Year __________________________

Exercise: Monthly Progress Record

Endurance, Lower Body and Balance

You might want to make copies of this form. Leave this one blank, so you can copy it as needed. Write in the exercises and activities you plan to do. Create a schedule you think you really can manage. You can change your plan as your fitness improves and you are able to do more.

(Make sure to check with your Doctor before starting any exercise program)

  Jan Feb March April May June July Aug Sept Oct Nov Dec
Endurance: Measure how far you are able to walk in 6 minutes. Use the same track and the same unit of measure each time.                        
Lower Body Power: Time how fast you can walk up a flight of stairs. Use the same stairs-at least 10 steps-each time.                        
Balance: Time yourself as you stand on one foot, then the other, without support, for as long as you can.                        

Source: National Institutes of Health (

Last Editorial Review: 7/14/2005

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