PT29 resistance exercise
Substitute motions
●compensatory movement patterns caused by muscle action of a stronger adjacent agonist or a muscle group that normally serves as a stabilizer (fixator).
Type I & Type IIA muscle fibers
●highly resistant with aerobic energy system.
Closed-chain exercises
●involve motions in which the body moves on a distal segment that is fixed or stabilized on a support surface. ●For example, when performing a bilateral short-arc squatting motion (mini-squat)
Eccentric exercise
●involves dynamic loading of a muscle beyond its force-producing capacity, causing physical lengthening of the muscle
Integration of Function
Applying resistance during exercise in anatomical planes, diagonal patterns, and combined task: Pushing, pulling, lifting, and holding activities
The greater the number and synchronization of motor units firing, the greater the force production.
Factors that Influence Tension Generation in Muscle (5) Recruitment of motor units
ambient temperature General Precautions During Resistance Training
General Precautions During Resistance Training ●Keep the [redacted] of the exercise setting comfortable for vigorous exercise.
Forms of Resistance
Manual resistance and mechanical resistance are the two broad methods by which resistance can be applied.
strength and muscle endurance
do not always correlate well with each other.
Concentric exercise
dynamic muscle loading in which tension in a muscle develops and physical shortening of the muscle
Open-chain exercises
involve motions in which the distal segment (hand or foot) is free to move in space.
work
produced over a very brief or an extended period of time
●maximum concentric contraction
produces less force than a maximum eccentric contraction under the same conditions. ● greater loads can be lowered than lifted.
muscle strength (Strength)
refers to the ability of contractile tissue to produce tension and a resultant force based on the demands placed on the muscle greatest measurable force that can be exerted by a muscle or muscle group to overcome resistance during a single maximum effort
★Hypertrophy ★Hyperplasia ★Muscle fiber types adaptation ★Vascular and metabolic adaptations ★Connective tissues adaptations
Physiological Adaptations to Resistance Exercise
DAPRE Technique
Sets Repetitions Resistance 1 10 50% 6-RM* 2 6 75% 6-RM 3 Maximum 100% 6-RM 4 Maximum 100% adjusted working weight**
❖Pain ❖Cramping ❖Inability to complete movement pattern ❖Inability to continue low-intensity physical activity
Signs and Symptoms of Muscle Fatigue
externally or internally
Stabilization can be achieved
Stabilization exercises.
This form of isometric exercise is used to develop a submaximal but sustained level of cocontraction to improve postural stability
Mechanical resistance exercise
a form of active-resistive exercise in which resistance is applied through the use of equipment or mechanical apparatus.
Isometric exercise
a static form of exercise in which a muscle contracts and produces force without an appreciable change in the length of the muscle and without visible joint motion.
Muscle endurance (local endurance)
ability of a muscle to contract repeatedly against a load (resistance), generate and sustain tension, and resist fatigue over an extended period of time a.k.a aerobic power
Functional strength relate
ability of the neuromuscular system to produce, reduce, or control forces, contemplated or imposed, during functional activities, in a smooth, coordinated manner.
Specificity of training (specificity of exercise)
adaptive effects of training, (improvement of strength, power, and endurance) are highly specific to the training method employed should be considered with respect to mode (type) and velocity of exercise as well as patient or limb position (joint angle) and the movement pattern during exercise
Resistance Exercise
also referred to as resistance training any form of active exercise in which dynamic or static muscle contraction is resisted by an outside force applied manually or mechanically
Wolff's law
body systems adapt over time to the stresses placed on them
Endurance
broad term that refers to the ability to perform low-intensity, repetitive, or sustained activities over a prolonged period of time
power
can be expressed by either a single burst of high-intensity activity (such as lifting a heavy piece of luggage onto an overhead rack or performing a high jump) or by repeated bursts of less intense muscle activity (such as climbing a flight of stairs).
constant or variable load
can be imposed using mechanical resistance (e.g., free weights or weight machines).
Insufficient muscular strength
can contribute to major functional losses of even the most basic activities of daily living.
cross-training effect
can occur from an exercised limb to a nonexercised, contralateral limb in a resistance training program
Muscle Performance
capacity of a muscle to do work (force × distance). a complex component of functional movement and is influenced by all of the body systems.
Transfer of Training
carryover of training effects from one variation of exercise or task to another also has been reported. occur on a very limited basis with respect to the velocity of training and the type or mode of exercise
❖Decrease in energy stores, insufficient oxygen, ❖Reduced intracellular calcium, and ❖Reduced excitability at the neuromuscular junction
cause of local muscle fatigue
injury, disease, immobilization, disuse, inactivity = impaired muscle performance, leading to weakness and muscle atrophy.
causes of impaired muscle performace
endurance exercise (endurance training)
characterized by having a muscle contract and lift or lower a light load for many repetitions or sustain a muscle contraction for an extended period of time more positive impact on improving function than strength training in patients with impaired muscle performance
Fatigue
complex phenomenon that affects muscle performance and must be considered in a resistance exercise program. has a variety of definitions that are based on the type of fatigue being addressed.
Cardiopulmonary (general) fatigue
diminished response of an individual (the entire body) as the result of prolonged physical activity, such as walking, jogging, cycling, or repetitive lifting or digging. related to the body's ability to use oxygen efficiently.
Muscle (local) fatigue
diminished response of muscle to a repeated stimulus—is reflected in a progressive decrement in the amplitude of motor unit potentials. occurs during exercise when a muscle repeatedly contracts statically or dynamically against an imposed load characterized by a gradual decline in the force-producing capacity of the neuromuscular system—that is, a temporary state of exhaustion (failure), leading to a decrease in muscle strength
Volume
encompasses variables such as repetitions, sets, or frequency of exercise.
resistance training
essential element of rehabilitation programs for persons with impaired function and an integral component of conditioning programs for those who wish to promote or maintain health and physical well-being, potentially enhance performance of motor skills, and reduce the risk of injury and disease.
●higher intensity exercises should be performed before lower intensity exercises
exercise order according to intensity
●large muscle groups should be exercised before small muscle groups
exercise order according to muscle group size
●multi-joint exercises should be performed before single-joint exercises
exercise order according to number of joints
underlying pathology; the extent and severity of muscle performance impairments; the presence of other deficits; the stage of tissue healing after injury or surgery; and a patient's or client's age, overall level of fitness, and ability to cooperate and learn, all must be considered
factors that influence how appropriate, effective, or safe resistance training is
SAID Principle (Specific Adaptation to Imposed Demands)
framework of specificity is a necessary foundation on which exercise programs should be built. extension of Wolff's law helps therapists determine the exercise prescription and which parameters of exercise should be selected to create specific training effects that best meet specific functional needs and goals
Power training
greater the intensity of the exercise and the shorter the time period taken to generate force, the greater is the muscle power
exercise should be performed eccentrically and concentrically in a weight-bearing pattern and progressed to the desired speed
if the desired functional outcome is the ability to ascend and descend stairs how should exercise be performed?
gains in strength and endurance
imperative that these are incorporated into daily activities as early as possible in a rehabilitation program.
development of muscle strength
integral component of most rehabilitation or conditioning programs
strength, power, and endurance
key elements of muscle performance
low-intensity muscle contractions, a large number of repetitions, a prolonged time period
key parameters of endurance training
Threshold for fatigue
level of exercise that cannot be sustained indefinitely. could be noted as the length of time a contraction is maintained or the number of repetitions of an exercise that initially can be performed. sets a baseline from which adaptive changes in physical performance can be measured.
Type IIB
low resistant with anerobic energy system
activity limitations (functional limitations) participation restriction (disability) increased risk of dysfunction
may ensue if element sof muslce performance is impaired
muscles adapt to endurance training by increases in their oxidative and metabolic capacities, which allows better delivery and use of oxygen
mechanism of endurance exercises
increase in the maximum force-producing capacity of muscle
most common adaptation to heavy resistance exercise increase in muscle strength, primarily as the result of neural adaptations and an increase in muscle fiber size
Muscle strength
necessary foundation for developing muscle power
Accommodating resistance
of an isokinetic dynamometer that controls the velocity of active movement during exercise
Intensity of resistance exercise
refers to how much weight (resistance) is imposed on the muscle,
Detraining
reflected by a reduction in muscle performance, begins within a week or two after the cessation of resistance exercises and continues until training effects are lost
muscle power (Power)
related to the strength and speed of movement work (force × distance) produced by a muscle per unit of time (force × distance/time). [redacted] = work/time rate of performing work rate at which a muscle contracts and produces a resultant force and the relationship of force and velocity are factors that affect muscle power
Cardiopulmonary endurance (total body endurance)
repetitive, dynamic motor activities, such as walking, cycling, swimming, or upper extremity ergometry, which involve use of the large muscles of the body.
plyometric training or stretch-shortening drills,
speed of movement is the variable that is most often manipulated
Internal stabilization
stabilization achieved from isometric contraction of an adjacent muscle group
External stabilization
stabilization achieved from the PT, belts and straps, or firm support surface.
Strength training (strengthening exercise)
systematic procedure of a muscle or muscle group lifting, lowering, or controlling heavy loads (resistance) for a relatively low number of repetitions or over a short period of time.
Overload Principle
to improve muscle performance: i a load that exceeds the metabolic capacity of the muscle must be applied—that is, muscle must be challenged to perform at a level greater than that to which it is accustomed. If the demands remain constant after the muscle has adapted, the level of muscle performance can be maintained but not increased
Resistance Exercise
use of this is appropriate therapeutic intervention to improve strength, power, and muscular endurance
anaerobic power and aerobic power
used to differentiate these two aspects of power.
Muscle Setting Exercise
●A low intensity isometric contractions performed against little to no resistance. ●used to decrease muscle pain and spasm and to promote relaxation and circulation ●Two common examples: quadriceps and gluteal muscles.
Force-Velocity Relationship
●As velocity of muscle shortening increases, the force the muscle can generate decreases. ●As velocity of active muscle lengthening increases, force production in the muscle increases
Type of Muscle Contraction
●Isometric (static) or dynamic muscle contractions are two broad categories
Multiple-angle isometrics
●Refers to a system of isometric exercise in which resistance is applied, manually or mechanically, at multiple joint positions within the available ROM.
Mode of Exercise
●Refers to the form of exercise, the type of muscle contraction that occurs, and the manner in which the exercise is carried out. ●Example, a patient may perform an exercise dynamically or statically or in a weight-bearing or non weight-bearing position. ●Mode of exercise also encompasses the form of resistance—manually or mechanically.
Frequency
●Refers to the number exercise sessions per day or per week.
Alignment and Stabilization
●The direction of muscle fibers and the line of pull of the muscle to be strengthened. ●To strengthen a specific muscle or muscle group effectively and avoid substitute motions ●Consider the effect of gravity
Rest Interval (Recovery Period)
●To allow time for the body to recuperate from the acute effects of exercise associated with muscle fatigue or with exercise-induced, delayed-onset muscle soreness (DOMS)
Isokinetic Training
●a form of dynamic exercise in which the velocity of muscle shortening or lengthening is held constant by a rate-limiting device known as an isokinetic dynamometer ●Constant velocity
Variable resistance exercise
●a form of dynamic exercise, addresses the primary limitation of dynamic exercise against a constant external load (DCER exercises).
Intensity
●amount of resistance (weight) ●The amount of resistance is also referred to as the exercise load or training load.
Dynamic resistance exercises
●can be performed using concentric (shortening) or eccentric (lengthening) contractions
overload principle
●progressive loading of muscle by manipulating, for example, the intensity or volume of exercise.
Exercise Order
●sequence in which exercises are performed during an exercise session
Repetition Maximum (RM)
●the greatest amount of weight (load) a muscle can move through the full, available ROM to a specific number of times before fatiguing.
Volume of Exercise
●the summation of the total number of repetitions and sets of a particular exercise during a single exercise session times the intensity of the exercise.
Exercise duration
●the total number of weeks or months during which a resistance exercise program is carried out.
Manual resistance exercise
●type of active-resistive exercise in which resistance is provided by a therapist or other health professional. ●A patient can be taught how to apply self resistance to selected muscle groups
Progressive Resistance Exercise
➢a system of dynamic resistance training in which a constant external load is applied to the contracting muscle and incrementally increased. ➢The RM is used as the basis for determining and progressing the resistance.
Daily Adjustable Progressive Resistive Exercise (DAPRE)
➢is more systematic and takes into account the different rates at which individuals progress during rehabilitation or conditioning programs. ●The system is based on a 6-RM working weight
Dynamic exercise against constant external resistance (DCER)
* a form of resistance training in which a limb moves through a ROM against a constant external load,provided by free weights such as a handheld or cuff weight, torque arm units weight machines, or weight-pulley systems
Oxford Regimen
1.Determination of a 10-RM 2. 10 reps @ 100% of the 10-RM 3. 10 reps @ 75% of the10-RM 4. 10 reps @ 100% of the 10-RM
De Lorme Regimen
1.Determination of a 10-RM 2. 10 reps @ 50% of the 10-RM 3. 10 reps @ 75% of the 10-RM 4. 10 reps @ 100% of the 10-RM
Reversibility Principle
Adaptive changes in the body's systems, are transient unless training-induced improvements are regularly used for functional activities or unless an individual participates in a maintenance program of resistance exercises
■ Decrease in blood sugar (glucose) levels. ■ Decrease in glycogen stores in muscle and liver. ■ Depletion of potassium, especially in the elderly patient.
Cardiopulmonary fatigue associated with endurance training is probably caused by a combination of these factors
■ Alignment of segments of the body ■ Stabilization of proximal or distal ■ Intensity: ■ Volume ■ Exercise order ■Frequency: ■ Rest interval: s ■ Duration: ■ Mode of exercise: ■ Velocity of exercise ■ Periodization: ■ Integration of exercises into functional activities
Determinants of Resistance Exercise
★The larger the muscle diameter, the greater its tension-producing capacity.
Factors that Influence Generation in Muscle (1) Cross-section and size of the muscle (includes muscle fiber number and size)
Cross-section and size of the muscle (includes muscle fiber number and size) Muscle architecture—fiber arrangement and fiber length (also relates to cross-sectional diameter of the muscle) Fiber-type distribution of muscle—type I (tonic, slow-twitch) and type IIA & IIB (phasic, fast-twitch) Length-tension relationship of muscle at time of contraction Recruitment of motor units Frequency of firing of motor units Type of muscle contraction Speed of muscle contraction (force-velocity relationship)
Factors that Influence Tension Generation in Muscle
★Short fibers with pinnate and multipinnate design
Factors that Influence Tension Generation in Muscle (2) Muscle architecture—fiber arrangement and fiber length (also relates to cross-sectional diameter of the muscle) -in high force-producing muscles (ex. quadriceps, gastrocnemius, deltoid, biceps brachii).
Long, parallel design in muscles
Factors that Influence Tension Generation in Muscle (2) Muscle architecture—fiber arrangement and fiber length (also relates to cross-sectional diameter of the muscle) -with high rate of shortening but less force production (ex. sartorius, lumbricals).
High percentage of type I fibers
Factors that Influence Tension Generation in Muscle (3) Fiber-type distribution of muscle—type I (tonic, slow-twitch) and type IIA & IIB (phasic, fast-twitch) —low force production, slow rate of maximum force development, resistant to fatigue.
High percentage of type IIA and IIB fibers
Factors that Influence Tension Generation in Muscle (3) Fiber-type distribution of muscle—type I (tonic, slow-twitch) and type IIA & IIB (phasic, fast-twitch) —rapid high force production; rapid fatigue.
Muscle produces greatest tension when it is near or at the physiological resting length at the time of contraction.
Factors that Influence Tension Generation in Muscle (4) Length-tension relationship of muscle at time of contraction
The higher the frequency of firing, the greater the tension.
Factors that Influence Tension Generation in Muscle (6) Frequency of firing of motor units
Force output from greatest to least—eccentric, isometric, concentric muscle contraction
Factors that Influence Tension Generation in Muscle (7) Type of muscle contraction
Eccentric contraction:
Factors that Influence Tension Generation in Muscle (8) Speed of muscle contraction (force-velocity relationship) ↑ speed → ↑ tension.
Concentric contraction
Factors that Influence Tension Generation in Muscle (8) Speed of muscle contraction (force-velocity relationship) : ↑ speed → ↓ tension.
morphological qualities of muscle; neurological, biochemical, and biomechanical influences; metabolic, cardiovascular, respiratory, cognitive, and emotional function.
Factors that affect muscle performance
A patient's health status, diet, lifestyle (sedentary or active) a In patients with neuromuscular, cardiopulmonary, inflammatory, cancer-related, or psychological disorders, the onset of fatigue is often abnormal. environmental factors
Factors that influence fatigue
the time a muscle contraction is sustained or the number of repetitions performed
For endurance training, more emphasis is placed on increasing ________________________ than on increasing resistance
eccentric exercise to minimize delayed-onset muscle soreness (DOMS) General Precautions During Resistance Training
General Precautions During Resistance Training resistance training should not be initiated at a maximal level of resistance, particularly with?
incorrect or substitute motions General Precautions During Resistance Training
General Precautions During Resistance Training these type of motions must be prevented
across an unstable joint or distal to a fracture site that is not completely healed. General Precautions During Resistance Training
General Precautions During Resistance Training Do not apply resistance to?
Valsalva maneuver General Precautions During Resistance Training
General Precautions During Resistance Training Have the patient avoid breath-holding to prevent the [redacted]; emphasize exhalation during exertion.
incorporating adequate rest intervals between exercise sessions to allow adequate time for recovery after exercise. General Precautions During Resistance Training
General Precautions During Resistance Training how do you void cumulative fatigue due to excessive frequency of exercise and the effects of overtraining or overwork by
pain General Precautions During Resistance Training
General Precautions During Resistance Training should caution patient that this doesn't occur during exercise
exercises that place excessive, unintended secondary stress on the back. General Precautions During Resistance Training
General Precautions During Resistance Training type of exercises that must be avoided
uncontrolled, ballistic movements General Precautions During Resistance Training
General Precautions During Resistance Training type of movements that must be avoided
children, older adults, patients with osteoporosis. General Precautions During Resistance Training
General Precautions During Resistance Training use of heavy resistance during exercise to these people should be avoided
Discontinue exercises if the patient experiences pain, dizziness, or unusual or precipitous shortness of breath. General Precautions During Resistance Training
General Precautions During Resistance Training when to discontinue exercise
patients may use medications that can alter acute and chronic responses to exercise. General Precautions During Resistance Training
General Precautions During Resistance Training why must we be aware of medications a patient is using
eccentric training
Greater loads can be controlled than concentric Training-induced gains in muscle strength is greater more efficient metabolically and generate less fatigue than concentric contractions. when done in high-intensity greater incidence and severity of DOMS than after concentric exercise.
amount of resistance applied to the muscle is incrementally and progressively increased
In a strength training, the _____________________ increased
Periodization and Variation of Training
Known as periodized training breaks up a training program into periods and builds systematic variation in exercise intensity and repetitions, sets, or frequency at regular intervals over a specified period of time