there. We just haven't made the shift to using those yet, but you can certainly do that. If you do, though, you want to make sure that you are noting that somewhere in their file, particularly if you use it for the target heart rate for the treadmill test on assessment.
Because that might dramatically change what their target heart rate is if you're using something different. for their max heart rate. It's probably not going to change it all that much, but it's still different than doing 220 minus your age. Make sure that you make note of that so that if you don't end up doing the next assessment on them, whoever does can look at their old assessment and be like, oh, they use that formula instead of 220 minus your age to get that target heart rate. All right, then we get to the meat of the...
of the manual, so to speak, which is the resistance training section. It has safety procedures, etiquette, designing a resistance training workout. All that is in the Logan materials as well.
And then there's a little bit of information in here on balance activity and how it's often beneficial to combine balance work with resistance training work. But you want to make sure that you master the balance activity and master the resistance training activity first. before you start to combine those two.
And there's a few other things that are noted in there. Most of that material comes from the material from week two of the Logan curriculum. Then it segues into all of the different major muscle groups.
And there are a couple of exercises a piece, at least in many cases, many more than that for each of those major muscle groups with pictures and descriptions. And The orientation of the exercises in that portion of the workout manual is exactly how it's laid out here. So you can see that chest starts on page eight and then quads on 12, upper back, so on and so forth.
And again, we lay this out so that it's upper body, lower body, upper body, lower body, upper body, lower body, upper body. The only exception is when you get to H and J technically. The abdominals and the lower back are part of the torso, so they're technically an upper body exercise, but in most cases you don't use your arms very much when you're doing an abdominal or lower back activity, so it does give your arms a chance to relax in that circumstance. All right, so I'm going to scroll through all those picture descriptions. There is a section on balance that shows up right after the resistance training portion and that is 33. Okay so lots of different exercises in here.
and lots of different exercises you can use different implements that we have here in the cancer rehab lab as well as Logan like fit balls, balance discs, balance pads. There's lots of different ways that you can increase balance challenge. One of the most basic ways of increasing balance challenge of course is what we do during an assessment if they're able to make it 30 seconds on either the left or the right leg or both during the first phase of the balance test and that is If you have them close their eyes while they're doing anything, sitting on a football even, hey, that's going to make them more unsteady and it's going to make more of a challenge for their balance system. And you want to make sure as a trainer, if you're having them do eyes closed activities, that you're right there to make sure that they're not, you know, if they're sitting on a football, they're not going to go rolling away and end up on the floor or if they're standing up.
That said, they're not going to stumble, fall, etc. And there are obviously some easier exercises in here balance-wise and some more challenging ones. You don't have too many people that do the balance on the knees on the football. But occasionally we do get folks that have better balance, better core strength, and they are able to do those activities. A following balance is a section of cool-down.
Again, this was pulled from the Logan materials for week. to eight, but we did pull out a little bit of that. We pared it down some to make it a little less, a little less lengthy, but the why to do it, the how to do it, where you start with that very light aerobic activity, and then you move into slow and static stretches.
And if they do all the slow and static stretches that are listed, pictured and described here, they're going to get a stretch on all the major muscle groups of the body. So we get down to the area. Hold on, let's go back up.
When you get to the, I'm going too far. I'll get there eventually. Quadriceps, you can see that there are three different ways to do it because a lot of people are unable to do the grab your foot or grab your sock or grab your shoe, the back of your shoe and pull, pull your, your, your leg while you're standing. because either they don't have the balance for it or they don't have the flexibility for it.
So there are other ways of doing the quadricep stretch. Same thing with the hamstring stretch and there are numerous ways to stretch your hamstring. What we want to avoid is having them sitting on the floor leaning forward.
That puts a lot of pressure on the low back. That might be okay. safety wise for a 20 year old but it's not okay for a 70 to 80 year old even if they have really good flexibility it's not a good plan so having them do the hamstring stretch in a way that that takes a little more pressure off the low back is the best thing there are numerous back stretches in here you don't obviously have to do all these just do the ones that that you feel would be beneficial for your participants and then at the end talks about different ways that they could extend their cool down if they wish to do so.
All right, so that's the workout manual. When you are initially writing exercise prescriptions, we want you to use exercises that are in the workout manual and include on the workout log the page numbers of those exercises so that if your participant is working out on their own, they can have those page numbers there on their workout logs and they can look to see descriptions of those exercises. And that's particularly important initially when you do a workout because that's the very first workout that you're going to design for your participant. Or if they're a continuing participant, you may update that home-based workout that they already have from a prior trainer potentially.
Or you may have to come up with something brand new if that trainer doesn't have a copy of it for some reason electronically or on paper. You may have to come up with something completely new based off of what they like to do and what sort of equipment they have in their home to be able to exercise appropriately. But the main thing is making sure that you use those workout manual exercises plus put the page numbers in there. In the top drawer of the black file cabinet where you find all of the, actually is it the pan file cabinet? The top drawer of one of those two file cabinets where you find all of the forms that you use for your participants to fill out, medical information, quality of life stuff, all that.
Towards the back of that, we always keep some extra copies of the workout manual in there. Now for the people in the Logan class. they get a copy along with their curriculum guide. And for the people at the CRL, we just hand them a copy.
They can also have a copy of the curriculum guide from Logan too. If anybody ever wants that, just let me know and I can make a copy for them. We don't generally keep that on hand because it's a little longer.
But the workout manual, we definitely keep copies of that around. So workout manual, very important. All right. Your main tool for writing exercise prescriptions is the exercise session log.
It's a space for your name, for your client's name, or your participant's name, the date. All of that's very important. First and last name all the time, just like on the assessment.
Always have first and last name on there. Always make sure that you have the date completely out there. So don't just write September 29th. What year? You have to know what year so we can figure out when this happened.
And then where did that exercise session take place? Most of the time it's either going to be Logan or the CRL. Occasionally we do have participants that have memberships at the rec center, prefer to work out there. And you can meet your participant over at the rec center and do the, with the workout log, you've got at the top pre-workout energy level, and you're just asking them how they feel energy wise from a kind of scale of one to 10. And you can describe it as one is the least amount of energy you've ever felt, whereas 10 is the most energy you've ever felt. And most people usually fall somewhere between four and seven.
We asked them that same question. after the workout is over down at the bottom. And what we're hoping is that they get a little bit of an energy boost. They might be a little bit exercise tired, but they're feeling kind of buoyed emotionally and buoyed physically by that workout.
Okay. The exercise session log is basically set up like the workout manual is for the most part. There's a section for warmup, and then there's a section for resistance balance.
And for aerobic activity. We put resistance balance first because that's what we want our trainers to focus on. If there's time after the resistance balance exercises are done, and then you can certainly move on to doing some aerobic activity before you get into the cool down flexibility period. But we generally, especially for the Logan class, we tend to focus on let's use the resistance training equipment we have access to. And then we assign them to do aerobic activity sort of as a homework assignment for that class.
And you can do the same thing with the cancer rehab lab, unless part of their goal is to, you know, be able to run a 5k, you know, then you're going to want to focus more, a little more during your sessions on that aerobic activity. So you're training for that particular event. All right. So when you are Filling this in, what we generally ask you to do is to type in the exercises electronically, type in the page numbers, type in all the information at the top, and save it electronically. That way, if you train a client for 12 weeks, let's say you do that for the Logan class in the spring.
And then let's say you go home or you have an internship or you have something where you're out of Carbondale for the summer or maybe you're doing other things and you're unable to work with that participant. They want to continue exercising at the cancer rehab lab, so we will reassign them to a new trainer. If you have these electronically, then you can send them to the new trainer and they can use them as a baseline for what they're going to do with that participant. Now, obviously, shifting from Logan to...
the cancer rehab lab and we don't have a vertical chest butterfly machine in the cancer rehab lab. That is a Logan only exercise. So you're going to have to change that in order to fit what equipment we have in the cancer rehab lab. Obviously you're going to prescribe the amount of resistance and there's a lot of different ways that you can do that.
You can say you know the the poundage of the dumbbells that they're using. You can say the number of plates that they're lifting on a particular machine. You can go with the actual amount of weight that they're lifting on that machine.
We went with, we started going with a number of plates on the machine, especially at Logan, because this, that was sort of a relic when they had some older equipment in there, that the numbering system was really weird on the stacks. So it got really confusing. So we started going with one plate, two plate, three plate.
core plate as opposed to anything else. And that was a little easier to follow. And the number of sets, number of reps. And then what's blank, of course, is the heart rate column and the RPE column. If you don't get heart rate during resistance training, that's okay. But you need to get RPE for every exercise that you do when you've asked for their RPE after the last repetitions of the last set that they do.
one set, two sets, three sets, whatever the last set that they do, you ask them for their RP. Here in the cancer rehab lab, there are two RP charts up on the wall, but we also have them on the back of the flipboards at Logan. We don't have any ARCNE charts on the wall, so you have to use what's on the back of the footboard, which matches what is in the Logan curriculum book in, I think it's in week one.
Obviously, you can make alterations during that session, depending on what the participant is able to do. You just want to make sure if you make an alteration, maybe make a note as to why you made that particular alteration. And that's... It didn't happen in every single case on our example here, but I always use that as a teaching point that, okay, you had three as their resistance, so three plates on that machine, but you ended up doing four. Why was it you went up to four?
Write a little note up there so that you can remind yourself of it. And then if you have someone who substitutes for you the next time that they're working out, they're doing this same exercise. they know why you moved up from three to four. And it may be that three just seemed a little too light. Maybe it was the first time you were doing that activity and you're playing a little bit of trial and error there with what they are doing exercise-wise.
All right. The only other thing that I want to show you in that folder is this, which is the client summaries. This is something that I will periodically ask you to do. summary on your client of their information, what their, if they're in treatment, what their most recent treatment data was, if they have any physical or psychological issues that you're aware of that might affect their ability to exercise, describe the nature of the sessions, what their adherence level was, how many sessions they made it to during the time frame that I'm asking you to summarize, any updates that you made to it. and then any assessments that have occurred during that time.
Then when you're planning to do the next assessment that keeps us on track, especially when we have folks that are past that initial 12 weeks where they're still exercising with us and we want to do an assessment every six months, it helps us to keep that on track. I will periodically ask you to put these together for me, and it's primarily not necessarily for you. It's more for me so that I kind of get an idea of where everybody is at in the program, because we have a lot of people that are working out both at Logan and here at the Cancer Rehab Lab. So it helps me to stay on top of things.
Okay, so this is what we're doing, doing a case study. And you're going to find your case study. on the My Courses page for 402. So if you haven't been on there yet, this is what that looks like when you pull it up.
And it's divided into a number of different portions. The only thing that's not on there is the study guides for the exams and the exercise prescription case studies. So if you open that up, you'll see that there are three case studies in here. peak cancer, RON tumor, and TAMI tumor. So if you're assigned to peak cancer, you will see that I have a bunch of documents that I have copied into a PDF.
You've got a participant information form. You've got an exercise history, potential contraindications form, got a cancer treatment history, and a medical history. and then you have an assessment.
Okay, so all that information is what you get out of the case study. Now what you will notice is that there is some missing information on some of these forms, and that is designed that way to be a part of the case study project. So what you're going to do is you're going to create a PowerPoint presentation.
It does not need to be fancy. Don't spend a whole bunch of time giving me a whole bunch of bells and whistles. If it's just black and white, that is fine. And don't make it super fancy unless you want to.
I do not want to stifle your creativity at all. But you don't have to feel like it needs to be super fancy. Okay, in that PowerPoint presentation, you need to summarize all of this basic information about that.
Don't try to put all this information on one slide. The smallest font that you should ever use in PowerPoint is 24. 24 for Times New Roman. All right. Smallest font is 24 for Times New Roman.
Anything smaller than that and it gets very, very difficult to read. And it means that you put a lot of information on the slide and it gets super busy and hard to interpret. So feel free to spread out this information on as many slides as you want. Make it as big as you want. All that information you should be able to get off of their case study that you find on the My Courses page.
Then section B, this is also going in your PowerPoint, is questions that you want to ask the participant about their fitness or their medical status that you feel would be valuable to writing their exercise program. And this is where some of that missing information on the forms will probably come into play. And maybe there's some other information that you want to ask them that you feel is relevant that's going to help you to write a safe and effective exercise program for them. Part C, you did not do their assessment and you were not able to work out the schedule so that you could be there for their assessment. So we had another strong survivor staff member do their assessment.
All you have is the data collection form. So section C is any questions that you want to ask that staff member about the assessment. Anything you feel would be valuable that you don't see on that data collection form that you want to know about the participant that might be helpful to you when you're writing their exercise prescription.
Then speaking of exercise prescriptions, that's the end of the PowerPoint session. Then you're going to make. two Word documents or you can make them into PDFs.
Either way is fine. I recommend doing the Word document because then you can actually use it and edit it a little bit. Okay, you're going to do a home-based workout for that person and then you're also going to do a CRL-based workout.
In both cases, you are going to use the workout log that we just looked at. Use that as your template and go ahead and type in those exercises for that person. And again, in both cases, for the CRL and for the home-based workout, use the workout manual exercises and include the page number.
Assume that this is the first time that they're doing this workout, so only one set per exercise. Because the first time that you do it with a participant... And the first time you run through that exercise program, there's going to be a lot of demonstration time, explanation time.
They're going to need to kind of be figuring out the technique. So it takes longer to get through there. So doing only one set, eight to 10 reps plus, that's a lower intensity.
You want to gradually move them up in intensity and not start them out too high. So eight to 10 reps is where we want to start them with that one set. One exercise per major muscle group. Except for inner and outer thighs, you guys can skip that one for this purpose.
Now, you may have a participant eventually who wants to work on that area of their physiology. And so then you'll need to prescribe exercises for inner and outer thighs. And we want to have them do one balance activity, but that is a balance activity independent of resistance training.
You would never do a combo resistance training balance activity. in the first workout that you do with that person, whether it's at the CRL or whether it's a home based workout. Remember for the home-based workout that you want to look at that exercise history form to see what sort of equipment that they have and that might lead you to some questions about that equipment.
And then five to ten minutes of aerobic activity and you can prescribe multiple pieces of equipment and you can do it all on one. one piece of equipment either way is fine. Just remember with the CRL, not all of the exercises that are in the workout manual are available in the CRL. All right, for both D&E, you're going to have your PowerPoint, you're going to have two Word files that we'll put up on the screen. For both the D&E part, you'll need to be prepared to answer questions about why you picked the exercises that you did for them.
hey, what was your strategy based on their medical and fitness status? I will definitely be asking you some questions once your presentation is over. So you have a few days to put that together and keep it as simple as possible.
Again, this is designed to mimic the first exercise session that you're doing with them, either both the home-based and then you're working out at the... Answering that one.