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