resistance exercise
acute exercise-induced muscle soreness
- burning or aching that develops during or after performing resistance exercise - not concerning, transient but should stop exercise or rest
overtraining
- decline in performance with training - Sx = decline in max force production, muscle fatigue quicker, longer time to recovery - factors = inadequate rest, progressing too quickly, poor nutrition
delayed exercise-induced muscle soreness
- develops 12-24 hrs post-exercise - usually last 2-3 days, up to 2 weeks in some cases
Specific adaptation to imposed demands (SAID) principle
- helps determine parameters of exercise and meet needs/goals of pt - training programs should match the constructs of the specific element of muscle performance being targetted
TRUE
T/F for healthy patients maximal force is not required to perform a functional activity
TRUE
T/F in terms of progression you should start simple/small/low then move to more complex/larger/higher types of exercise
TRUE
T/F resistance exercise should be performed for life
TRUE
T/F strength training has been shown to improve muscle endurance but muscle endurance has little to no effect on strength
reversibility principle
The physical benefits of exercise are lost through disuse or inactivity - use it or lose it
2-3x/week, every other day, or 5x/week
as intensity and volume increase, common frequencies include ___, ___, or ____
transfer of training
carryover effects from one program to another form or element of exercise or muscle performance
- LESS than 5 reps = decrease load - between 5-6 reps = keep load the same - MORE than 6 reps = increase the load
describe how the DAILY adjustable PRE (DAPRE) protocol determine when to increase, decrease, or maintain the load?
- 3 sets of 10 based on 10RM - Delorme = load progressively INcreased (50, 75, 100%) - Oxford = load progressively DEcreased (100, 75, 50%)
describe the Delorme and Oxford PRE protocols
fatigue, DOMS
eccentric contractions generate less ___ but have a greater likelihood of developing ___
interference
effects of training are impacted when multiple components of fitness are trained at once
less
effects of transfer of training are ___ compared to effects of specificity training so exercise programs should be based on the targeted element of muscle performance
individuality
even patients with similar conditions or goals will respond to training differently - highlights importance of matching program to the pt abilities and goals
pathological fracture
failure of bone already weakened by disease d/t osteoporosis, osteomalacia, osteomyelitis, Paget's disease, tumor or cancer spread to bone
- manipulate amount of force, distance the load is moved, ROM, or decrease time to do work - plyometric exercise
how can we improve muscle power?
- neural adaptation - hypertrophy
how does strength training improve the force capacity of muscle (2)?
multiple times per day or daily
how frequently can lower intensity and volume programs be performed?
maintained
if the training stimulus is kept constant then muscle performance will be ____
discontinue resistance exercise
if you see any of the following symptoms when exercising your patient what should you do? - disoriented or confused - dizziness, blurred vision, faintness - unusual tiredness or muscle weakness - unusual or extreme shortness of breath - heart palpitations - nausea or vomitting - unrelieved pain or worsening of swelling - any unrelieved pain especially chest pain
important to perform isometric contraction at multiple angles or progress to dynamic exercise when appropriate in order to continue improving muscle performance through available ROM
improvements only seen about 10° in either direction of training angle with isometric contraction. what is the implication of this?
dynamic, muscle setting
in the presence of inflammation, __ exercise is contraindicated but ___ exercise might be appropriate
specificity
match type of muscle contraction, speed of movement, body/joint position, and movement pattern to desired functional outcome or pt goal
periodization
process of breaking training into specific time intervals by manipulating intensity, volume, and the type of exercise - maximize training while reducing overtraining/fatigue
overwork
progressive muscle weakness in muscles already impaired by disease - patients with non-progressive disease or certain systemic metabolic/inflammatory disorders should not exercise to point of exertion
circuit training
sequence of exercises performed targeting different muscle groups with short rest intervals to allow for both strength and cardiovascular training - low intensity, high volume - exercise order important
2-3
strength gains d/t neural adaptation are seen after ___ weeks
delayed-onset muscle soreness
the following are signs and symptoms of ____ - muscle soreness and aching - tenderness to palpate - increased soreness with muscle elongation/stretching and contraction - increased muscle stiffness - decreased ROM and strength - signs of local inflammation
muscle fatigue
the following are signs and symptoms of ____ - pain or muscle cramping - muscle shaking or trembling - unintentional slowing of movement with successive reps - jerky movements - inability to complete movement through desired ROM - substitute or compensatory movement patterns - decline in force production
new capabilities, maintenance program
the reversibility principle highlights the importance of training through the muscle's ____ and patient/client participation in a ______
10, 6, number of reps performed in set 3 (will be the same, increased, or decreased)
under the DAPRE protocol based on 6RM set 1 = 50% = __ reps set 2 = 75% = __ reps set 3 = 100% = max # of reps set 4 = determined by ____
- amount of ROM - ability to perform specified # of reps
what are other methods of determining the 1RM for a patient?
increase postural stability or joint stability
what is the benefit of isometric stabilization exercises?
must keep program or exercises challenging (greater than what pt is used to) in order to continue making gains as the body adapts to the training stimulus - progressive overload
what is the overload principle?
5 min
what is the rest time for strength or power training at very high intensities?
2-3x/week
what is the typical frequency for maintenance programs?
low intensity <50% 1RM
what percent of the 1RM should you start at for older adults or deconditioned individuals or those with certain health conditions?
can perform 1-2 reps over desired number... - increase load 2-10% (lower % for small muscles, greater % for large muscle groups)
you tell your patient to perform a set of 10 bicep curls but they are able to perform 12 reps instead. what does this indicate?
2-4, 1-6
__ sets are common but positive training results have been shown with ___ sets
concentric, eccentric, high-impact
___ contractions accelerate body segments while __ contraction controls deceleration of body segments and absorbs energy during ____ activity
longer
___ recovery is needed for eccentric exercise programs and programs of higher intensity and volume
decreases, constant
increasing the speed ___ muscle force of concentric contractions but force increases then remains ____ for eccentric contractions
- level of experience (novice or advanced, trained or untrained) - goal
intensity is dependent on the ___ and ____
shorter
rest periods for endurance training are ___
6-8
strength gains d/t significant changes in muscle (hypertrophy and vascularization) are seen after ___ weeks
20-90%
the % 1RM can range from ____ depending on goal or health status
1. breathing = consistent with activity level, holding breath 2. substitute motions = load may be too high, pt experience muscle fatigue, or pain; can contribute to injury 3. pain 4. fatigue
what 4 factors should you monitor during resistance exercise?
- muscle = hypertrophy, muscle fiber adaptation - neural = increased recruitment of motor units, increased rate and synchronization of motor unit firing
what are neural and skeletal muscle physiological adaptations to strength training?
- pain - promote soft tissue healing - improve bone health - improve muscle performance
what are some reasons for prescribing resistance exercise (4)?
1. increases strength in significantly weak patients 2. can help decrease pain and edema
what are the 2 benefits of isometric muscle setting exercises?
1. severe cardiopulmonary disease 2. acute inflammation pt, risk of tissue damage 3. pain (relative) w/ AROM, restricted isometric contractions, or does not improve w/ repeated movement/decreased load
what are the 3 contraindications of resistance exercise (S.A.P.)?
1. muscle setting = low intensity isometric contraction against little to no resistance 2. stabilization = isometric contractions performed to maintain body or part of body in a fixed position 3. multi-angle = isometric contraction performed against resistance that is applied at multiple joint positions within the available ROM
what are the 3 types isometric contraction resistance exercise and describe them
- helps avoid plateau - may increase adherence by decreasing boredom
what are the benefits of variety in an exercise program?
- strength = 6-12 - endurance = 15-25 (or up to 50) - power = 3-6
what are the common # of reps for strength, endurance, and power training?
- pt health condition - comorbidities - stage of healing post-injury or surgery - extent/severity of impaired muscle performance - presence of other deficits
what are the factors that can influence the design and implementation of exercise programs?
- low intensity + high reps - sustained contraction for extended period of time (30-60s)
what are the key elements for improving muscle endurance training (2)?
- increased tensile strength of tendons, ligaments, and CT in muscles - increased bone mineral density
what are the physiologic adaptations of connective tissue to endurance and strength training?
1. valsalva maneuver = decreases amount of blood returning to heart, rapidly increases BP 2. age (children/adolescents, older adults) 3. applying resistance across unstable joints 4. poor control of movements
what are the precautions of resistance exercise (4)?
- low = 1-2 min - moderate = 2-3 min - high = >3 min
what are the rest times for the following intensities of strength training? - low - moderate - high
types = isometric, concentric, and eccentric contraction (variable vs. constant) mode = dumbbells, resistance bands
what are the types of resistance exercise? modes?
- increased capillary bed density - increased number and size of mitochondria
what are the vascular and metabolic physiologic adaptations to endurance training?
assessment of strength will not match activity performed if prescribing dynamic activity
what is a drawback of using the handheld dynamometer to determine intensity?
allows for back to back days of exercise
what is the benefit of a program that alternates muscle groups each day?
can increase strength throughout ROM when dynamic exercise is painful or difficult
what is the benefit of multi-angle isometric contraction exercise?
useful in measuring exercise intensity when max effort/load is difficult to assess or inappropriate
what is the benefit of using the Borg CR10 scale?
- large muscles then small - multi-joint then single joint - high intensity then low
what is the exercise order for muscles, joint exercises, and intensity?
- intensity = 60% of max voluntary muscle contraction - time = 6-10s - can gradually apply and release force (2s hold, 2s release)
what is the intensity and time/duration of muscle contraction for isometric contraction?
- baseline status - determine load/weight/resistance level to be used during specific exercise
what is the purpose of determining the RM (2)?
- minimize atrophy - re-establish neuromuscular control - develop postural or joint stability
what is the rationale of isometric contraction exercises (3)?
at least 48 hrs
what is the recommended recovery period for a single muscle group as intensity and volume increases?
- novice = 60-80% 1RM - advanced = 80-100% 1RM
what percent of the 1RM should a novice perform at for strength training? advanced?
- lower = 60-90% 1RM - upper = <60% 1RM
what percent of the 1RM should a patient perform at if power training the lower body? upper body?
< 60% 1RM
what percent of the 1RM should a patient perform if goal is endurance training?
1-2 weeks
when does muscle performance begin to decline following discontinuation of training?
- goal is to increase muscle strength and power - advanced phase of rehab in preparation for return to sport - conditioning programs for individuals with no known pathology
when is maximal intensity appropriate (3)?
- improving muscle endurance - acute stage of tissue healing - after prolonged immobilization (cartilage or bone health a concern; fx risk) - learning new exercise (ensure correct form) - slow velocity isokinetic training - most children and older adults
when is sub maximal intensity appropriate (6)?
1. unstable pulmonary artery disease 2. decompensated HF 3. severe pulmonary HTN 4. uncontrolled arrhythmias or HTN 5. carditis
which severe cardiopulmonary diseases would contraindicate resistance exercise (5)?
eccentric
which type of contraction can generate more maximal force?
1 RM is inappropriate d/t amount of stress, exertion (injury, high fx risk, severe cardiovascular pathology)
why might you decide to use the predicted 1 RM for a patient?