Chapter 6 Therapeutic exercise
II B
ANEROBIC & Fatigue FAST
ankle, foot, hip, elbow, finger
Avulsion fx. common sites
cardiopulmonary lipid well-being
Benefits of balanced ex -Kids: Increased ___ fitness Decreased blood ___ levels Improved psychological ___
weights; light
Body ___ or ___ weights during preadolescence
injuries Ephiphyseal or avulsion
Concerns that kids who participate in resisted exercise risk for ___ ___ or ___ fractures
Threshold for FATIGUE
Level of exercise that cannot be sustained indefinitely
aerobic power
Often ___ used interchangeably with endurance
TYPE II FIBERS
Phasic Fast twitch Generate great amount of tension-within short period of time
injuries or improves sport performance
Resisted ex for pre-pubescent children now common—insufficient evidence to support structured resistance training program-when coupled with general sports conditioning reduces ___ or ___
work; time period time
To increase power: Either increase the ___ a muscle must perform during a specified ___ Or.... Reduce the amount of ___ required to produce work
Endurance
___ training -little to no cross training effect on mm. strength
greater ROM
long fibered muscles produced?
Neural Hypertrophy vs. Hyperplasia Vascular and Metabolic Connective Tissues
Physiological Adaptations to Resisted EX: ___ adaptations ___ vs ___ ___ and ___ Adaptations Adaptations of ___ Tendons, ligaments, and connective tissue is muscle Bone-
single burst of high intensity activity repeated bursts of less intense activity
Power can represent a ____ (such as lifting a heavy piece of luggage overhead or performing a high jump) or ___ (climbing a flight of stairs)
Depression attention; memory
Psychological and Cognitive Factors: ___ related to physical illness Impaired ___ or impaired ___ (age, head injury, meds side effects) all affect motor ability
15-20%
Rate of decline of tension-generating capacity of mm. accelerates to ___% to ___% per decade for men and women in their 60's and 70's
endurance
Refers to ability to perform repetitive or sustained activities over a prolonged period of time
velocity; patient or joint; movement Task specific
Specificity of Training: Must also incorporate optimal mode (type), ___ of exercise and ___ or ___ position, and the ___ patterns ___ practice must be focus
30; 20s 1%; 8% 50 active than sedentary
Strength peaks in men at age ___ in women during ___ After these peaks, strength declines approx. ___ per year or about __ a decade Strength declines minor until about age __ Slower decline if ___ than ___
Endurance Training
Systematic practice of using muscle force to raise, lower, or control a light external load for many reps over an extended period of time
Cardiopulmonary Fatigue
Systemic diminished response of an individual as a result of prolonged physical activity such as walking, jogging, cycling or repetitive work
avulsion fracture
Tendon or ligament pulls bone away at site of attachment.
contraction reps
Threshold for FATIGUE could be noted as the Length of time a mm ___ maintained Or number of ___ of ex. that can be performed
free play and organized
Toddler, preschooler, and during early elementary years- ___ and ___ age appropriate physical activities rather than resisted exercises
bone health
WB promotes?
strength endurance
What does activity require, ___ (high intensity over short period of time), power, or ___ (low intensity over prolonged period of time)?
oxidative and metabolic oxygen
With endurance training-mm. adapt by increasing ___ and ___ capacities which allows better delivery and use of ___
MM. strength and mm. endurance
___ and ___ increases linearly with chronological age in both boys and girls from birth-puberty
Resistance ex
___ in children-can increase mm. strength- before puberty results are due to neuromuscular adaptation (not increase in mm mass).
Muscle strengthening
___ program-transfers by moderately improving muscular endurance
endurance
___ used more often for older population
Muscle strength
____ is needed as foundation BEFORE developing power
Function Strength
ability of neuromuscular system to provide enough force during functional activities in a smooth coordinated manor.
IIA
aerobic
Wolff's Law
body systems adapt over time to the stresses placed on them
Mental status
can affect muscle performance
Psychological factors
can positively or negatively affect mm. performance
blood glucose glycogen potassium
cardiopulmonary fatigue associated with endurance training is probably caused by a combination of the following factors: 1: Decreased ___ levels 2: Decreased ___ stores in mm and liver 3: Depletion of ___ esp. in elderly patients
fatigue
complex phenomenon that affects performance and must be considered in a resistance ex program
tension
cross section and size of muscle (includes muscle fiber number and size) 1: the larger the muscle diameter, the greater its ___ producing capacity
detraining
decreased muscle performance begins 7-14 days after resistance ex. program stops and continues until training effects are lost
muscle fatigue
diminished response of muscle to a repeated stimulus
injury, disease, immobilization, disuse, and inactivity
factors such as ___, ___, ___, ___ and ___ may impair muscle performance, leading to weakness and muscle atrophy
activity limitation, participation restriction and dysfunction
if any one or more of the key elements of muscle performance is impaired ____ and ____ or increased risk of ___ may ensue
Specific adaptation to imposed demands (SAID) principle
improve muscle performance in a specific area must match resistance program Principle applies to all body systems and is extension of Wolff's Law
9-12
may take ___ to ___ months of exercise for detectable and significant increase in in bone mass to occur.
high force
muscle architecture-fiber arrangement and fiber length (also relates to cross sectional diameter of muscle) 2: short fibers with pennate and multipennate design are typical in ___ producing muscles (ex quad, gastroc, deltoid and biceps brachii)
amplitude statically or dynamically
muscle fatigue causes a progressive decrease in ___ of motor potentials. it occurs if muscle contracts ___ or ___ against imposed load
intensity and volume
muscle no longer fatigues means they have adapted to?
Insufficient rest
patient's performance plateaus or deteriorates (overwork or overtraining)
Anaerobic power vs aerobic power
power can be defined as ___ power vs ___ power
90-95% 3-4
recovery from ex, in which the force producing capacity of muscle returns to __-___% of the pre-ex capacity, usually takes ___ to ___ min with the greatest proportion of recovery occurring the first minute
resistance training
resistance ex, also called ____, is an essential element of rehab programs for persons with impaired function
health; well being performance; motor skills injury and disease
resistance is an integral component of conditioning programs for those who wish to promote of maintain ___ and physical ___, enhance ___ and ___ and reduce risk of ___ and ___
spinal fractures
resistance training-does not prevent ___ but---increases strength of trunk extensors which correlates to vertebral bone density
LOW LOADS AND REPS
resisted ex program may be of value if program performed at appropriate level----___ and ___, Includes sufficient rest and is closely supervised
greater force
short fibered muscle produce?
strength training
systematic practice of using muscle force to raise, lower or control heavy external loads for a relatively low number of reps or over a short period of time It is an integral component of most rehabilitation or conditioning programs
strength training program
the amount of external resistance applied to the muscle is incrementally and progressively increased
max force producing capacity of muscle
the most common adaptation to strength training is an increase in the?
intensity or volume
the overload principle focuses on progressively loading muscle by changing ___ or ___ of exercise
cardiopulmonary endurance
total body endurance associated with repetitive, dynamic motor activities, such as walking, cycling or UE ergometry, which involve the large muscles of the body
ecc, isometric, concentric
10: type of muscle contraction force output greatest to least- ___, ___, ___ muscle contraction
concentric ecc
11: speed of muscle contraction (force velocity relationship) ___ contraction: increased speed, decreased tension ___ contraction: increased speed and increased tension
shortening force
3: long fibers with parallel design are typical in muscles with fast ___ rates but lower ___ production (sartorius and lumbricals)
type 1
4: fiber type distribution of muscle type 1 (tonic slow twitch) and type 2A and 2B (phasic and fast twitch) high percentage of ___ fibers favors low force production, slow rate of max force and resistance to fatigue
type 2A and 2B
5: high percentage of ___ and ___ fibers favors rapid high force production and rapid fatigue
physiological resting length
6: length tension relationship of muscle at time of contraction muscle produces greatest tension when its near or at the ___ at the time of contraction
longer
7: moment arm between muscle force vector and axis of joint rotation greater tension is produced with ___ moment arm
force
8: recruitment of motor units the greater the number and synchronization of motor units firing, the greater ___ production
frequency; tension
9: rate of motor firing the higher the ___, the greater the ___
Resistance Exercise
Activity in which dynamic or static mm. contraction is resisted by outside force applied manually or mechanically
Reversibility Principle
Adaptive changes in response to resistance ex-are not permanent Unless training induced improvements are used regularly for functional activities or individual participates in resistance ex-maintenance program
Specificity of Training
Adaptive effects of training such as improvement of strength and power and endurance are specific to training method used Whenever possible-exercises should mimic anticipated function
pathology, age, tissue healing, response, goals, abilities adapt
Always consider patient ___, ___, stage of ___, patient ___, and overall ___ and ___ of patient. MM and related systems must be given time to ___ to increased intensity or volume
type I (slow twitch, tonic)
Are called tonic or slow twitch Generate low level of muscle tension but can sustain contraction for long period of time Geared toward aerobic metabolism More resistant to fatigue than type II A fibers Heavy distribution of ___ found in postural muscles
resistance joint reaction forces soft tissues comfortable
Benefits of Endurance Training: Uses lower level of ___ Minimizes potentially harmful ___ Produces less irritation to ___ More ___ for the patient than heavy resistance ex.
muscle performance connective tissue mineral density; demineralization joint soft tissue repair and healing; balance daily living, occupational, and recreational activities lean muscle; body fat feeling disability and quality of life
Benefits of Resistance Exercise: enhanced ___ through restoration, improvement or maintenance of muscle strength, power and endurance increased strength of ____: tendons, ligaments, and intramuscular connective tissue increased bone ___ and or less bone ___ decrease ___ stress during physical activity reduced risk of ___ injury during physical activity improved capacity for ___ and ___ of damaged soft tissues and for tissue remodeling improved ___ enhanced physical performance during ___, ___ and ___ positive changes in body composition: increase in ___ mass or decrease of ___ enhanced ___ of physical well being positive perception of ___ and ___
10%
Boys approx. ___ stronger than girls from early childhood -puberty
30% mass strength mass
Boys-rapid increase in mm. strength Strength in adolescent boys increases ___ per year between ages 10 and 16 Muscle ___ peaks before mm. strength Resistance training-results in significant ___ gains Muscle ___-increase 5x in boys and approx 3.5 x girls during adolescence
Muscle Strength
Broad term that refers to the contractile elements of muscle that produce force
Muscle Performance
Capacity of mm. to do work (force x distance)
oxygen efficiently
Cardiopulmonary fatigue is related to body's ability to use ___
transfer of training
Carryover of training effects from one variation of exercise or task to another—aka overflow, cross training or ___
MOTIVATION
Charting or graphing performance Incorporating gains in mm. performance into functional activities early on-makes movements meaningful Modifying exercise routine
Uncomfortable; pain and cramping Shaking or trembling slowing jerky or inconsistent full range of available motion substitute low-intensity isokinetic testing
Clinical Signs of MM. Fatigue: ___ sensation in muscle (___ and ___ possible) ___ or ___ of contracting mm An unintentional ___ of contraction velocity with successive repetitions of an exercise Active movements ___ or ___ Inability to complete movement pattern through the ___ during dynamic resistance during same level of resistance Use of ___ motions- to complete activity Inability to continue ___ physical activity Decline in peak torque during ___
70 physical activity greater inactivity and disuse
Decline increases to 30% each decade after age ___ Can be significantly less if both men and women maintain high level of ___ Loss of mm. strength may be due to ___ and ___
Muscle power
Defined as work (force x distance) produced by a muscle per unit of time (force x distance/time) Rate of performing work
low-intensity high number of reps time
Endurance Training: Key parameters: ___ muscle contractions, ___ , and a prolonged ___ period
function
Endurance training -In some patients improves ___ better than strength training
work demands; time
Ex: to increase muscle power the ex program should consist of interventions that increase ___ while decreasing the __ that work is accomplished
health status age Diet Lifestyle neuromuscular, cardiopulmonary, inflammatory, cancer, psychological fatigue MS
Factors that influence fatigue: Patient's ___ ___ ___ ___ (sedentary or active) If patient has ___, ___, ___, ___-relate or ___ disorders- Onset of ___ irregular ___ and fatigue
intensity power
Greater ___ of exercise and shorter time period taken to generate force= greater mm. ___— Ex : Plyometric drills or stretch shortening drills increase power
Intensity
How much external resistance is placed on muscle
light exercise
If ___ (active recovery) performed during recovery period; recovery occurs more rapidly than with total rest (passive recovery)
strength
If adequate ___ Contractile tissues generates enough force to meet physical and functional demands placed on muscle system
adapted increased
If external demands on mm. remain constant after mm. has ___, level of muscle performance can be maintained but not ___
Overload Principle
If muscle performance is to improve, a resistance load that exceeds metabolic capacity must be applied that is MM. must be challenged to perform at a GREATER LEVEL than its current status
single maximum effort
In Practice - Greatest measurable force that is exerted by the muscle or mm. group to overcome resistance during a??
Volume of ex
Includes repetitions, sets, or frequency or any combination that can be adjusted to increase demands on mm
strength, power, endurance
Key elements of muscle performance are
rate force and velocity
Key factors in power are ___ at which mm produces force and relationship between ___ and ___
power
Many motor tasks involve both strength and speed may be important priority in rehab
Acute; NORMAL; reversible force-producing capacity temporary
Muscle Fatigue: ___ physiological response to exercise that is ___ and ___ Characterized by gradual decline in ___ of neuromuscular system Decline is ___ that leads to a decrease in muscle strength
repeatedly; tension; fatigue
Muscle endurance -ability of mm. to contract ___ against external load, generate and sustain ___, and resist ___ over an extended period of time
strength and speed
Muscle power related to ___ and ___ of movement
mass (atrophy) I and II muscle fibers; connective tissue cross sectional II length-tension flexibility motor units
Neuromuscular Factors- late adulthood: Decreased muscle ___ Decreased #'s of type ___ and ___ and increase in ___ in muscle Decreased ___ size of mm Selective atrophy of type ___ fibers Change in ___ relationship Associated with more loss of ___ than deficits in motor unit activation and firing rate Number of ___ appears to decline after age 60
movement
Neuromuscular Factors-late adulthood: As rate of ___ declines-ability to generate muscle power during activities that require quick response declines EX: preventing fall, rising from low chair
mm. strength speed endurance fatigue advanced age torque relaxation
Neuromuscular Factors-late adulthood: Decrease in ___ Declines is ___ of muscle contraction, Declines in mm. ___, Declines in ability to recover from muscular ___ All occur with ___ Also increased time for same ___ output is longer in elderly and increased time necessary to achieve ___ after voluntary contraction
power; strength
Neuromuscular Factors-late adulthood: Stronger relationship with loss of mm. ___ with age to functional limitation and disability than mm. ___
