2401AHS Therapeutic Exercise : Neuromuscular Viva

Isotonic contraction

A contraction that causes joint motion - shortening (concentric) and lengthening (eccentric) contractions - work performed (force x distance)

Open Kinetic Chain Exercises

Involves motion in which the distal segment (hand or foot) is free to move in space, without movement at adjacent joint (single joint exercise). E.g. elbow flexion

RIR + RPE = ?

Resistance Exercise Specific Rating of Perceived Exertion Scale (RES-RPE) A combination of RPE and RIR is a better estimate of perceived exercise intensity than RPE alone.

How many trials for: medicine ball put

PRACTICE: 2 throws with 2 minutes rest TEST: 3 throws with 2 minutes rest between RECORD: best throw

How many trials for: upper limb Y balance test?

PRACTICE: 2 trials in each direction TEST: 3 attempts in each direction RECORD: max distance for each direction or calculate composite score

How many trials for: lower limb Y balance test?

PRACTICE: 2 trials in each direction TEST: 3 attempts in each direction RECORDS: max distance for each direction or calculate composite score

How many trials for: hexagon test?

PRACTICE: none TEST: 1 attempt of 3 rotations in each direction but can restart 2 times. 5 minutes rest between turns RECORD: time for each direction

How many trials for: push-up capacity test?

PRACTICE: none TEST: 1 attempt. Stop testing after 3 incorrect push-ups RECORD: reps completed

How many trials for: vertical jump test?

PRACTICE: none TEST: 3 attempts RECORD: best jump

How many trials for: single leg hop for distance test?

PRACTICE: none TEST: 3 attempts RECORD: max distance recorded

How many trials for: triple hop/triple cross over hop for distance test?

PRACTICE: none TEST: 3 attempts RECORD: max distance recorded

How many trials for: grip Strength test?

PRACTICE: none TEST: 3 attempts each side, alternating each time to provide some rest. RECORD: average for each side

How many trials for: stair-climb test?

PRACTICE: none TEST: 3 attempts with 5 minutes rest RECORD: best time

Acute Program Variables: Static stretching

Sets: 2-4 per muscle Reps: hold 30-60s. Frequency: 2-3 d/wk for a duration of 6 weeks

Muscular Endurance

The ability of a muscle or muscle group to contract repeatedly against an external load or to sustain tension and resist fatigue for a given period of time

Agility

The ability to change direction rapidly. It involves power, speed, balance, coordination, and the ability to react to a change in the environment

Power

The amount of work performed by a muscle/muscle group per unit of time

Balance

The dynamic process by which the body's position is maintained in equilibrium at rest (static equilibrium) or in steady state motion (dynamic equilibrium). A state in which the body's centre of mass is maintained over its base of support

1RM

The maximum weight that can be safely lifted with appropriate technique through full available range of motion for a single repetition. %RM are used to assign training loads

Isometric co-contractions

Type of isometric contraction - Agonist and antagonist muscles contraction and are matched in terms of timing and magnitude of contraction; similar force output generated simultaneously resulting in no net moment of force produced.

Symmetry Index Formula

(Affected side / unaffected side ) x 100

How Can We Use Outcome Measures?

- Track resistance training progress - Compare to normative data - Compare between sides - Some scores/tests are able to identify instability (balance), increased risk of injury (balance/agility) or CV disease (muscular endurance)

Optimising Exercise Instruction

1. Explain and demonstrate - clear and simple what to do 2. Observe client performance - performance criteria 3. Provide feedback - verbal, tactile, visual 4. Reassess client performance - repeat process until satisfactory exercise performance is achieved

How to Calculate RES-RIR

1. Submaximal set - Pick up a weight the client deems as heavy. Example do 5 reps (strength). Ask how many more they can do - record RES-RIR score - refer to table 2. Subsequent set - Actually, do and see how many more they can do (establish original score accuracy) 3. Repeat until they can only do 7 before they give up 4. Now we know what weight to use for 5 reps

Acute Program Variables: PNF

A 3-6s contraction at 20-75% followed by 10-30s assisted stretch

Repetitions in Reserve (RIR) and Rate of Perceived Exertion (RPE)

As load increase (movement velocity decreases), individuals report an increased perception of effort (RPE) and a decreases number of reps in reserve.

Acute Program Variables: Muscular Endurance

Contraction type: ECC : CON Sets: 1-3 Reps: 15-20 Rest: 30-60s Temp: 1s ECC : No Pause : 1s CON Frequency: 2-3 d/wk

Acute Program Variables: Power

Contraction type: ECC : ISO : CON Sets: 3-5 Reps: 1-3 Rest: 5-8 min Temp: Explosive Frequency: 4-6 d/wk

Acute Program Variables: Maximal Strength

Contraction type: ECC : ISO : CON Sets: 3-5 Reps: 3-8 Rest: 3-5 min Temp: 4s ECC : 1s Pause : 2s CON Frequency: 3-5 d/wk

Acute Program Variables: Hypertrophy

Contraction type: ECC : ISO : CON Sets: 4-6 Reps: 8-15 Rest: 1-2 min Temp: 4s ECC : 1s Pause : 2s CON Frequency: 3-5 d/wk

Dynamic stretching

Cyclic intermittent and ballistic

Isotonic eccentric

Dynamic muscle contraction; physical muscle lengthening that produces force insufficient to overcome an external resistance. The muscle produces force as it lengthens; when a client lowers a weight in a controlled manner

Isotonic concentric

Dynamic muscle contractions; physical muscle shortening that produces force sufficient to overcome an external resistance

Strength

Greatest force produced by a muscle/muscle group to overcome resistance during "maximum" effort

Closed Kinetic Chain Exercises

Involves exercises where the body or proximal segments move on the distal segment which is fixed on a support surface. E.g. push up (hands are the fixed point or squat where the feet are fixed

Static stretching

Manual and self-stretching

Neutral spine

Mild thoracic kyphosis and lumbar lordosis

Isometric contractions

Muscle contracts, produces force without an appreciable change in muscle length and without visible joint motion. Static form of exercise

Proprioceptive stretching (PNF)

Neuromuscular facilitation: hold-relax/contract-relax, agonist contraction, combined