APPENDIX: QUANTIFYING EXERCISE INTENSITY USING DIFFERENT METHODS
OTHER NOTES:
Patient Handout 2: Exercise Prescription “Pad”–Frequency Path
Exercise is Medicine Clinician’s Name: ______________________
Exercise Prescription for ______________________________________________
GOAL:
To _____________ __ times each week for at least ___ minutes each time by
(type of exercise) (#) (#)
__________.
(target date)
In order to reach this goal, begin with the following:
BEGIN WITH:
Frequency F _________ times each week
Intensity I _________ intensity (i.e., an intensity where you can talk / sing
while active) (circle)
Time/duration T _________minutes each day
Type T _________type of exercise (e.g., walking, gardening, swimming, etc.)
This corresponds to level ______ on the graph above.
Maintain this level for _______ weeks before starting your progression
EXERCISE PROGRAM LEVEL 30
40
MINUTES PER EXERCISE SESSION
20
10
1 2 3 4 5 6 7 8 9
GOAL ACHIEVED!
30min 5x/week moderate
intensity
INTENSITY:
LOW: <3/10 MODERATE: 3-4/10 VIGOROUS: >4/10 FREQUENCY:
3x/WEEK 4x/WEEK 5x/WEEK
PROGRESSION:
Every week 1 / 2 weeks, progress to the next level on the graph above.
(circle)
PRECAUTIONS:
OTHER NOTES:
Patient Handout 3: Exercise Prescription “Pad”–Intensity Path
Exercise is Medicine Clinician’s Name: ______________________
Exercise Prescription for ______________________________________________
GOAL:
To _____________ __ times each week for at least ___ minutes each time by
(type of exercise) (#) (#)
__________.
(target date)
In order to reach this goal, begin with the following:
BEGIN WITH:
Frequency F _________ times each week
Intensity I _________ intensity (i.e., an intensity where you can talk / sing
while active) (circle)
Time/duration T _________ minutes each day
Type T _________type of exercise (e.g., walking, gardening, swimming, etc.)
This corresponds to level ______ on the graph above.
Maintain this level for _______ weeks before starting your progression
EXERCISE PROGRAM LEVEL 30
40
MINUTES PER EXERCISE SESSION
20
10
1 2 3 4 5 6 7 8 9
GOAL ACHIEVED!
20min 3x/week vigorous intensity
LOW: <3/10 MODERATE: 3-4/10 VIGOROUS: >4/10 FREQUENCY:
3x/WEEK 4x/WEEK 5x/WEEK INTENSITY:
PROGRESSION:
Every week 1 / 2 weeks, progress to the next level on the graph above.
(circle)
PRECAUTIONS:
OTHER NOTES:
Patient Handout 4: Exercise Prescription for Resistance Training
Exercise is Medicine Clinician’s Name: ______________________
Exercise Prescription for ______________________________________________
In order to reach this goal, begin with the following:
BEGIN WITH:
Frequency F _________ times each week
Intensity I __________ intensity (e.g., 3–4 on a 10-point scale of perceived exertion)
Time/duration T __________one set each session.
Type T __________type of exercise (e.g., lifting weights, resistance bands, etc.)
This corresponds to level ______ on the graph above.
GOAL ACHIEVED!
3 sets of 8-12 reps
EXERCISE PROGRAM LEVEL/WEEK 3
NUMBER OF SETS
2
1
1 2 3 4 5 6
INTENSITY:
In weeks 1 and 2 perform 15 repetitions until fatigue. In weeks 3 and beyond, increase resistance so that you can perform only 8-12 repetitions until fatigue.
5-6/10 6-7/10
FREQUENCY:
2x/WEEK 3x/WEEK 4x/WEEK
GOAL:
To do resistance training two times each week for three sets of 8–12 repetitions in 8–10 different muscle groups.
References
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Philadelphia (PA): Lippincott Williams & Wilkins; 2009. p. 1–17 PROGRESSION:
Every week 1 / 2 weeks, progress to the next level on the graph above.
(circle)
PRECAUTIONS:
OTHER NOTES:
7. American College of Sports Medicine. Position stand: exercise and physical activity for older adults. Med Sci Sports Exerc. 1998 Jun;30(6):992–1008.
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16. Centers for Disease Control and Prevention (US). Physical activity for everyone: mea-suring physical activity: metabolic equivalent (MET) level [Internet]. Atlanta (GA):
Department of Health and Human Services (US); [updated 2007 May 22; cited 2008 Feb 4]. Available from: http://www.cdc.gov/nccdphp/dnpa/physical/measuring/met.htm 17. Ainsworth BE, Haskell WL, Whitt MC, Irwin ML, Swartz AM, Strath SJ, O’Brien
WL, Bassett DR, Schmitz KH, Emplaincourt PO, Jacobs DR, Leon AS. Com-pendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc. 2000 Sep;32(9suppl):498–516.
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