· web viewwatts:_____ level: _____ notes: exercise instructions: exercise to a 3 or 4 out of 5 on...
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PAD PRAIRIE Initiative: Alternative EquipmentNamecode:
Date Pre - BP (if checked)
Exercise Prescription Mode:
Post BP(if checked)
Plan for Next Session
RPM:_______
Watts:_____
Level: _____
RPM:_______ Watts:_____ Level: _____
RPM:_______
Watts:_____
Level: _____
RPM:_______ Watts:_____ Level: _____
RPM:_______
Watts:_____
Level: _____
RPM:_______ Watts:_____ Level: _____
RPM:_______
Watts:_____
Level: _____
RPM:_______ Watts:_____ Level: _____
RPM:_______
Watts:_____
Level: _____
RPM:_______ Watts:_____ Level: _____
RPM:_______
Watts:_____
Level: _____
RPM:_______ Watts:_____ Level: _____
RPM:_______
Watts:_____
Level: _____
RPM:_______ Watts:_____ Level: _____
RPM:_______
Watts:_____
Level: _____
RPM:_______ Watts:_____ Level: _____
RPM:_______
Watts:_____
Level: _____
RPM:_______ Watts:_____ Level: _____
RPM:_______
Watts:_____
Level: _____
RPM:_______ Watts:_____ Level: _____
RPM:_______
Watts:_____
Level: _____
RPM:_______ Watts:_____ Level: _____
RPM:_______
Watts:_____
Level: _____
RPM:_______ Watts:_____ Level: _____
Exercise Instructions: Exercise to a 3 or 4 out of 5 on the claudication scale if using NuStep or
recumbent bicycle and then rest until pain subsides. If using arm ergometry, exercise according to the UBE Protocol. Exercise/rest periods are repeated throughout the exercise session (a total
of 60 minutes).
Notes:
PAD PRAIRIE Initiative Exercise Equipment:
Dat
e
RP
M /
Wat
ts/
Leve
l
Ons
et
Tim
e
Exe
rcis
e Ti
me
Res
t Ti
me
CLD
/ R
PE
Ons
et
Tim
e
Exe
rcis
e Ti
me
Res
t Ti
me
CLD
/ R
PE
Ons
et
Tim
e
Exe
rcis
e Ti
me
Res
t Ti
me
CLD
/ R
PE
Ons
et
Tim
e
Exe
rcis
e
Tim
e
Res
t Ti
me
CLD
/ R
PE
Namecode: Notes: ID:
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