Lecture #8 (Muscular Strength and Endurance) Flashcards
What is an isometric activity?
A muscle contraction and tension without a change in a muscles length
When are isometrics used during rehab?
When trying to protect a healing joint from stress or in a very weak or inhibited muscle because they do not produce a lot of joint stress (so they are good right after surgery). These are used as a way to combat atrophy and kind of serve as a filler right after an injury.
Where do isometric contractions help strength gains?
Limited to within 20 degrees of where the contraction is performed–so they should be
How long does it take an isometric contraction so reach 50% of a full muscular contraction?
10 seconds…so it is not necessary to hold isometrics for more than 5-10 seconds
What percentage of effort can strength gains be made with isometric exercises?
35-100% of effort…35-66% the gains are very slow but 67-100% the gains are higher. In fact, with 67-100% of effort, strength can be gained by as much as 5-12% per week.
How fast is strength lost due to immobilization?
8% per week to 5% per day
What is dynamic activity divided into?
Isotonic and isokinetic activity
What is static activity?
Isometric activity
What are the subcategories of isotonic activity?
Concentric or eccentric
Which is a higher force, eccentric or concentric? Which causes more muscle soreness?
Eccentric
When a muscle is significantly weak and/or actively healing, what types of exercises should be avoided to reduce the intensity of soreness form the exercise routines?
Eccentrics–but they must be included later in rehab to better replicate sport activities
What is the strength of a muscle or group?
The greatest amount of tension created isotonically at the weakest point of the muscle
What is isokinetic activity?
Concentric contractions at a controlled rate…usually measured in degrees / sec. Also, the muscle forces varies thoughout the ROM as the part is moved at the same speed
What is isokinetic activity called?
Accomodating resistance…where the patient’s force is greatest so is the resistance from the machine as the resistance is dependent on the force placed on it (since the speed won’t change)
What are open chain exercises?
The distal segment is moving freely in space
What are closed chain exercises?
The distal segment is fixed and not moving freely in space
OKC or CKC?? Which is usually higher velocity and higher in joint stress? Which is usually used early in rehab because they decrease shear force and joint stress?
Higher velocity/ stress = OKC
Early in rehab/ decrease force = CKC
True or false:
In OKC, no part of the chain can move independently from the others.
False–this is true of CKC.
What are the advantages of OKC? (x6)
- can start to do strengthening even if pt has WB restrictions
- can isolate and focus on one muscle
- requires less strength to perform
- resistance can be more variable
- less substitution by other stronger muscles
- easier to instruct and do correctly
What are the advantages of CKC? (x4)
- functional movements (mimic sport motions)
- exercises the entire kinetic chain (stabilizers,multiple muscles, and trains for stability, balance, coordination, and agility)
- more difficult to complete so it requires more strength in general
- decreased shear forces on the joints
What is the graduation of muscle activity? (In terms of ROM)
PROM to AAROM to AROM to RROM
True or false:
Your imagination and knowledge is the ultimate key to the success of a rehabilitation program, not the facility or the equipment. You possess the best equipment in your mind and hands.
True
Where is the force application with manual resistance?
Usually at the distal segment
What are the advantages of manual resistance? (x6)
- no equipment needed
- good rapport with pt
- greater desire to work hard as pt knows you are working hard too
- variable resistance and motion to isolate muscles or avoid pain
- flexibility in performing sets, reps, motions, and speed
- clinican right there to give feedback
What are the disadvantages of manual resistance? (x6)
- one-on-one so you can only deal with one pt at a time
- needs to be done by same clinician for consistency
- difficult to measure progress
- can cause more soreness
- clinician may not be able to provide enough resistance
What is an example of an open chain exercise that use body weight?
Total gym incline bench
With using body weight exercises, what two things need to be considered?
1) proper instructions for exercise and monitor pt for proper technique
2) handouts may be needed to promote patient compliance and encourage proper technique
What are the disadvantages of body weight exercises? (x5)
- difficulty using correct form
- if at home, can’t be monitored for compliance
- body weight may be too much resistance so it may be difficult to start with
- only able to do certain motions
- only able to work certain muscles and areas of body concentrically and eccentrically
What is the hardness levels for theraband use?
Tan-white-yellow-red-green-blue-black-silver-gold
Are therabands results or progress subjective or objective?
Somewhat objective as the resistance is dependent on the amount of stretch
What is a safety concern when using therabands?
The bands can fail so never use the bands near the eyes for safety precautions
What does the term free weights include?
Cuff weights, dumbbells, barbells, pulleys
What is one disadvantage of free weights?
They could potentially be more expensive because you need many different weights
How should the patient perform free weight exercises?
Slow and controlled to avoid substitutions and compensatory motions.
What changes the resistance curve when using free weights?
Muscle weakest point–the sticking point
What are the advantages of free weights? (x6)
- resistance not limited by clinician
- progress easily tracked
- variety of types of equipment
- dynamic (the moment arm is not stabilized) so other areas must stabilize
- can be used in functional activities to provide resistance
- can be used in variety of position to isolate muscles and or motions
What are the disadvantages of free weights? (x4)
- dangerous
- substitution and compensation is common when pt is very weak
- weight being used is heaviest when the body part is the weakest
- cost is high and not easily transported
What is the main advantage of an isotonic machine?
It can isolate specific muscles and motions
What is unique about the isokinetic machines?
They provide accomodating resistance in that they only provide as much resistance as the patient provides force
What is a combination of primitive movements performed with a maximal amount of resistance applied throughout the ROM? What is its advantage?
PNF strengthening; it helps restore flexibility, strength, and coordination of injured muscles and joints because it is all encompassing
What do PNF patterns do?
Produce mass movement (not straight plane movements) that incorporate diagonal motion and spiral movement (flexion and extension, abduction and adduction, and rotation)
What does the D2 PNF pattern mimic?
Throwing (upper extremity)
What is the D1 PNF pattern for upper extremity?
Flexion/lateral rotation/ adduction —–> extension/medial rotation/abduction dracula to slap the midget*
What is the D2 PNF pattern for upper extremity?
Extension/medial rotation/adduction —–> flexion/lateral rotation/abduction **sword and sheath
What is the D1 PNF pattern for lower extremity?
Flexion/lateral rotation/adduction ——-> extension/medial rotation/abduction
What is the D2 PNF pattern for lower extremity?
Flexion/abduction/medial rotation—–> extension/abduction/medial rotation
True or false:
Hand placement during PNF techniques should be on the side that the movement is to move towards for optimum stimulation of those muscles.
True
Where does rotation occur for PNF patterns?
Gradual throughout the middle 3/4 of the motion
What are the five types of PNF strengthening techniques?
1) Rhythmic initiation (have them point, push away, and them bring it back)
2) Rhythmic stabilization (have them maintain isometric contraction and you make it tough by hitting them)
3) Reversal of antagonist (D1 and D2 patterns)
4) Slow-reversal (max resistance in the antagonist pattern followed by resistance in the agonist pattern)
5) Slow-reversal-hold (same as #4 but with an isometric hold at the end of the motion)
What is the SNAP principles for strengthenig guidelines?
S-specific exercises
N-no pain
A-attainable goals
P-progressive overload
What is the SAID principle of specific exercises?
S- specific
A- adaptations to
I- imposted
D- demands
After how many weeks of strength rehab do you typically see a plateau in strength gains by the patient?
12 weeks
