Trunk Extension Stretch Log Form
Log and track details of each trunk extension stretch session for progress and feedback.
Participant Full Name
*
First Name
Last Name
Date of Session
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Type of Trunk Extension Stretch
*
Please Select
Prone Press-Up
Standing Back Extension
Superman Stretch
Other
Duration of Stretch (minutes)
*
Number of Repetitions
*
Perceived Difficulty Level
*
Very Easy
1
2
3
4
5
6
7
8
9
Very Difficult
10
1 is Very Easy, 10 is Very Difficult
Pain or Discomfort Experienced During Stretch?
*
None
Mild
Moderate
Severe
Other
Location of Any Pain or Discomfort (if applicable)
Progress Compared to Previous Session
*
Improved
Same
Worse
Additional Comments or Notes
Instructor or Therapist Feedback (if applicable)
Submit Log
Should be Empty: