ExRx iRA 3- from katie

% of 1RM necessary at beginning of strength training program

At the beginning of an exercise program the percentage necessary to achieve training-induced adaptations in strength is low (30% to 40%) for sedentary, untrained individuals or very high (>80%) for those already highly trained. For healthy but untrained adults, a typical training zone usually falls between 40% and 70% of the baseline RM.

List the general precautions and contraindications for resistance training when INFLAMMATION is present

Dynamic and static resistance training is absolutely contraindicated in the presence of inflammatory neuromuscular disease. (ex/ Guillain Barre, polymyositis, dermatomyositis). Dynamic resistance exercises are contraindicated in the presence of acute inflammation of a joint. The use of dynamic resisted exercise can irritate the joint and cause more inflammation. Gentle setting (static) exercises against negligible resistance are appropriate.

There are two main reasons for determining a repetition maximum:

(1) to identify an initial exercise load (amount of weight) to be used during exercise for a specified number of repetitions (2) to document a baseline measurement of the dynamic strength of a muscle or muscle group against which exercise-induced improvements in strength can be compared

Compare and contrast different methods of determining initial exercise load

1RM Cable tensiometry and isokinetic or handheld dynamometry A percentage of body weight The level of perceived loading, as measured by the Borg CR 10 Scale

shorter and longer rest intervals depending on intensity

A shorter rest interval is adequate after low-intensity exercise. Longer rest intervals (>3 minutes) are appropriate with high-intensity resistance training, particularly when exercising large, multi-joint muscles

reversibility principle

Adaptive changes in body system's responses to a resistance exercise program are transient unless training-induced improvements are regularly used for functional activities or unless an individual participates in a maintenance program of resistance exercises

When does hypertrophy occur?

After an extended period of moderate- to high-intensity resistance training, usually by 4 to 8 weeks but possibly as early as 2 to 3 weeks with very high-intensity resistance training, hypertrophy becomes an increasingly important adaptation that accounts for strength gains in muscle. The greatest increases in protein synthesis and, therefore, hypertrophy are associated with high-volume, moderate resistance exercise performed eccentrically.

what does frequency depend on?

As with other aspects of dosage, frequency is dependent on other determinants, such as intensity and volume as well as the patient's goals, general health status, previous participation in a resistance exercise program, and response to training.

what determines the mode of exercise?

As with other determinants of resistance training, the modes of exercise selected are based on a multitude of factors (type of muscle contraction, WB or NWB, forms of resistance, energy systems, range of movement (short arc or full arc), application to function

In contrast to the SAID principle, what does the research say about transfer of training?

Despite the evidence that a small degree of transfer of training does occur in a resistance exercise program, most studies support the importance of designing an exercise program that most closely replicates the desired functional activities.

maximum effort concentric contraction FV relationship

During a maximum effort concentric muscle contraction, as the velocity of muscle shortening increases, the force the muscle can generate decreases

maximum effort eccentric contraction FV relationship

During a maximum effort eccentric contraction, as the velocity of active muscle lengthening increases, force production in the muscle initially increases to a point but then quickly levels off

oxygen and energy stores in exercise recovery

During recovery oxygen and energy stores are replenished quickly in muscles. Lactic acid is removed from skeletal muscle and blood within approximately 1 hour after exercise, and glycogen stores are replaced over several days.

Advantages Exercise with Elastic Resistance

Elastic resistance products are portable and relatively inexpensive, making them an ideal choice for home exercise programs. Because elastic resistance is not significantly gravity dependent, elastic bands and tubing are extremely versatile, allowing exercises to be performed in many combinations of movement patterns in the extremities and trunk and in many positions It is safe to exercise at moderate to fast velocities with elastic resistance because the patient does not have to overcome the inertia of a rapidly moving weight. As such, it is appropriate for plyometric training

examples of closed chain exercises

Examples in the upper extremities include balance activities in quadruped, press-ups from a chair, wall push-offs, or prone push-ups; Examples in the lower extremities include lunges, squats, step-up or step-down exercises, or heel rises to name a few.

rest interval for moderate intensity

For moderate-intensity resistance training, a 2- to 3-minute rest period after each set is recommended.

frequency recommendations for a maintenance program

Frequency is again reduced for a maintenance program, usually to two times per week.

what causes DOMS?

High-intensity eccentric muscle contractions consistently cause the most severe DOMS symptoms The underlying mechanisms (mechanical, neural, or/or cellular) of tissue damage associated with DOMS is still unclear

frequency recommendations for highly trained athletes

Highly trained athletes involved in body building, powerlifting, and weight lifting, who know their own response to exercise, often train at a high-intensity and volume up to 6 days per week.

general precautions and contraindications for resistance training when PAIN is present

If a patient experiences severe joint or muscle pain against no external load, dynamic resistance exercises should not be initiated. If a patient experiences acute muscle pain during a resisted isometric contraction, resistance exercises (static or dynamic) should not be initiated. If a patient experiences pain that can not be eliminated by reducing the external resistance, the exercise should be stopped.

overload principle

If muscle performance is to improve, a resistance load that exceeds the metabolic capacity of the muscle must be applied - that is, the muscle must be challenged to perform at a greater level than that to which it is accustomed.

Advantages of Isokinetic Equipment

If the patient puts forth a maximum effort, isokinetic equipment provides maximum resistance through the entire ROM Both high- and low-velocity training can be done safely and effectively. The equipment accommodates for a painful arc of motion. As a patient fatigues, exercise can still continue. Isolated strengthening of muscle groups is possible to correct strength deficits in specific muscle groups. External stabilization keeps the patient and moving segment well aligned. Concentric and eccentric contractions of the same muscle group can be performed repeatedly, or reciprocal exercise of opposite muscle groups can be performed, allowing one muscle group to rest while its antagonist contracts; the latter method minimizes muscle ischemia. Computer-based visual or auditory cues provide feedback to the patient so submaximal to maximal work can be carried out more consistently.

Body composition Strength training adaptations:

Increase in lean (fat-free) body mass; decrease in % body fat

Metabolic system and enzymatic activity Strength training and endurance training adaptations:

Increased ATP and PC storage Increased myoglobin storage Increased triglycerides storage (change not known) Increased creatine phosphokinase Increased myokinase

Connective tissue Endurance training adaptations:

Increased tensile strength of tendons, ligaments, and CT in muscles Increase in bone mineralization with land-based, WB activities

Connective tissue Strength training adaptations:

Increased tensile strength of tendons, ligaments, and CT in muscles Increased bone mineral density; no change or possible Increase in bone mass

What types of adaptations account for early adaptations to resistance training programs

It is well accepted that in a resistance training program the initial, rapid gain in the tension-generating capacity of skeletal muscle is attributed largely to neural responses, not adaptive changes in muscle itself. This is reflected by an increase in electromyographic (EMG) activity during the first 4 to 8 weeks of training with little to no evidence of muscle fiber hypertrophy. It is also possible that increased neural activity is the source of additional gains in strength late in a resistance training program even after muscle hypertrophy has plateaued. The initial neural responses to resistance exercise are attributed to motor learning and improved coordination through increased recruitment in the number of motor units firing and an increased rate and synchronization of motor unit firing. It is speculated that these changes are caused by decreased inhibition of the CNS, decreased sensitivity of the Golgi tendon organ (GTO), or changes at the myoneural junction of the motor unit.

general adaptations to endurance training

Minimal or no muscle fiber hypertrophy Increase in capillary bed density Increase in mitochondrial density and volume (increase in both number and size)

Neural system Strength training adaptations

Motor unit recruitment (x # of motor units firing) Increased rate of firing (decreased Switch contraction time) Increased synchronization of firing

general adaptations to strength training

Muscle fibers hypertrophy: greatest types in IIX fibers Possible hyperplasia of muscle fibers Fiber type composition: remodeling of type IIX to type IIA; no change in type I to type II distribution (ie no conversion) Decrease or no change in capillary bed density Decrease in mitochondrial density and volume

Delayed Onset Muscle Soreness

Muscle soreness and aching beginning 12-24 hours after exercise, peaking at 48-72 hours, and subsiding 2-3 days later

Body composition Endurance training adaptations:

No change in lean body mass; decrease in % body fat

Neural system Endurance training adaptations

No changes

when is a 1RM not safe?

Not safe for pt's with joint impairments, pt's recovering from/at risk of soft tissue injury, or pt's at risk/with known osteoporosis or CV pathology

Disadvantages of Exercise with Elastic Resistance

One of the most significant drawbacks to the use of elastic resistance is the need to refer to a table of figures for quantitative information about the level of resistance for each color-coded grade of material. This makes it difficult to know which grade to select initially and to what extent changing the grade of the band or tubing changes the level of resistance. As with free weights, there is no source of stabilization or control of extraneous movements when an elastic band or tubing is used for resistance. The patient must use muscular stabilization to ensure that the correct movement pattern occurs. Although the effects of material fatigue are small with typical clinical use (up to 300% deformation in most exercises), elastic bands and tubing should be replaced on a routine basis to ensure patient safety. If many individuals use the same precut lengths of bands or tubing, it may be difficult to determine how much use has occurred. Some elastic products contain latex, which is a fairly common allogen, thus eliminating use by some individuals

List the general precautions and contraindications for resistance training for CARDIOPULMONARY DISEASE

Patients with severe coronary artery disease, carditis, or cardiac myopathy should not participate in vigorous physical activities, including a resistance training program, nor should patients with congestive heart failure or uncontrolled hypertension or dysrhythmias After myocardial infarction or coronary artery bypass graft surgery resistance training should be postponed for at least 5 weeks (that includes participation in 4 weeks of supervised cardiac rehabilitation endurance training) and clearance from the patient's physician has been received

periodization

Periodization, also known as periodized training, is an approach to resistance training that breaks up a training program into periods and establishes systematic variation in exercise intensity and repetitions, sets, or frequency This approach to training was developed for highly trained athletes preparing for competitive weight lifting or power lifting events. The concept was designed for optimal progression of training programs, to prevent overtraining and psychological staleness prior to competition, and to optimize performance during competition. The idea is to prepare for a "peak" performance at the time of competition by breaking the training calendar up into cycles

load and reps for power

Power can be developed and improved by modifying the intensity and speed of training Recommended intensity ranges from 20%-70% of 1RM, while the rate of exercises should be explosive or ballistic Mean training combo from over 350 studies shows that 3.8 sets of 6.4 reps of an exercise performed at 81% shows a small increase in power 3-4 sessions per week recommended to increase power of both UE and LE

Prevention of DOMS

Prevention and treatment of DOMS at the initiation of an exercise program after a short or long period of inactivity have been either ineffective or, at best, marginally successful There is some evidence to suggest that the use of repetitive concentric exercise prior to DOMS-inducing eccentric exercise does not entirely prevent but does reduce the severity of muscle soreness and other markers of muscle damage. Paradoxically, a regular routine of resistance exercise, particularly eccentric exercise, prior to the onset of DOMS or after an initial episode of DOMS has developed and remitted. This response is often referred to as the "repeated-bout effect," whereby a bout of eccentric exercise protects the muscle from damage from subsequent bouts of eccentric exercise.

recovery from acute exercise

Recovery from acute exercise, in which the force-producing capacity of muscle returns to 90% to 95% of the pre-exercise capacity, usually takes 3 to 4 minutes, with the greatest proportion of recovery occurring in the first minute

ROM and strength development

Resistance through the full, available range of movement (full-arc exercise) is necessary to develop strength over the entire ROM

purpose of rest intervals

Rest is a critical element of a resistance training program and is necessary to allow time for the body to recuperate from the acute effects of exercise associated with muscle fatigue or to offset adverse responses, such as exercise-induced, delayed-onset muscle soreness. Only with an appropriate balance of progressive loading and adequate rest intervals can muscle performance improve. Therefore, rest between sets of exercise and between exercise sessions must be addressed.

disadvantages of Free weights and simple weight pulley systems:

Stabilizing muscle groups are recruited; however, because there is no external source of stabilization and movements must be controlled entirely by the patient, it may take more time for the patient to learn correct alignment and movement patterns Most exercises with free weights and weight-pulley systems must be performed slowly to minimize acceleration and momentum and prevent uncontrolled, end-range movements that could compromise patient safety. It is thought that the use of exclusively slow movements during strengthening activities has less carryover to many ADLs compared with incorporating slow and fast velocities Dumbbells and barbells that allow adjustable resistance through interchangeable plates are versatile and can be used for pt's w many different levels of strength, but they require personnel for proper assembling Bilateral lifting exercises w barbell weights often require the assistance of a spotter, thus increasing personnel time

strength deficits and DOMS

Strength deficits develop prior to the onset of soreness and persist after soreness has remitted.

what causes the initial neural responses to exercise training?

The initial neural responses to resistance exercise are attributed to motor learning and improved coordination through increased recruitment in the number of motor units firing and an increased rate and synchronization of motor unit firing. It is speculated that these changes are caused by decreased inhibition of the CNS, decreased sensitivity of the Golgi tendon organ (GTO), or changes at the myoneural junction of the motor unit.

intensity in a resistance training program

The intensity of exercise in a resistance training program is the amount of resistance (weight) imposed on the contracting muscle during each repetition of an exercise

mode of exercise

The mode of exercise in a resistance exercise program refers to the form of exercise, the type of muscle contraction that occurs, and the manner in which the exercise is carried out

advantages of variable resistance machines

The obvious advantage of these machines compared to constant load equipment is that the resistance is adjusted in an attempt to match a muscle's torque-generating capabilities throughout the ROM. --> The contracting muscle is subjected to near maximal loads at multiple points in the ROM, rather than just one small portion of the range. The equipment is adjustable to a certain extent to allow individuals of varying heights to perform each exercise in a well-aligned position. Each unit provides substantial external stabilization to guide or limit movements. --> This makes it easier for the patient to learn how to perform the exercise correctly and safely and helps maintain appropriate alignment without assistance or supervision.

velocity

The velocity at which a muscle contracts significantly affects the tension that the muscle produces and subsequently affects muscular strength and power

relationship of sets and reps of an exercise and the intensity of the resistance

There is an inverse relationship between the sets and repetitions of an exercise and the intensity of the resistance. The higher the intensity or external resistance, the lower the number of repetitions and sets possible. Conversely, the lower the external resistance, the greater the number of repetitions and sets possible. Therefore, the external resistance directly dictates how many repetitions and sets are possible.

Specific Adaptations to Imposed Demands (SAID) principle

To improve a specific muscle performance element, the resistance program should match the constructs of that element.

disadvantages of variable resistance machines

Unlike functional movement, most machines allow only single-plane movements, although some newer units now offer a dual-axis design allowing multiplanar motions that strengthen multiple muscle groups and more closely resemble functional movement patterns. One of the main disadvantages of weight machines is the initial expense and ongoing maintenance costs. Multiple machines, usually 8 to 10 or more, must be purchased to target multiple major muscle groups. Multiple machines also require a large amount of space in a facility. Most pieces of equipment are designed to isolate and exercise specific muscle groups. --> Consequently, numerous units are needed to exercise all major muscle groups.

exercise order

When several muscle groups are exercised in a single session, as is the case in most rehabilitation or conditioning programs, large muscle groups should be exercised before small muscle groups, and multi-joint exercises should be performed before single-joint exercises. In addition, after an appropriate warm-up, higher intensity exercises should be performed before lower intensity exercises.

Recognize the signs and symptoms of muscle fatigue

a. Muscle fatigue is the diminished response of muscle to a repeated stimulus b. An uncomfortable sensation in the muscle, with pain and cramping possible c. Shaking or trembling of the contracting muscle d. An unintentional slowing of contraction velocity with successive repetitions of an exercise e. Active movements are jerky or inconsistent f. Inability to complete the movement pattern through the full ROM during dynamic exercise against the same level of resistance g. Use of substitute motions, incorrect movement patterns, to complete the activity h. Inability to continue low-intensity physical activity i. Decline in peak torque during isokinetic testing

hypertrophy

an increase in the size (bulk) of an individual muscle fiber caused by an increase in myofibrillar volume.

cardiopulmonary endurance

associated w repetitive, dynamic motor activities (walking, cycling, swimming, UE ergometry) which involve the use of the large muscles of the body

aerobic exercise

associated with low-intensity, repetitive exercise of large muscle groups performed over an extended period of time. This mode of exercise primarily increases muscular and cardiopulmonary endurance

Proper alignment in a resistance training program

determined by considering the fiber orientation, line of pull, and specific action desired of the muscle to be strengthened Body segment/pt must be positioned so that the direction of movement of the limb/segment replicates the action of the muscle to be strengthened If gravity involved: should be positioned in a way that considers how both gravity and weight provide external resistance to the muscle being strengthened

overload principle in endurance training

emphasis is placed on increasing the time over which a muscle contraction is sustained or the number of repetitions performed

frequency recommendations for prepubescent children and very elderly

frequency typically is limited to no more than 2 to 3 sessions per week.

stabilization in a resistance training program

holding the body steady. Exercising on a stable surface helps achieve stabilization, and bodyweight serves as a source of stability during exercise as well.

Describe the evidence related to muscle recovery

if light exercise is performed during the recovery period (active recovery), recovery from exercise occurs more rapidly than with total rest (passive recovery) Faster recovery with light exercise is probably the result of neural as well as circulatory influences

closed chain exercise

involve motions in which the body or proximal segments move on a distal segment that is fixed or stabilized on a support surface. Movement at one joint causes simultaneous motion at distal and proximal joints in a relatively predictable manner. Typically performed in WB positions

open chain exercises

involve motions in which the distal segment (hand or foot) is free to move in space, without necessarily causing simultaneous motions at adjacent joints. Limb movement only occurs distal to the moving joint, and muscle activation occurs in the muscles that cross the moving joint. Open-chain exercises are typically performed in non weight-bearing positions.

anaerobic exercise

involves high intensity (near-maximal) exercise carried out for a very few number of repetitions because muscles rapidly fatigue. Strengthening exercises fall into this category.

when is a 1RM safe to use?

it is a frequently used method for measuring muscle strength in research studies and has been shown to be a safe and reliable measurement tool with healthy young adults and athletes as well as active older adults prior to beginning conditioning programs

endurance training has ___________ cross-training effect on strength.

little to no

load and reps for strength

moderate exercise load (60% to 80% of a 1-RM) that causes fatigue after 8 to 12 repetitions for 2 or 3 sets. When fatigue no longer occurs after the target number of repetitions has been completed, the level of resistance is increased to overload the muscle once again.

DOMS etiology

peaks between 48-72 hrs after exercise, caused from body being overloaded

detraining

reductions in muscle performance - begins 1-2 weeks after stopping resistance training, continues until training effects are lost in an average of 2-4 weeks.

endurance

refers to the ability to perform repetitive or sustained activities over a prolonged period of time

muscle power

related to the strength and speed of movement and is defined as the work (force × distance) produced by a muscle per unit of time (force × distance/time). In other words, it is the rate of performing work.

Current research suggests that DOMS is linked to

some form of contraction-induced, mechanical disruption or microtrauma of muscle fibers and/or connective tissue in and around muscle that results in degeneration of the tissue. Evidence of tissue damage, such as elevated blood serum levels of creatine kinase, is present for several days after exercise and is accompanied by inflammation and edema

muscle endurance

the ability of a muscle to contract repeatedly an external load, generate and sustain tension, and resist fatigue over an extended period of time

overload principle in strength training

the amount of external resistance applied to the muscle is incrementally and progressively increased

Frequency in a resistance exercise program refers to

the number of exercise sessions per day or per week.

volume in a resistance training program

the summation of the total number of repetitions of a particular exercise session multiplied by the intensity of the exercise → Ex: 3x10 bicep curls w 5 lb dumbbell = 150 lbs of volume (30x5)

exercise duration

the total number of weeks or months during which a resistance exercise program is carried out. Strength gains observed early in a resistance training program (after 2 to 3 weeks) primarily are the result of neural adaptation. For significant changes to occur in muscle, such as hypertrophy or increased vascularization, at least 6 to 12 weeks of resistance training is required.

T or F: it has been suggested that a cross-training effect can occur from an exercised limb to a non exercised, contralateral limb in a resistance training program.

true

Describe the components of a resistance exercise program

Alignment of segments of the body during exercise Stabilization of proximal or distal joints to prevent substitution Intensity: the exercise load (level of resistance) Volume: the total # of reps and sets in an exercise session Exercise order: the sequence in which muscle groups are exercised during an exercise session Frequency: the number of exercise sessions per day or week Rest interval: time allotted for recuperation bw sets and sessions of exercise Duration: total time frame of a resistance training program Mode of exercise: type of muscle contraction, position of the patient, form (source) of resistance, arc of movement, or the primary energy system utilized Velocity of exercise Periodization: variation of intensity and volume during specific periods of resistance training Integration of exercises into functional activities: use of resistance exercises that approximate or replicate functional demands

treatment of DOMS

Effective treatment of DOMS, once it has occurred, is continually being sought because, to date, the efficacy of DOMS treatment has been mixed Evidence shows that continuation of a training program that has induced DOMS does not worsen the muscle damage or slow the recovery process.

advantages of Free weights and simple weight pulley systems:

Exercises can be set up in many positions, such as supine, side-lying, or prone in bed or on a cart, sitting in a chair or on a bench, or standing. Many muscle groups in the extremities and trunk can be strengthened by simply repositioning the patient typically are used for dynamic, non weight-bearing exercises but also can be set up for isometric exercises and resisted weight-bearing activities Many movement patterns are possible, incorporating single plane or multiplanar motions. An exercise can be highly specific to one muscle or generalized to several muscle groups. Movement patterns that replicate functional activities can be resisted. If a large enough assortment of graduated free weights is available, resistance can be increased by very small increments, as little as 1 pound at a time. The weight plates of pulley systems have larger increments of resistance, usually a minimum of 5 pounds per plate. Dumbbells and barbells that allow adjustable resistance through interchangeable plates are versatile and can be used for pt's w many different levels of strength

Disadvantages of Isokinetic Equipment

The equipment is large and expensive to purchase and maintain. Setup time and assistance from personnel are necessary if a patient is to exercise multiple muscle groups. Most units allow only open-chain (non weight-bearing) movement patterns, which do not simulate most lower extremity functions and some upper extremity functions. Although functional movements typically occur in combined patterns and at varying velocities, most exercises are performed in a single plane and at a constant velocity. Although the range of concentric training velocities (up to 500˚/sec) is comparable to some lower extremity limb speeds during functional activities, even the upper limits of this range of velocities cannot begin to approximate the rapid limb speeds that are necessary during many sports-related motions, such as throwing. --> In addition, the eccentric velocities available, at best, only begin to approach medium-range speeds, far slower than the velocity of movement associated with quick changes of direction and deceleration. Both of these limitations in the range of training velocities compromise carryover to functional goals.

frequency and rest periods

The greater the intensity and volume of exercise, the more time is needed between exercise sessions to recover from the temporarily fatiguing effects of exercise. A common cause of a decline in performance from overtraining is excessive frequency, inadequate rest intervals, and progressive fatigue. It has been known for some time that high-intensity eccentric exercise is associated with greater microtrauma to soft tissues and a higher incidence of delayed-onset muscle soreness than concentric exercise → Therefore, rest intervals between exercise sessions are longer and the frequency of exercise is less than with other forms of exercise.

rest period when strength training is initiated at moderate intensities (typically in the intermediate phase of a rehabilitation program after soft tissue injury)

a 48-hour rest interval between exercise sessions (that is, training every other day) allows the patient adequate time for recovery

Define muscle strength

a broad term that refers to the extent that the contractile elements of muscle produce force.

external stabilization in a resistance training program

can be applied manually by the therapist or sometimes by the patient with equipment, such as belts and straps, or by using gravity to hold the body against a firm support surface, such as the back of a chair or the surface of a treatment table.

internal stabilization in a resistance training program

is achieved by an isometric contraction of an adjacent muscle group that does affect the desired movement pattern but holds the body segment of the proximal attachment of the muscle being strengthened firmly in place For example, when performing a bilateral straight leg raise, the abdominals contract to stabilize the pelvis and lumbar spine as the hip flexors raise the legs. This form of stabilization is effective only if the fixating muscle group is strong enough or not fatigued.

load and reps for endurance

performing many repetitions of an exercise against a submaximal load When increasing the number of repetitions or sets becomes inefficient, the load can be increased slightly. Endurance training also can be accomplished by maintaining an isometric muscle contraction for incrementally longer periods of time.

frequency recommendations in an initial exercise program

short sessions of exercises sometimes can be performed on a daily basis several times per day as long as the intensity of exercise and number of repetitions are low. T his frequency often is indicated for early postsurgical patients when the operated limb is immobilized and the extent of exercise is limited to non resisted isometric (setting) exercises to minimize the risk of muscle atrophy. As the intensity and volume of exercise increases, a frequency of 2 to 3 times per week, every other day, or up to five exercise sessions per week is common. A rest interval of 48 hours for training major muscle groups can be achieved

rest period for patients with pathological conditions that make them more susceptible to fatigue, as well as children and the elderly

should rest at least 3 minutes between sets by performing a non resisted exercise, such as low-intensity cycling, or performing the same exercise with the opposite extremity. Active recovery is more efficient than passive recovery for neutralizing the effects of muscle fatigue.