Module Five Wellness Plan
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Fill in all logs and answer the reflection questions completely with supporting details
for sections 1-5. After completing all sections, submit this file as your Module Five
Wellness Plan assignment.
Section 1: Fitness Assessments
Complete the following steps on the chart below:
Step 1
Complete Column B. Use your results from the Module 4 Wellness Plan Fitness
Assessments.
Step 2
Complete Column C. Use your current results from the Module 5 Wellness Plan
Fitness Assessments.
Column A Column B Column C
Activity Module 4 Module 5
Wellness Plan Results Wellness Plan
Results
Mile Run/Walk 1 mile 1 mile
Body Mass Index 24.3 23.7
Aerobic Capacity
Curl-ups 25 20
Push-ups 25 30
Trunk Lift 15 15
Sit and Reach 15 15
Fitness Assessment Reflection Chart:
Some athletes choose to use supplements and performance-enhancing drugs in hopes
of gaining an edge over their opponents. Research and describe at least three risks of
using anabolic steroids and other performance-enhancing drugs. Complete the chart
with your findings.
Sample:
Risk Description Link to Source
Severe Acne Steroids cause the skin to [Link]
secrete more oils and lead
to acne.
Answer:
Risk Description Link to Source
muscle cramps creatine causes CREATINE - Uses, Side
dehydration that leads to Effects, and More - WebMD
more muscle cramps.
heart attacks Steroids cause the risk of Anabolic steroids - Better
blood clots forming in blood Health Channel
vessels, potentially causing
a heart attack.
liver cancer steroids can cause liver Anabolic Steroid (Oral
cancer during long term, Route, Parenteral Route)
high dose therapy with Side Effects
anabolice steriods.
Section 2: Flexibility Workout Log
Perform and log stretching exercises for all eight muscles listed below at least two
days per week, but you may stretch every day. Module Two suggests starting with two
repetitions held for 15 seconds for a total of 30 seconds for each exercise. Refer
to the yellow highlighted example below.
Please refer to Video Gallery in the course for demonstrations of how to perform
the stretching exercises.
Date #1 Date #2
_________ ___________
Flexibility Muscle # of # of
Time Time
Exercises Stretched Repetitions Repetitions
15
EXAMPLE EXAMPLE 2 15 seconds 2
seconds
Lying Quad
Quadriceps 5 25sec 5 25sec
Stretch
Modified
Hurdler's Hamstrings 5 25sec 5 25sec
Stretch
Upper Back
& Torso Trapezius 5 25sec 5 25sec
Stretch
Gastrocnemiu
Calf Stretch 5 25sec 5 25sec
s
Lower Back Latissimus
5 25sec 5 25sec
Stretch Dorsi
Chest/Bicep Pectoralis/Bic
5 25sec 5 25sec
Stretch eps
Shoulder/Tri Trapezius/Delt
5 25sec 5 25sec
cep Stretch oids
Date #1 Date #2
_________ ___________
Flexibility Muscle # of # of
Time Time
Exercises Stretched Repetitions Repetitions
Lying
Abdominal Abdominal 5 25sec 5 25sec
Stretch
Flexibility Reflection Question:
Discuss which of the static stretches is most effective for you and which is least
effective.
Answer:lying abdominal stretch
Section 3: Muscular Strength and Endurance Log
Complete the chart below. Remember:
● Exercises listed should show an increase from your previous plan to show
your growth. If you completed 3 sets of 8 for the last Wellness Plan, then 3
sets of 10 would be an increase for this plan.
● Complete muscular exercises on nonconsecutive days.
● Do not work the same muscle groups more than once within a 48-hour period.
● You may select a different exercise than what is listed.
● Module Two suggests starting with 2 or 3 sets.
● The suggested number of repetitions is 8-10 for challenging weights and
exercises.
● If you are using very light weight or bodyweight, you can complete as many as
18 repetitions depending on your current ability level.
Please refer to Video Gallery in the course for demonstrations of how to perform
the muscle exercises.
Sample:
Exercise Muscle Dates # of sets # of reps Resistance
Worked (Weight)
Squats Quadriceps 8/3 3 8 20 lbs.
Day 1 Day 2
Exercise Muscle Date # of # of Resistan Date # of # of Resist
Worked s sets reps ce s sets rep ance
(Weight) s (Weig
ht)
Squats Quadricep 3/17 2 20 0 3/21 2 20 0
s
Push-ups Pectoralis 3/17 2 15 0 3/21 2 15 0
Bridges Hamstrings 3/17 2 10 0 3/21 2 10 0
Pull-ups Latissimus 3/17 2 6 0 3/21 2 6 0
Dorsi
Calf Gastrocne 3/17 2 25 25lbs 3/21 2 25 25lbs
Raises mius
Chair Dip Triceps 3/17 2 5 0 3/21 2 5 0
Day 1 Day 2
Exercise Muscle Date # of # of Resistan Date # of # of Resist
Worked s sets reps ce s sets rep ance
(Weight) s (Weig
ht)
Curls Biceps 3/17 2 10 45lbs 3/21 2 10 45lbs
Crunches Abdominal 3/17 1 15 0 3/21 2 15 0
Muscular Strength and Endurance Reflection Chart:
Alcohol, tobacco, and drugs negatively impact physical and mental health. Use the chart
below to list two risks associated with each substance.
Sample:
Substance Risk One Risk Two
Club Drugs Club drugs can cause Club drugs can cause loss
confusion and clouded of consciousness, leaving
judgement. the user vulnerable to
harm.
Answer:
Substance Risk One Risk Two
alcohol Alcohol can cause liver Alcohol can cause extreme
disease. headaches and fatigue .
tobacco Tobacco can cause lung Tobacco can also cause
cancer. dental problems.
Substance Risk One Risk Two
Alcohol Alcohol can cause brain Alcohol can also cause
damage and seizures. sexual problems and sexual
violence.
Section 4: Physical Activity Log
Include all moderate and vigorous physical activity in the table below. You need at least
three different moderate to vigorous activities that add up to 420 minutes. Activities
need to add up to 420 minutes without your warm-ups. Keep adding rows to show all of
your activities. The first five rows are completed as a sample only.
Activity Minutes
Date Warm-up Physical Activity
without Warm-up
12/25 5-minute jog 3-mile run 30 minutes
12/26 None or NA Mowing the lawn 45 minutes
12/27 Stretching 2-mile bike ride 30 minutes
12/28 Stretching Roller blading–3 miles 35 minutes
1/5 5-minute jog Surfing 2 hours
3/23 2 min jog soccer practice 150minutes
3/24 none skateboarding 90 minutes
Activity Minutes
Date Warm-up Physical Activity
without Warm-up
3/26 2min jog soccer practice 150 minutes
3/27 stretching strength training 60 minutes
Activity Minutes
Date Warm-up Physical Activity
without Warm-up
TOTAL Activity Minutes 🡪
Remember the 420-minute minimum 450minutes
Physical Activity Reflection Chart:
Many physical activities offer a chance to interact with others as teammates, training
partners, or opponents. Describe one specific way you used appropriate personal,
social, and ethical behavior while participating in physical activities this week. Use your
examples to complete the chart:
Sample:
Behavior Activity Explanation
Ethical Golf I hit the ball out of play and
assessed a penalty on
myself.
Answer:
Behavior Activity Explanation
Personal skateboarding When I go down the ramps
and practice my trick, I do it
by myself.
Behavior Activity Explanation
Social soccer It is a team game, so you
are constantly talking to
your teammates.
Ethical soccer You have to be respectful of
the other team.
Section 5: Fitness Tracker Data:
You have two options to complete this section.
Choose Option A OR Option B:
A. If you have a fitness tracker, such as MOVBand, Fitbit, iPhone Health App, etc.,
please include a screen shot of your results here AND use your results to fill out
the chart:
● Average daily moves this week = Total number of physical activity
minutes for the last 7 days x 26.19
● Percent toward my goal this week = Total average daily moves ÷ 12,000
● Total moves this week = Total number of physical activity minutes for the
last 7 days x 183.33
Module 4 Module 5
Wellness Plan Results Wellness Plan Results
Average Daily 11309 12105
Moves This Week
% Toward My Goal 82% 90%
This Week
Module 4 Module 5
Wellness Plan Results Wellness Plan Results
Total Moves This 82389.20 82498.5
Week
B. If you do not have a Fitness Tracker, you may complete the chart using the
following formula:
● Average daily moves this week = Total number of physical activity minutes
for the last 7 days x 26.19
● Percent toward my goal this week = Total average daily moves ÷ 12,000
● Total moves this week = Total number of physical activity minutes for the last
7 days x 183.33
Module 4 Module 5
Wellness Plan Results Wellness Plan Results
Average Daily
Moves This Week
% Toward My Goal
This Week
Total Moves This
Week
Fitness Tracker Reflection Question:
Describe any changes in your activity level and choices you made this week that
account for any differences in your Module Four and Module Five results. What specific
changes can you make to continue to improve the average daily moves?
Answer:
Module Five Wellness Plan Grading Rubric
Excellent Good Needs Poor
Improvement
Section 1: 18–20 points 16–17 points 13–15 points 0–12 points
Fitness
Assessmen ● Fitness ● Fitness ● Fitness ● Fitness
t assessmen assessmen assessment assessme
Results for: t results t results results are nt results
• Modul are are recorded. are
e4 recorded. recorded. ● Reflection recorded.
• Modul ● Reflection ● Reflection responses ● Reflection
e5 question responses are responses
responses are complete are
are adequatel but lacking incomplet
thoughtful y detailed detail and e or
ly detailed and support. inaccurat
and supported. e.
supported.
Section 2: 36–40 points 32–35 points 25–31 points 0–24 points
Flexibility
Log ● At least ● More than ● At least ● Less than
two days one day of one day of one day of
of stretching stretching is stretching
stretching is recorded. is
are recorded. ● At least recorded.
recorded. ● At least four ● Less than
● All eight six stretching four
stretching stretching activities stretching
activities activities are activities
are are recorded are
recorded recorded each day. recorded
each day. each day. ● Some each day.
● All ● Most stretches ● Few
stretches stretches are held an stretches
are held an are held an appropriate are held
appropriate appropriate length of an
length of length of time. appropriat
time. time. ● Reflection e length of
● Reflection ● Reflection responses time.
question responses are ● Reflection
responses are complete responses
are adequatel but lacking are
thoughtful y detailed detail and incomplet
ly detailed and support. e or
and supported. inaccurat
supported. e.
Section 3: 36–40 points 32–35 points 25–31 points 0–24 points
Excellent Good Needs Poor
Improvement
Muscular
Strength ● All 10 ● At least ● At least six ● Less than
and muscles eight muscles are four
Endurance are muscles exercised at muscles
Log exercised are least two are
at least two exercised days. exercised
days. at least two ● Most at least
● All days. muscles are two days.
muscles ● All rested for at ● Few
are rested muscles least 48 muscles
for at least are rested hours are rested
48 hours for at least between 48 hours
between 48 hours workouts. between
workouts. between ● Appropriate workouts.
● Appropriate workouts. reps, sets, ● Appropriat
reps, sets, ● Appropriate and e reps,
and reps, sets, resistance sets, and
resistance and are used for resistance
used for all resistance some used for
exercises. are used exercises. few
● Reflection for most ● Reflection exercises.
question exercises. responses ● Reflection
responses ● Reflection are responses
are responses complete are
thoughtful are but lacking incomplet
ly detailed adequatel detail and e or
and y detailed support. inaccurat
supported. and e.
supported.
Section 4: 45–50 points 40–44 points 30–39 points 0–29 points
Physical
Activity Log ● All ● Most ● Some ● Few
YOU ARE exercises exercises exercises exercises
REQUIRED are are are are
TO LOG moderate moderate moderate to moderate
EACH to vigorous to vigorous vigorous to vigorous
WEEK YOU intensity. intensity. intensity. intensity,
ARE IN THE ● At least ● At least ● At least or intensity
COURSE 420 activity 385 activity 350 activity is not
minutes minutes minutes are indicated.
are are recorded. ● At least
recorded. recorded. ● Some 315
● All ● All exercise activity
exercises exercises dates listed minutes
Excellent Good Needs Poor
Improvement
are dated are dated are not in are
as daily or as daily or an effective recorded.
every other every other pattern. ● Few
day. day. ● At least exercise
● At least ● Most two dates
three exercise different listed are
different dates are exercises in an
exercises listed and have been effective
have been are not in logged, pattern.
logged, an effective including ● One type
including pattern. specific of exercise
specific ● At least exercises has been
exercises three when logged,
when different required. including
required. exercises ● Reflection specific
● Reflection have been responses exercises
question logged, are when
responses including complete required.
are specific but lacking ● Reflection
thoughtful exercises detail and responses
ly detailed when support. are
and required. incomplet
supported. ● Reflection e or
responses inaccurat
are e.
adequatel
y detailed
and
supported.
Section 5: 36–40 points 32–35 points 25–31 points 0–24 points
Fitness
Tracker ● Average ● Average ● Average ● One or
Data daily daily daily more of
moves, moves, moves, the fitness
percent percent percent tracker
toward toward toward data is
goal, and goal, and goal, and missing
total moves total moves total moves ● Reflection
for the for the for the responses
week are week are week are are
recorded recorded recorded incomplet
and at and at and at least e or
least 90% least 80% 70% inaccurat
completed. completed. completed. e.
Excellent Good Needs Poor
Improvement
● Reflection ● Reflection ● Reflection
question responses responses
responses are are
are adequatel complete
thoughtful y detailed but lacking
ly detailed and detail and
and supported. support.
supported.
Presentatio 18–20 points 16–17 points 13–15 points 0–12 points
n
● Plan format ● One or ● Three ● Four or
is properly two errors errors in more
followed. in plan plan format. errors in
● All format. ● Some plan
responses ● Most responses format.
are in the responses are in the ● Few
form of are in the form of responses
complete form of complete are in the
sentences. complete sentences. form of
● No spelling sentences. ● Three complete
errors. ● One or spelling sentences.
two errors. ● Four or
spelling more
errors. spelling
errors.
Total Points Possible: 210 points
