Transcript Chapter 6 - PHT 1227 Therapeutic Exercise I

Resistance Exercise for
Impaired Muscle Performance
Chapter 6
Part II: Applied Science of Exercise and
Techniques
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Muscle Performance and Resistance
Exercise: Definitions and Guiding Principles
 Strength, Power, and Endurance
– Strength
• Strength training
– Power
• Power training
– Endurance
• Endurance training
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Muscle Performance and Resistance
Exercise: Definitions and Guiding Principles
(cont'd)
 Overload Principle
– Description
– Application of the Overload Principle
 SAID Principle
– Specificity of training
– Transfer of training
 Reversibility Principle
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Factors That Influence Tension
Generation in Normal Skeletal Muscle
 Energy Stores and Blood Supply
 Fatigue
– Muscle (local) fatigue
– Cardiopulmonary (general) fatigue
– Threshold for fatigue
– Factors that influence fatigue
 Recovery From Exercise
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Factors That Influence Tension Generation
in Normal Skeletal Muscle (cont'd)
 Age
– Early childhood and preadolescence
– Adolescence
– Young and middle adulthood
– Late adulthood
 Psychological and Cognitive Factors
– Attention
– Motivation and feedback
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Physiological Adaptations to
Resistance Exercise
 Neural Adaptations
 Skeletal Muscle Adaptations
– Hypertrophy
– Hyperplasia
– Muscle fiber type adaptation
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Physiological Adaptations to
Resistance Exercise (cont'd)
 Vascular and Metabolic Adaptations
 Adaptations of Connective Tissues
– Tendons, ligaments, and connective tissue in
muscle
– Bone
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Determinants of Resistance
Exercise
 Alignment and Stabilization
– Alignment
• Alignment and muscle action
• Alignment and gravity
– Stabilization
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Determinants of Resistance
Exercise (cont'd)
 Intensity
– Submaximal versus maximal exercise loads
– Initial exercise load (amount of resistance) and
documentation of training effects
• Repetition maximum
– Use of repetition maximum
• Alternative methods of determining baseline strength
or an initial exercise load
• Training zone
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Determinants of Resistance
Exercise (cont'd)
 Volume
– Repetitions
– Sets
– Training to improve strength or endurance: impact
of exercise load and repetitions
• To improve muscle strength
• To improve muscle endurance
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Determinants of Resistance
Exercise (cont'd)
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Exercise Order
Frequency
Duration
Rest Interval (Recovery Period)
– Purpose of rest intervals
– Integration of rest into exercise
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Determinants of Resistance
Exercise (cont'd)
 Mode of Exercise
– Type of muscle contraction
– Position for exercise: weight-bearing or nonweight-bearing
– Forms of resistance
– Energy systems
– Range of movement: short-arc or full-arc exercise
– Mode of exercise and application to function
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Determinants of Resistance
Exercise (cont'd)
 Velocity of Exercise
– Force-velocity relationship
– Application to resistance training
 Periodization and Variation of Training
 Integration of Function
– Balance of stability and active mobility
– Balance of strength, power, and endurance
– Task-specific movement patterns with resistance exercise
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Types of Resistance Exercise
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Static (Isometric) and Dynamic
Concentric and Eccentric
Isokinetic
Open-Chain and Closed-Chain
Manual and Mechanical
Constant and Variable
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Manual and Mechanical Resistance
Exercise
 Manual Resistance Exercise
 Mechanical Resistance Exercise
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Isometric Exercise (Static Exercise)
 Rationale for Use of Isometric Exercise
 Types of Isometric Exercise
– Muscle-setting exercises
– Stabilization exercises
– Multiple-angle isometrics
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Isometric Exercise (Static Exercise)
(cont'd)
 Characteristics and Effects of Isometric
Training
– Intensity of muscle contraction
– Duration of muscle activation
– Repetitive contractions
– Joint angle and mode specificity
– Sources of resistance
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Dynamic Exercise: Concentric and
Eccentric
 Rationale for Use of Concentric and Eccentric
Exercise
 Special Considerations for Eccentric Training
– Exercise-induced muscle soreness
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Dynamic Exercise: Concentric and
Eccentric (cont'd)
 Characteristics and Effects of Concentric and
Eccentric Exercise
– Exercise load and strength gains
– Velocity of exercise
– Energy expenditure
– Specificity of training
– Cross-training effect
– Exercise-induced muscle soreness
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Dynamic Exercise: Constant and
Variable Resistance
 Dynamic Exercise-Constant External
Resistance (DCER)
 Variable-Resistance Exercise
 Special Considerations for DCER and VariableResistance Exercise
– Excursion of limb movement
– Velocity of exercise
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Isokinetic Exercise
 Characteristics of Isokinetic Training
– Constant velocity
– Range and selection of training velocities
– Reciprocal versus isolated muscle training
– Specificity of training
– Compressive forces on joints
– Accommodation to fatigue
– Accommodation to a painful arc
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Isokinetic Exercise (cont'd)
 Training Effects and Carryover to Function
– Limitations in carryover
 Special Considerations for Isokinetic Training
– Availability of equipment
– Appropriate set up
– Initiation and progression of isokinetic training
during rehabilitation
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Open-Chain and Closed-Chain
Exercise
 Background
 Controversy and Inconsistency in Use of Open-Chain
and Closed-Chain Terminology
 Alternatives to Open-Chain and Closed-Chain
Terminology
 Characteristics of Open-Chain and Closed-Chain
Exercises
– Open-chain exercises
– Closed-chain exercises
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Open-Chain and Closed-Chain
Exercise (cont'd)
 Rationale for Use of Open-Chain and Closed-Chain
Exercises
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Isolation of muscle groups
Control of movements
Joint approximation
Co-activation and dynamic stabilization
Proprioception, kinesthesia, neuromuscular control, and
balance
– Carryover to function and injury prevention
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Open-Chain and Closed-Chain
Exercise (cont'd)
 Implementation and Progression of Open- and
Closed-Chain Exercises
– Introduction of open-chain training
– Closed-chain exercises and weight-bearing
restrictions: use of unloading
– Progression of closed-chain exercises
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General Principles of Resistance
Training
 Examination and Evaluation
 Preparation for Resistance Exercises
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Implementation of Resistance
Exercises
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Warm Up
Placement of Resistance
Direction of Resistance
Stabilization
Intensity of Exercise/Amount of Resistance
Number of Repetitions, Sets, and Rest Intervals
Verbal or Written Instructions
Monitoring the Patient
Cool Down
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Precautions for Resistance Exercise
 Valsalva Maneuver
– At-risk patients
– Prevention during resistance exercise
 Substitute Motions
 Overtraining and Overwork
– Overtraining
– Overwork
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Precautions for Resistance Exercise
(cont'd)
 Exercise-Induced Muscle Soreness
– Acute muscle soreness
– Delayed-onset muscle soreness (DOMS)
• Etiology of DOMS
• Prevention and treatment of DOMS
 Pathological Fracture
– Prevention of pathological fracture
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Contraindications to Resistance
Exercise
 Pain
 Inflammation
 Severe Cardiopulmonary Disease
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Manual Resistance Exercise
 Definition and Use
 Guidelines and Special Considerations
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Body mechanics of the therapist
Application of manual resistance and stabilization
Verbal commands
Number of repetitions and sets: rest intervals
 Techniques: General Background
 Upper Extremity Techniques
 Lower Extremity Techniques
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Proprioceptive Neuromuscular
Facilitation: Principles and Techniques
 Diagonal Patterns
 Basic Procedures With PNF Patterns
– Manual contacts
– Maximal resistance
– Position and movement of the therapist
– Stretch
• Stretch stimulus
• Stretch reflex
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Proprioceptive Neuromuscular Facilitation:
Principles and Techniques (cont'd)
 Basic Procedures With PNF Patterns (cont’d)
– Normal timing
– Traction
– Approximation
– Verbal commands
– Visual cues
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Proprioceptive Neuromuscular Facilitation:
Principles and Techniques (cont'd)
 Upper Extremity Diagonal Patterns
 Lower Extremity Diagonal Patterns
 Specific Techniques With PNF
– Rhythmic initiation
– Repeated contractions
– Reversal of antagonists
– Alternating isometrics
– Rhythmic stabilization
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Mechanical Resistance Exercise
 Application in Rehabilitation Programs
 Application in Fitness and Conditioning
Programs
 Special Considerations for Children and Older
Adults
– Children and resistance training
– Older adults and resistance training
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Selected Resistance Training
Regimens
 Progressive Resistance Exercise
– Delorme and Oxford regimens
– DAPRE regimen
 Circuit Weight Training
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Selected Resistance Training
Regimens (cont'd)
 Isokinetic Regimens
– Velocity spectrum rehabilitation
• Selection of training velocities
• Repetitions, sets, and rest
• Intensity
– Eccentric isokinetic training: special considerations
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Equipment for Resistance Training
 Free Weights and Simple Weight-Pulley
Systems
– Types of free weights
– Simple weight-pulley systems
– Characteristics of free weights and simple weightpulley systems
– Advantages and disadvantages of free weights and
simple weight-pulley systems
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Equipment for Resistance Training
(cont'd)
 Variable-Resistance Machines
– Variable resistance weight-cable systems
– Hydraulic and pneumatic resistance devices
– Advantages and disadvantages of variableresistance machines
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Equipment for Resistance Training
(cont'd)
 Elastic Resistance Devices
– Types of elastic resistance
– Properties of elastic resistance: implications for
exercise
• Effect of elongation of elastic material
• Determination and quantification of resistance
• Fatigue characteristics
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Equipment for Resistance Training
(cont'd)
 Elastic Resistance Devices (cont’d)
– Application of elastic resistance
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Selecting the appropriate grade of material
Selecting the appropriate length
Securing bands or tubing
Setting up an exercise
Progressing exercises
– Advantages and disadvantages of exercise with
elastic resistance
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Equipment for Resistance Training
(cont'd)
 Equipment for Dynamic Stabilization Training
– BodyBlade®
– Swiss balls (stability balls)
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Equipment for Resistance Training
(cont'd)
 Equipment for Closed-Chain Training
– Body weight resistance: multipurpose exercise
systems
– Slide boards
– Balance equipment
– Mini-trampolines (rebounders)
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Equipment for Resistance Training
(cont'd)
 Reciprocal Exercise Equipment
– Stationary exercise cycles
– Portable resistive reciprocal exercise units
– Stair-stepping machines
– Elliptical trainers and cross-country ski machines
– Upper extremity ergometers
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Equipment for Resistance Training
(cont'd)
 Isokinetic Testing and Training Equipment
– Features of isokinetic dynamometers
– Advantages and disadvantages of isokinetic
equipment
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Independent Learning Activities
 Critical Thinking and Discussion
 Laboratory Practice
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