Resistance Exercise
How is Submaximal vs. Maximal Exercise loads determined?
Determined by: Goals and Functional Outcomes Causes of: Deficits in Muscle Performance Stage of: Healing of Injured Tissues Pt's Age, health, general fitness level.
What is Fiber Type Distribution amount in Muscles of body?
High % STFR = Low Force Prod, Slow rate Max Force Dev, Resists Fatigue. High % FTFR, FTF = Rapid High Force Prod, Rapid Fatigue.
What is the SAID Principle?
Specific Adaptation to Imposed Demands
What is the Application of the Overload Principle?
Progressive and Incrementally increase amount of resistance. Through Endurance training, increase the time a muscle contraction is sustained or increase the number of repetitions performed.
What is Stabilization?
Proximal or Distal joints to prevent substitution, maintain alignment. May be External (PT/PTA, equipment or support of firm surface) May be Internal (Isometric contraction of adjacent muscle group)
What is Power?
Rate of Doing Work. Work = Force x Distance Rate of Work = Force x Distance / Time Can be a Single burst of High-Intensity Activity (Anaerobic Power). Can also be Repeated Bursts of Less Intense muscle activity (Aerobic Power).
What is Cardiopulmonary Endurance?
Repetitive, Dynamic Motor activity which involves use of large muscles of body. Total body performance.
Variable Resistance Unit
Replicates Length-Tension Relationship with the greatest resistance in the midrange; utilizes a CAM.
What is Alignment?
Segments of body during exercise, determined by direction of muscle fibers and line of pull of muscle relative to gravity.
Contraindications to Resistance Exercise
Sever joint muscle pain; any resistance. INf. NM disease (Guillain Barre, poliomyelitis, dermatomyositis). Irreversible deterioration of strength as result to damage to muscle. Acute inflammation of joint. Severe cardiac resp. disorders.
What is Muscle Architecture? ( fiber arrangement. length. cross sectional diameter )
Short fibers with Pennate and Multipennate (slanting) design are found in high-force producing muscles (quadriceps). Long, parallel design in muscles = High rate of Shortening, but Less Force Production (shortening).
Body Composition Changes-Strength, Endurance Adaptation
Strength: Increase in lean, fat free body mass, Decrease in body fat Endurance: No change in body muscle mass, Decrease in body fat
What is Strength Training?
Systematic muscle or muscle group which is Lifting, Lowering, or Controlling Heavy Loads (the Resistance) for a relatively low number of repetitions or over a short period of time.
Repetition Maximum (RM)
The Greatest Amount of Weight (load) a muscle can move through the full, available ROM with Control, a specific number of times before fatiguing. Uses: Document baseline measurement of dynamic strength of a muscle or muscle group; Identify an initial exercise load (amount of weight) to be used during exercise. DeLorme Method (10 Reps) used as Progressive Resistive Exercise (PRE)
What is Strength?
The ability of contractile tissue to produce Tension and a Resultant Force based on demands placed on muscle.
What is the Recruitment of Motor Units?
The greater the Number and Synchronization of MU firing = Greater Force Production
What is Cross-Section and Size of Muscle?
The larger the muscle diameter, the greater the tension it can produce.
Submaximal Loading (Low Intensity) is for?
Tissue healing post injury After prolonged immobilization when articular cartilage is unable withstand large compressive forces. When bone demineralization occurs, increasing risk of pathological fracture. Emphasize correct form. For most children/older adults. Goal to improve muscle endurance. Warm up and cool down
Mode of exercise
Type of muscle contraction, position of pt., form of resist, arc of mvmt., primary energy system utilized.
What are the clinical signs/symptoms of Muscle Fatigue?
Uncomfortable sensation in muscle; pain/cramping Tremulousness in contracting muscle Unintentional slowing of movement with further reps Jerky movements Inability to complete movement pattern through full ROM against same level of resistance Use of Substitute Motions to complete movement pattern Inability to continue low-intensity physical activity
What is Intensity?
Utilizing the Overload Principle, improve muscle performance where muscle is loaded to greater extent that what that muscle usually is experiencing. Gradual increase in weights.
What is the Length-tension relationship of Muscle at time of Contraction?
When a Muscle produces greatest tension when it is near or at physiological Resting Length at time of Contraction.
What are the Components of the SAID Principle?
Wolff's Law (body systems adapt over time to the stresses placed on them) Specificity of Training (specificity of exercise) - Exercises in program should mimic the anticipated function; type and velocity of exercise, and pt or limb position (joint angle). Transfer of Training (you get what you train for) - Carryover Effects from one exercise to another, a.k.a. overflow, cross-training effect.
Frequency of training program
# exercise programs per day or week dependent on intensity, volume, pt's goals, general health status, response, participation High-intensity must allow more recovery time Low-intensity, less recovery 2-3x's per week, or every other day, or up to 5 times per week. Maint. = less frequent
Repetitions
# of times particular movement is repeated (#contractions performed) If RM used--10 reps of the RM of 5 lbs. (example) 75% of 1RM = 10 Reps 60% of 1RM = 15 Reps 90% of 1RM = 4 - 5 Reps (80 to 90% highly trained) 30-40% 10RM = Children, Immobile, Elderly 40-70% 10RM = For healthy, untrained individuals # of Reps selected depends on pt status and whether goal is to Improve Strength or Endurance. For strength, 2-3RM to 15RM. Use 1RM for baseline measurement of pt's maximal effort. 10 Rep Max inappropriate for pts with joint impairments, soft tissue injury, osteoporosis, cardiovascular pathology. Fatigue = Inability to complete full ROM repetitions against applied resistance.
DOMS
12-24 hours post exercise. Due to intense eccentric contractions. Peaks at 48-72 hours, goes away 2-3 days later. Tenderness at myotendinous junction..Local edema and warmth. Decreased ROM during soreness Due to contraction induced mechanical disruption or muscle fibers and/or connective tissue. Damage at Z lines. Increase blood serum levels of CPK for several day; inf. and edema. Warm up and cool down. Cryotherapy.
What is Detraining?
A decrease in muscle performance occurring after one or two weeks of stopping resistance exercise and continues until training effects are lost. 5% loss strength/day from not training.
What are Sets?
A predetermined number of consecutive repetitions grouped together (bout). After each set, rest. No optimal # of sets per session, but 2 to 4 is common.
What are the Factors that Influence Tension Generation in Normal Skeletal Muscle?
A) Cross Section and Size of Muscle (# and size) B) Muscle Architecture (fiber arrangement and fiber length, cross sectional diameter) C) Fiber-Type distribution of muscle D) Length-Tension Relationship of Muscle at time of Contraction E) Recruitment of Motor Units F) Frequency of firing motor units G) Type of Muscle Contraction H) Speed of Muscle Contraction (Force-Velocity Relationship)
What is Muscle Endurance?
Ability of muscle to contract repeatedly against a load (resistance), generate and sustain tension and resist fatigue over extended periods of time. Local Endurance.
What is Endurance?
Ability to perform Low-Intensity, Repetitive, or Sustained Activities over a prolonged period of time.
What is the Reversibility Principle?
Adaptive changes in response to resistance exercise are temporary unless training-induced improvements are used regularly or the individual participates in maintenance program.
Energy Systems
Anaerobic (high intensity, few reps) Aerobic (low intensity, high reps, large muscle groups)
What is Resistance Exercise?
Any form of active exercise in which Dynamic or static muscle contraction is resisted by outside force and is applied manually or mechanically.
Dynamic Stabilization Training
Body Blade -- Reactive device that produces oscillatory resistance proportional to the force applied via patient; proximal stability. Good for scapular mobility.
What is the Speed of Muscle Contraction (force-velocity relationship)
Concentric Contraction = Increase Speed, Decrease Tension Eccentric Contraction = Increase Speed, Increase Tension
Eccentric Dynamic Exercise
Controlling, deceleration of body segments; shock absorption...more efficient...max resist. Requires less motor units to control. Greater stress on CV system during eccentric than concentric, easier to control eccentrically
DAPRE Regimen
Daily Adjustable Progressive Resistive Exercise; not often used in PT; often for body builders Based on 6RM day 1: set 1 @ 50% 6RM set 2 @ 75% 6RM set 3 @ 100% 6RM set 4 @ 100% adjusted working weight Weight adjustments: Set 3 reps: 0-2 reps, reduce by 5-10 lbs. 3-4 reps, reduce by 0-5 lbs. 5-6 reps, keep same--day 4 increase 5-10 lbs. 7-10 reps, increase 5-10 lbs--day 4 5-15 lbs. 11++, increase 10-15 lbs--day 4 10-20 lbs.
DeLorme vs. Oxford
DeLorme: 3 sets x 10reps; progressive loading 50, 75, 100% of 10RM (increase resist. overtime) Oxford: 3 sets x 10 reps; regressive loading 100, 75, 50% of 10RM (decrease resist overtime)
What are the factors that can lead to Muscle Fatigue?
Decrease in Energy Stores Insufficient O2 Low Ca2+ Build up of H+ Decreased Excitability via NMJ Inhibitory Input via CNS (protective; pain) Muscle Fiber type
Overtraining
Deterioration in muscle performance and physical capabilities via high intensity, high volume strength and endurance programs...Insufficient rest intervals. Periodization remedies this.
Overwork
Deterioration of weakened muscles with neuromuscular disease; may be permanent..should not exercise to exhaustion; should be given longer and more frequent rest intervals.
Rest Interval
Determined based on impaired muscle performance type. 1 - 2 months of training to return to function; otherwise, continue. Prog. loading and rest to improve. Depends on intensity and volume, higher intensity means longer rest interval. 6 to 12 weeks of resistance training of hypertrophy, inc. vascularization.
Acute Muscle Soreness
Develops during/directly after strenuous exercise at pt. of muscle exhaustion; inadequate blood flow, ischemia, build up of metabolites with stimulating of free nerve endings that cause pain. Burn/aching. Subsides quickly.
What are the CardioPulmonary s + s of fatigue?
Diminished response of prolonged phys activity O2 usage ability lessened Decrease in Blood Glucose Levels, Glycogen Stores in Muscle + Liver, and Depletion of Potassium (esp. in elderly).
Maximal Loading Facets
Duration = Total time of resistance training program Velocity of exercise Periodization = Variations of intensities and volume set within different phases of a resistance training program. Integration of Exercises into Functional Activities. Use of resistance exercises approximate or identical to Functional Demands. Initial Exercise Load (Amnt. of Resistance): IF applied manually, judgment can be made during exercise; with Mechanical device--can be made quatitatively (.lbs).
DCER
Dynamic exercise against constant external resistance. Changing torque and changing length tension relationship throughout ROM; limit where max torque of resistance matches max torque of muscles.
What is Progressive Resistance Exercise?
Dynamic resistance training = constant external load is applied to contracting muscle by some mechanical means (free weights or machine) and is incrementally increased. RM used as basis for determining and progressing the resistance.
What is Force of Output from Greatest to Least?
Eccentric > Isometric > Concentric
What is considered Recovery from Exercise?
Enough time between sets and between sessions in program so body can restore itself to state prior to exhaustive exercise. From acute exercise, force-producing capabilities returns to levels around 90 to 95 percent capacity after 3 to 4 minutes of rest between sets. Within minutes, Oxygen and energy stores replenished in muscles. Lactic Acid is removed within 1 Hour after exercise. Glycogen replaced after several days. Age affects muscle performance through life-span.
What is the Overload Principle?
For Muscle Performance to Improve, a load that Exceeds the Metabolic Capacity of the muscle must be applied. If Demand remains Constant after muscle has adapted, the level of muscle performance can be maintained but not increased.
Manual Resistance Exercise
Form of active resisted exercise in which the resistive force is applied by the PT/PTA to either a DYNAMIC or STATIC muscular contraction. PNF - Proprioceptive Neuromuscular Facilitation. Isometric = PT "hold; don't let me move you" Concentric = PT "push!" "pull!" Eccentric = PT "slowly let go as I push or pull you!"
Maximal Loading (High Intensity) is for?
Goal: Increase Muscle Strength and Muscle Size For: Adults in adv. stage of Rehab after Musculoskeletal injury in prep to occupational/recreation activities. For: Individuals with no known pathology For: Individuals competing in weight lifting or body building.
What is Endurance Training?
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. Muscles adapt via Increasing their Oxidative and Metabolic Capacities, which Increase Delivery and Usage of Oxygen.
What is the Frequency of Firing Motor Units?
Higher Frequency of Firing = Greater the Tension Action Potential.
Volume
Higher load (lbs.) = Low Reps and Sets Lower Load (lbs.) = High Reps and Sets Exercise load dictates # reps and sets
Metabolic System, Enzymatic Activity-Strength, Endurance Adaptation
Increase in ATP storage, Creatine Phosphate storage, Myoglobin Storage, Creatine Phosphokinase
Connective Tissue-Strength, Endurance Adaptation
Increase in tensile strength of tendons, ligaments, and CT in muscle, bone mineral density or mineralization and bone mass, through Wbing activities.
What are Strength Adaptations?
Increases in MAX Force Producing Capacity of Muscle: Strength, Fiber Size, and Increase in Neural Adaptations.
Valsalva Maneuver
Increases intra abdominal and intra thoracic pressure which causes abrupt temporary increase in BP. Patients with CAD, MI, CV disorders, HTN; neuro pt, eye surgery, vertebral disc pathology. Do not hold breath. Breath rhythmically.
What is Power Training?
Increasing amount of work a muscle must perform during a period of time, or Reducing the amount of time required to produce a given force.
Alternative Methods for Determining Baseline Strength or Initial Exercise Load
Isokinetic Machines (Cybex, Lumax) Handheld Dynomometers Bench Press = 30% body weight Leg Extension = 20% body weight Leg Curl = 10-15% body weight Leg Press = 50% body weight
Closed Chain
Joint Approximation/Balance Total Body Machine Slide Board- LE or UE closed Balance Board or Wobble Board, BOSU (Both Sides UP); BAPS (Biomechanical Ankle Platform) Trampolines (bi/uni lateral activities) Reciprocal: Stationary bike, stair stepper, elliptical, ergometers (UE)
Concentric Dynamic Exercise
Joint moement and excursion of body segment as external force is overcome; accelerates; recruits more motor units as eccentric...less mech. efficiency..more effort to control same load as ecc.
What is Fatigue?
Localized Muscles. Decreased response of muscle to repeated stimulus; Decrease in amplitude of MEPP; Acute Physio. Response normal + reversible.
Nervous System-Strength Adaptation
MU Recruitment (Inc # MU firing, ate of, synch) **No endurance training adaptations
Forms of Resistance
Manual, Mechanical, Constant Load (free weight), Variable Load (machine, quantitatively measured), Accommodating Resistance (isokinetic), body/partial body weight
Skeletal Muscle Structure-Endurance Adaptation
Minimal Muscle Fiber Hypertrophy Increase in Capillary Bed Density Increase in Mitochondrial Density and Volume (Inc. # and size)
Skeletal Muscle Structure-Strength Adaptation
Muscle Fiber Hypertrophy (>>>FTFR, FTF; 2a, 2b) Remodels FTF to FTFR Hyperplasia of MF due to cancer No change or decrease in capillary bed density and mitochondrial density and volume.
Types of Isometric Exercise
Muscle Setting: Low intensity isometric contractions with little to no resistance. Decrease muscle pain/spasms; relax. Stabilization: Develop submaximal/sustained level of co contraction via stability thru midrange isometric in antigravity, or Wbing position. Improve strength over multi-angle multi joint position. Hold for 6 seconds and no more than 10 seconds because of fatigue. Gains in strength occur at training angle; 4 to 6 points. Doesn't impact dynamic strength. Avoid Valsalva maneuver, rapid BP increase.
Isometric Exercise
No mechanical involvement. Co-contraction, postural muscles required. Loss of static muscle strength with immobilization and disuse at 8% per week to as much as 5% per day. Used for pt's to min. mus. atrophy when jt. mvmt. is not possibly externally. Reestablish neuromuscular control, protect tissues. Posture, jt. stability Improve muscle strength.
