Lecture 3 - Strength in rehabilitation Flashcards
Describe anti-gravity movement (GD)
Body part is lifted against the force of gravity
Type of resistance training
Describe gravity assisted movement (GA)
Movement of body part is assisted or helped by gravity
Less work required by the muscle
Muscle in question is moving perpendicular to the floor in downward motion
Describe gravity eliminated movement (GL)
Movement of the body part is neither hindered or assisted by gravity
Muscle in question is parallel to the floor, perpendicular to gravity
Bodies muscles must be able to do 3 things to carry out physical demands of the body in ADL and sport
Produce
Sustain
Regulate muscle tension
If one of these components is impaired, the person will have activity limitations, or increased risk of injury (3)
Strength
Power
Endurance
Types of contraction - movement stays the same (hold)
Isometric contraction
Type of contraction - muscle is shortening (produce the force against something)
Concentric contraction
Type of contraction - muscle is lengthening (often against gravity because they are slowing our body down)
Eccentric contraction
Term to say you create a force against something
Strength
Why isometric exercise? (5)
- Minimize muscle atrophy when joint movement is not possible
- Activate muscles to begin to re-establish neuromuscular control
- Develop postural and joint stability
- Improve muscular strength when dynamic RT could compromise joint integrity or cause pain
- Develop static muscular strength at particular points of ROM (work on the gap where injuries occur)
What is muscle setting?
Involve low intensity isometric contractions performed against little or no resistance
What is muscle setting used for?
Decrease muscle pain and spasm
Promote relaxation and circulation after injury
When is muscle setting used?
In acute stages of healing
What is stabilization exercise?
Form of isometric exercise where you use rhythmic stabilizations and alternating isometrics to facilitate sequential muscle activation
What is stabilization exercise used for?
Improve postural stability or dynamic stability of a joint
What is multi-angle isometrics?
Manual or mechanical resistance is applied at multiple joint positions within available ROM
What is the goal of multi-angle isometrics?
Improve strength through ROM
When is multi-angle isometrics used?
When dynamic resistance exercise is painful or inadvisable
2 benefits of repetitive isometric contractions
- Decrease muscle cramping
- Increases effectiveness of isometric goals
T or F: for isometrics, the resistance must be progressively increased to overload the muscle apply and release the tension gradually
TRUE
Intensity of muscle contraction - isometrics
Sufficient to use 66-100% of a muscles voluntary contraction to improve strength
Isometrics - at 5 sec, 75% of the tension exerted at beginning, and __ by 10 sec
50%
Shortening of muscle with contraction
Accelerate body segments or objects
Concentric
Lengthening of muscle while controlling against a resistance/force
Decelerates body segments
Shock absorber
Eccentric
T or F: more injuries occur at concentric motions
FALSE
Eccentric motions
- Involves change in muscle length
- Constant resistance throughout the exercises
- Speed of movement will change
Isotonic activity
- Involves change in muscle length
- Velocity is controlled and maintained at a specific speed of movement
- Amount of resistance provided to the muscle varies as the muscle goes through a range
Isokinetic activity
Characteristics of isokinetic exercises (5)
Can train reciprocal muscles
Compressive forces on the joint are LESS with faster velocities than at slow velocities
Patient can still perform exercise even if fatigued
Patient is able to eliminate painful arc
Speeds available in sport is more than in machine
Type of resistance exercise is chosen dependent on what? (5)
- Extent of impairments
- Stage of tissue healing
- Condition of joints and their tolerance to compression and movement
- General physical and cognitive abilities of the patient
- Patient’s goals
What happens if you put the patient into combination movement too earl in rehab process?
Compensation from muscles around it so not strengthening the muscle targeted
Positioning for RT : Weight bearing/CKC
Typically weight bearing position
Less shear forces at joint (more compression at the joint)
Generally safer in rehab program
Positioning for RT: Non-weight bearing/OKC
Typically NWB
More shear force at joint
Can better isolate muscle
High velocity movements (throw, kick, etc.)
Distal end of the joint working is fixed on something
Closed kinetic chain
Distal end of the joint working is free to move in space
Open kinetic chain
Which of OKC or CKC would you use in early-mid rehab program?
OCK to make sure you don’t use other muscles to compensate
When to use open kinetic chain? (4)
- When WB is contraindicated
- Soft tissue pain and swelling or restricted ROM of any segment in the chain, may require OKC exercises at adjacent joints
- First to develop isolated control and strength of weak musculature
- Sport/activity requires it
When to use closed kinetic chain? (4)
- Promote dynamic stabilization and co-activation
- Provides greater proprioceptive and kinesthetic feedback
- Provides more joint stability
- Sport/activity requires it
Parameters and progression of CKC exercises - % BW
PWB to FWB to FWB + add weight
Parameters and progression of CKC exercises - base of support
Wide to narrow
Bilateral to unilateral
Fixed on support surface to sliding on support surface
Parameters and progression of CKC exercises - Support surface
Stable to unstable/moving
Rigid to soft
Height: ground level to increasing height
Parameters and progression of CKC exercises - Balance
With external support to no external support
Eyes open to eyes closed
Parameters and progression of CKC exercises - Exclusion of limb movement
Small to large ranges (full depth vs 1/4 squat)
Short arc to full arc (if appropriate)
Parameters and progression of CKC exercises - Plane or direction of movement
Uniplanar to multiplanar (ex: lunge to curtsey lunge)
Anterior to posterior to diagonal
Parameters and progression of CKC exercises - Speed of movement or directional change
Slow to fast
Rapid gains in strength are seen in a debilitated or deconditioned muscle during the first __
3-5 weeks
Choosing our sets and reps - Strength of injured part should be within ___ of strength of uninjured counterpart
10%
Recommendations for early rehabilitation (sets and reps)
6-15 reps for 2 sets
Continue until able to perform 3 sets of 20-25 reps
Common guideline for increasing weight
Increase weight 5-10% when all prescribed repetitions and sets can be completed easily without significant fatigue (5-10 for UE, 10-20 for LE)
Training goal : strength
What is goal rep & sets?
Less than 6 reps for 2-6 sets
Training goal : power, single effort or multiple effort
What is goal rep & sets?
Single effort 1-2 reps for 3-5 sets
Multiple effort 3-5 reps for 3-5 sets
Training goal : hypertrophy
What is goal rep & sets?
6-12 reps for 3-6 sets
Training goal : muscular endurance
What is goal rep & sets?
More than 12 reps for 2-3 sets
When you had an ustable surface, your primary goal becomes neuromuscular and not strength (neuromuscular requirements increase – accessory muscles and brain connections for balance will increase when unstable)
If you want true strength gains, you need to stay on a stable surface
Can include both stable and unstable in the same training session
Contributions of stabilizing muscles increases ___ when the handle changed from stable to unstable during pushing motions in squat
~40%
Guidelines for progression of strength training (4)
- Change 1 parameter at a time (FIIT)
- Begin with isometrics if required (i.e. high pain level, ROM deficiencies, post-op, activation of muscles)
- Begin concentric/eccentric RT as soon as possible
- Begin plyometric exercises ONCE the patient has met the appropriate requirements
Fundamental movements required before going into plyometrics (4)
- Stand in proper posture (DL and SL)
- Squatting (DL and SL)
- Lunging
- Step up/down
Return to play requirements (2)
1/4 SL squats for 3x15 or step down controlled
SL calf raises 3x15
What makes up the quick stretch-shortening cycle for plyometrics?
- Eccentric phase
- Amortization phase
- Concentric phase
