DEPARTMENT OF HEALTH AND FAMILY SERVICES Division of Public Health DPH 40073 (12/05)
STATE OF WISCONSIN
MONTHLY PHYSICAL ACTIVITY SHEET
Point Goal ______
1 Point/12 min Badminton Basketball shooting Construction/remodel Dancing Golf without cart Health Club general Housework vigorous Hunting Kayaking Mowing lawn walking Play w/kids vigorous Skate/Roller blade Softball or Baseball Volleyball vigorous Yard work, raking etc. 1 Point/15 min Archery Auto Repair Bicycling <10 mph Bowling Canoeing light Golf using motor cart Home repaircarpentry, Plumbing, etc. Horseback riding Housework cleaning Musicvigorous, drums Play w/kids moderate Sailing/sail board Snowmobiling Stretching, Yoga Table tennis Walk moderate 3 mph Water Aerobics Weight Lift moderate 1 Point/20 min Billiards/pool Cooking Fishing Mowing lawn riding Music playing general Playing catch Play w/kids light Walking slow 2 mph Yard games Croquet, frisbee, darts, etc
Month ___________
1 Point/4 min Bicycling >16 mph Handball, Squash, Racquetball Rowing-vigorous Running > 7 mph X-C skiing racing 1 Point/5 min Boxing/sparring Football Martial arts Rope jumping Running, 6 mph Soccer -vigorous Swimming - vigorous X-C skiing vigorous 1 Point/6 min Basketball game Bicycling 12-15 mph Bicycling stationary Calisthenics-vigorous Carrying heavy loads Circuit training Hockey Rock climbing Running, 5 mph X-C skiingmoderate Snow shoeing Swimmingmoderate Tennis, singles Volleyball, beach Walking upstairs 1 Point/10 min Aerobic general Backpacking/hiking Bicycling 10-12 mph Canoeing - moderate Dancing aerobic, fast Jet-skiing, water Jogging < 5 mph Moving boxes Rowing moderate Shoveling snow Skating vigorous Skiing-moderate Sledding Soccer moderate Swimming-leisure Tennis doubles Weight lifting-vigorous Walking brisk, 4 mph
Name _______________________________________________
Length of Time
Date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Activity
Points
Sub-total
Total Points
Approximate calories burned during activity 1 point = 40 calories for a 105 pound person 1 point = 50 calories for a 130 pound person 1 point = 60 calories for a 155 pound person 1 point = 70 calories for a 180 pound person 1 point = 80 calories for a 210 pound person 1 point = 90 calories for a 235 pound person 1 point = 100 calories for a 260 pound person Resting Metabolic Rate = about 1 to 2 points/hr
Multiply by calories/point (see weight chart) x ______ Total calories burned this month