Personal Fitness Information---EXAMPLE

This worksheet is intended to have you think about your strengths and weaknesses, good and bad habits, motivation strategies, barriers, warm-up and cool down exercise and general activities that you enjoy. When developing a fitness plan, use the information on this worksheet.

FITNESSGRAM Assessment Results and Habits

1.  Review and evaluate your fitness assessment and fill in the chart below.

Health-Related Component of Fitness Assessment / Pre-test
Met the fitness level
Yes or No / Post-test
Met the fitness level
Yes or No / Explain how you met the healthy fitness level.
If you did not meet the healthy fitness level, explain what can be done to improve.
Cardio-Respiratory (Aerobic Capacity)
·  PACER Test
Muscle Strength and Endurance
(Abdominal-Core)
·  Curl up Test
Muscle Strength and Endurance
(Upper Body)
·  90˚ Push up
Flexibility
·  Back Saver Sit and Reach

Ohio PE Assessments

Standard 4: Achieves and maintains a health-enhancing level of physical fitness.

Benchmark A: Meet or exceed criterion-referenced health-related physical fitness standards.

2.  After evaluating your fitness assessment, use the SMART criteria below to set personal fitness goals for yourself.

Specific What do you want to achieve? How will you achieve it? Why is it important to you?

Measureable How will you measure your success? Will you use numbers, target dates, specific events?

Achievable Your goals should push you past your comfort zone but should still be attainable.

Realistic Your goals should be important to you; the outcome should impact your life some way.

Timely Your goals should have a timeline that will help keep you on track for reaching them.

Health-related physical fitness component / Goal
Example: Score in the upper level of the Healthy Fitness Zone.
Cardio-respiratory
Muscle Strength and Endurance
Lower body/Core / Do 50 sit-ups in a minute
Muscle Strength and Endurance
Upper Body / Do 2 pull ups on my own
Flexibility / Be able to touch my toes without pain

3.  Complete the chart below to outline your personal fitness plan. Complete the number of exercises that are sufficient for your plan (you do not need to complete each row available).

FITT Principle:

Frequency How often you perform and exercise (this could be the number of reps, or the number of times you perform and exercise each week)

Intensity How hard you perform the exercise (this could be measured by heart rate) or by categorizing your effort as LIGHT, MODERATE or Vigorous

Time How long you perform the exercise (duration, i.e.: hold each stretch for 30 seconds)

Type What type of exercise you are doing (cardio, strength, endurance, flexibility, speed)

Component / Frequency
Days per week / Intensity
How hard? / Type(s)
What exercises? / Time
How long?
Cardio-respiratory
Exercise 1 / 3 X / moderate / running / 30 min.
Exercise 2
Muscle Strength and Endurance – Upper Body (pick at least 3)
Exercise 3 / 4X / moderate / Straight arm plank / 1 min. hold
3 times
Exercise 4 / 2X / Vigorous / Shoulder press / 3x 15 reps 12 lbs
Exercise 5
Exercise 6
Exercise 7
Muscle Strength and Endurance – Core and Lower Body (pick at least 3)
Exercise 8
Exercise 9
Exercise 10
Exercise 11
Exercise 12
Flexibility
Exercise 13 / 7X / light / Hamstring stretch / 10 sec. hold each leg
Exercise 14
Exercise 15
Exercise 16
Exercise 17

4.  Develop your personal fitness plan using the activities that you listed in the preceding chart. When, within your week, will you complete your exercise plan? Use the numbers of the exercises from the previous page to fill in the boxes. This will help with space without writing it all out. You should flexibility exercises every day. You should flexibility exercises every day. Use your recall sheet to develop a better plan here.

Monday / Tuesday / Wednesday / Thursday / Friday / Saturday / Sunday
Cardio / 1 / 1 / 1
Strength & Endurance / 3 / 4 / 3 / 3 / 4 / 3
Flexibility / 13 / 13 / 13 / 13 / 13 / 13 / 13

5.  List two things that will help you follow your exercise plan (example: rewards, social).

6.  List two things that will make following your exercise plan challenging (example: rewards, social, environment).

Ohio PE Assessments

Standard 4: Achieves and maintains a health-enhancing level of physical fitness

Benchmark B: Understands the principles, components and practices of health-related physical fitness