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07 - Therapeutic Exercise I > 07-05: Resistance Exercise for Impaired Muscle Performance > Flashcards

07-05: Resistance Exercise for Impaired Muscle Performance Flashcards

1
Q

Three elements of muscle performance

A
  • Strength
  • Power
  • Endurance
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2
Q

Strength

A
  • Force
  • Force x Distance = Work
  • Greatest measurable force that can be exerted by a single muscle to overcome resistance during a single maximum effort
  • Withstands resistance of muscles
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3
Q

Functional Strength

A
  • Neuromuscular system’s ability to produce and control forces during functional activities
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4
Q

Power

A
  • Force x distance/time
  • Work over time - can be brief or over extended periods of time
  • Burst
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5
Q

Endurance

A
  • Repetitive or sustained activities over a prolonger period of time
  • Walking, cycling, swimming
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6
Q

Muscle Endurance

A
  • Ability to contact repeatedly against load and resist against fatigue over an extended period of time
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7
Q

Resistance Exercise

A
  • Active exercise in which dynamic or static muscle contraction is resisted by an outside force (manual - PT/PTA - or mechanical - machine)
  • Also resistance training
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8
Q

Muscle types of resistance exercise

A
  • Type 1 (Tonic): Slow twitch, postural muscles

- Type 2 (Phasic): Fast twitch, burst of energy, quick fatigue

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9
Q

Overload Principle

A
  • Muscle must be challenged to perform at a greater level than its usual
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10
Q

SAID Principle

A
  • Specific Adaptation to Imposed Demand
  • Extension of Wolff’s law
  • Specificity of training: Anticipate function and incorporate into training
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11
Q

Reversibility Principle

A
  • Use it or lose it
  • Gains in performace reduce 1-2 weeks following cessation of exercise
  • Increases in performance must be incorporated into functional activities to maintain
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12
Q

Skeletal muscle function and adaptation to resistance exercise

A
  • Factors that influence tension generation: blood, fatigue
  • Recovery from fatigue: 3-4 minutes
  • S/S of fatigue: pain and cramping, tremors, jerky motions, incomplete ROM, substitutions, unable to finish movement
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13
Q

Physiologic Adaptations to Resistance Exercise

A
  • Depends on patient
  • Neural adaptations
  • Hypertrophy
  • Hyperplasia
  • Fiber type adaptations
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14
Q

Neural adaptations

A
  • Increased recruitment of motor units

- Increased rate and synchronization of firing - strength increases with no evidence of hypertrophy

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15
Q

Hypertrophy

A
  • Increase in size of myofibrils
  • 4-8 weeks of high intensity training
  • Greatest gain with high-volume moderate resistance eccentric training
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16
Q

Hyperplasia

A
  • Fiber splitting (Longitudinal sploit

- Increase number of muscle fibers

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17
Q

Fiber Type Adaptation

A
  • Type I (Tonic) to Type II (Phasic), as seen in SCI pts

- Primarily for movement: slow to fast

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18
Q

Determinants (Parameters) of Resistance Exercise

A
  • Alignment and stabilization
  • Intensity
  • Volume
  • Exercise Order
  • Frequency
  • Duration
  • Rest Interval (recovery period)
  • Mode of exercise
  • Velocity of exercise
  • Integration of Function
19
Q

Alignment and Stabilization

A
  • Alignment: Direction of muscle fibers, line of pull
  • Stabilization (External): Hand on patient, stabilize proximal
  • Stabilization (Internal): Isometric contraction of Agonist group
20
Q

Intensity

A
  • The amount of resistance used
  • Should never cause pain
  • Submaxima: Early stages of healing, goal is for endurance, after immobilization
  • Maximal loading: Increase mm size and strength
21
Q

Volume

A
  • Total number of sets and reps
  • Reps: Goal is strength or endurance
  • Sets: Single - early phases, Multiple - Advanced programs
22
Q

Exercise Order

A
  • Exercise large muscle groups before smaller groups, multijoint muscles before single joint muscles
  • Warm up before exercises, intensity is pt-specific
23
Q

Frequency

A
  • No optimal frequency
  • Low load can be performed daily, several times daily (HEP isometrics)
  • Higher loads require more recovery time, usually every other day
24
Q

Duration

A
  • 2-3 weeks for neural adaptation

- 6-12 weeks for hypertrophy and true strength gains

25
Q

Rest Interval (Recovery Period)

A
  • 2-3 minutes after moderate training
  • 4-5 minutes for high-intensity training
  • Active recovery more efficient than passive recovery; light ex better to reduce fatigue
26
Q

Mode of exercise

A
  • Isometric, Isotonic, Isokinetic, OKC, CKC, manual resistance, mechanical resistance, body weight, short arc, long arc
27
Q

Velocity of exercise

A
  • Increase in velocity eccentric contraction = increased force production
  • Increase in velocity concentric contraction = decreased force production
28
Q

Integration of function

A
  • Requires balance, strength and task-specific training
29
Q

Types of Resistance Exercise

A
  • Manual and Mechanical Resistance
  • Isometric Exercise (Static Exercise)
  • Dynamic Exercise (Concentric/Eccentric)
  • Dynamic Exercise (Constant/Variable resistance
  • Isokinetic Exercise
  • Open Chain and Closed Chain Exercise
30
Q

Manual/Mechanical Resistance

A
  • Manual: Resistance needs to be controlled; cannot be quantified
  • Mechanical: Can be quantified to varying degrees
31
Q

Isometric Exercises

A
  • Loss of static muscle strength from 8%/week to as much as 5%/day with immobilization
  • Three types of isometric exercises
  • Muscle Setting: Prevents atrophy
  • Stabilization: Increases strength and function
  • Multi-angle stabilization: Precursor to stabilization or functional activities
32
Q

Dynamic Exercise (Concentric/Eccentric)

A
  • Plyometrics
  • Picking up objects
  • Eccentric weakness associated with tendonopathies; also greater DOMS
33
Q

Dynamic Exercise (Constant/Variable)

A
  • Constant = free weights, pulley systems, machines

- Variable = manual resistance, elastic products, designed machines and isokinetic macthines

34
Q

Isokinetic Exercise

A
  • Used sparsely

- Later phases of rehab

35
Q

OKC/CKC

A
  • CKC = distal
  • Determined by task specific training
  • Effective in increasing strength and endurance
36
Q

Precautions for resistance exercise

A
  • Valsalva Maneuver
  • Substitute motions
  • Overtraining
  • Overwork
  • Exercise-induced muscle soreness
  • Pathologic fracture
37
Q

Valsalva Maneuver

A
  • Closing of the epiglottis

- Deep inspiration, increase in BP

38
Q

Overtraining

A
  • Decreased strength due to inadequate rest/recovery; reversible
39
Q

Overwork

A
  • Weakness
  • Decreased strength in nonprogressive neuromuscular diseases such as Guillan Barre or post polio
  • Requires longer recovery time
40
Q

Exercise-Induced Muscle soreness

A
  • NO known cause
  • Prevent with stretching
  • Treat with modalities (massage, light exercise)
  • Soreness may occur within 24-48 hours, subsides within 3-4 days, can last 10 days
41
Q

Pathologic fracture

A
  • Osteopenia or Osteoporosis
42
Q

Manual Resistance

A
  • Form of active resisted exercise where resistive force is applied by PT/PTA to either static or dynamic muscular contraction
  • Stabilize body parts; consider gravity
43
Q

Types of Resistance Training

A
  • PRE
  • Circuit Training
  • Plyometric training
  • Isokinetic regimens

07 - Therapeutic Exercise I (11 decks)

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