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
Body Mass Index
Aerobic Capacity
Curl-ups
Push-ups
Trunk Lift
Sit and Reach
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
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
Stretch
Modified Hamstrings
Hurdler's
Upper Back Trapezius
& Torso
Calf Stretch Gastrocnemiu
s
Lower Back Latissimus
Stretch Dorsi
Chest/Bicep Pectoralis/
Stretch Biceps
Shoulder/ Trapezius/
Tricep Deltoids
Lying Abdominal
Abdominal
Flexibility Reflection Question:
Discuss which of the static stretches is most effective for you and which is least
effective.
Answer:
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
s
Push-ups Pectoralis
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)
Bridges Hamstring
s
Pull-ups Latissimus
Dorsi
Calf Gastrocne
Raises mius
Chair Dip Triceps
Curls Biceps
Crunches Abdominal
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
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.
Date Warm-up Physical Activity Activity Minutes
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
Date Warm-up Physical Activity Activity Minutes
without Warm-up
TOTAL Activity Minutes
Remember the 420-minute minimum
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
Social
Ethical
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
Moves This Week
% Toward My Goal
This Week
Total Moves This
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
Assessm Fitness Fitness Fitness Fitness
ent assessm assessm assessm assess
Results ent ent ent ment
for: results results results results
• Module are are are are
4 recorded recorded recorded. recorde
• Module . . Reflectio d.
5 Reflectio Reflectio n Reflectio
n n response n
question response s are respons
response s are complet es are
s are adequat e but incompl
thoughtf ely lacking ete or
ully detailed detail inaccur
detailed and and ate.
and support support.
support ed.
ed.
Section 2: 36–40 points 32–35 points 25–31 points 0–24 points
Flexibility
Log At least More At least Less
two days than one day than
of one day of one day
stretchin of stretchin of
g are stretchin g is stretchin
recorded g is recorded. g is
. recorded At least recorde
All eight . four d.
stretchin At least stretchin Less
g six g than
activities stretchin activities four
are g are stretchin
recorded activities recorded g
each are each activities
day. recorded day. are
Excellent Good Needs Poor
Improvement
All each Some recorde
stretches day. stretches d each
are held Most are held day.
an stretches an Few
appropri are held appropria stretche
ate an te length s are
length of appropri of time. held an
time. ate Reflectio appropri
Reflectio length of n ate
n time. response length of
question Reflectio s are time.
response n complet Reflectio
s are response e but n
thoughtf s are lacking respons
ully adequat detail es are
detailed ely and incompl
and detailed support. ete or
support and inaccur
ed. support ate.
ed.
Section 3: 36–40 points 32–35 points 25–31 points 0–24 points
Muscular
Strength All 10 At least At least Less
and muscles eight six than
Enduranc are muscles muscles four
e Log exercise are are muscles
d at least exercise exercised are
two d at least at least exercise
days. two two days. d at
All days. Most least
muscles All muscles two
are muscles are days.
rested are rested for Few
for at rested at least muscles
least 48 for at 48 hours are
hours least 48 between rested
between hours workouts. 48 hours
workouts between Appropri between
. workouts ate reps, workout
Appropri . sets, and s.
ate reps, Appropri resistanc Appropri
sets, and ate reps, e are ate reps,
Excellent Good Needs Poor
Improvement
resistanc sets, and used for sets,
e used resistanc some and
for all e are exercises resistan
exercise used for . ce used
s. most Reflectio for few
Reflectio exercise n exercise
n s. response s.
question Reflectio s are Reflectio
response n complet n
s are response e but respons
thoughtf s are lacking es are
ully adequat detail incompl
detailed ely and ete or
and detailed support. inaccur
support and ate.
ed. support
ed.
Section 4: 45–50 points 40–44 points 30–39 points 0–29 points
Physical
Activity All Most Some Few
Log exercise exercise exercises exercise
YOU ARE s are s are are s are
REQUIRE moderat moderat moderate moderat
D TO LOG e to e to to e to
EACH vigorous vigorous vigorous vigorous
WEEK intensity. intensity. intensity. intensity
YOU ARE At least At least At least , or
IN THE 420 385 350 intensity
COURSE activity activity activity is not
minutes minutes minutes indicate
are are are d.
recorded recorded recorded. At least
. . Some 315
All All exercise activity
exercise exercise dates minutes
s are s are listed are are
dated as dated as not in an recorde
daily or daily or effective d.
every every pattern. Few
other other At least exercise
day. day. two dates
At least Most different listed
Excellent Good Needs Poor
Improvement
three exercise exercises are in an
different dates have effective
exercise are listed been pattern.
s have and are logged, One
been not in an including type of
logged, effective specific exercise
including pattern. exercises has
specific At least when been
exercise three required. logged,
s when different Reflectio includin
required. exercise n g
Reflectio s have response specific
n been s are exercise
question logged, complet s when
response including e but required
s are specific lacking .
thoughtf exercise detail Reflectio
ully s when and n
detailed required. support. respons
and Reflectio es are
support n incompl
ed. response ete or
s are inaccur
adequat ate.
ely
detailed
and
support
ed.
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
percent percent percent fitness
toward toward toward tracker
goal, and goal, and goal, and data is
total total total missing
moves moves moves Reflectio
for the for the for the n
week are week are week are respons
recorded recorded recorded es are
Excellent Good Needs Poor
Improvement
and at and at and at incompl
least least least ete or
90% 80% 70% inaccur
complete complete complete ate.
d. d. d.
Reflectio Reflectio Reflectio
n n n
question response response
response s are s are
s are adequat complet
thoughtf ely e but
ully detailed lacking
detailed and detail
and support and
support ed. support.
ed.
Presentat 18–20 points 16–17 points 13–15 points 0–12 points
ion
Plan One or Three Four or
format is two errors in more
properly errors in plan errors in
followed. plan format. plan
All format. Some format.
response Most response Few
s are in response s are in respons
the form s are in the form es are in
of the form of the form
complete of complete of
sentence complete sentence complet
s. sentence s. e
No s. Three sentenc
spelling One or spelling es.
errors. two errors. Four or
spelling more
errors. spelling
errors.
Total Points Possible: 210 points
