Muscle Waekness

Question 1

Rehab physios

Answer 1

Rehabilitation physiotherapists aim to strengthen retrain and redevelop muscles and neural connections

Question 2

Primary empowerment of the UMN results in…..

Answer 2

Loss of organist motor neurons

Reduced firing rate of Agonist motor units

Atrophy of fast contracting fibress

Hypertrophy of slow contracting fibres

Question 3

Primary empowerment of the UMN causes

Answer 3

Weaker contractions

slowed activation

delayed relaxation times

Question 4

Secondary muscular adaptations include….

Answer 4

Could be preventable

Decreased muscle length volume and cross-sectional area

Loss of sarcomeres

Remodelling of connective-tissue

Thickened perimysium and endomysium

Question 5

Ageing in muscle is characterised by

Answer 5

Reduced number of motoneurons

Loss of muscle fibre is

Atrophy a fast contracting fibres

Age related atrophy and deconditioning

Question 6

Aim of therapists in rehabilitation

Answer 6

Optimise motor function

Prevent the cycle of weakness – use -weakness that can eventually lead to muscle and joint contracture and irreversible mobility

The program is intended to….

Increase muscle contractility
Improve ability of muscles to generate time force production
Preserve or increase muscle compliance
Maintain or improve exercise capacity/aerobic fitness

Question 7

Strength

Answer 7

Ability of the muscle to overcome a Force or resistance in one effort

Amplitude of peak force

Resistance increases this

Question 8

Power

Answer 8

Amount of force produced per unit time ability to Produced peak force rapidly

Alter load and speed

Question 9

Endurance

Answer 9

Sustain contraction over a long period of time

Repetitions

Question 10

Progressive resistance training

Answer 10

Improves muscle force generation in numerous neurological conditions its recommended in clinical management e.g. MS Parkinson‘s

Want to overload muscle = stimulus for neural muscular increase strength

Question 11

Progressive resistance training

Evidence

Answer 11

Muscle specific priorities can result in strength gain without increasing hypertonia David et al 2012 Parkinson‘s

Grade resistance to suit ability

Start by training at submaximal loads 60–70% of rep max

Weak muscles = select muscle activation counterbalance gravity assisted starting positions feedback

Add load of resistance exercise machines inclines bodyweight

Question 12

Progressive resistance training

Neurological function

Answer 12

Single joint open chain exercises promote contractility but after certain point task specific multi joint close chain exercise seems to be more appropriate and the practice of complex multi joint movements are critical for improving functional performance

Resistance training with a functional basis is associated with improved functional outcomes and reduction of disability status

Task specific training

Question 13

How much practice is optimal for neurological adaptations

Answer 13

Intensity = training hours but the number of repetitions of purposeful movement performed within a single training session is really reported and the optimum number of repetitions remains unclear

Create the number of repetitions to sit there ability of patient

In order to calculate repetition rate observe maximum number of continuous repetitions achieved until mild muscle fatigue = one set

Short break then patient repeat and. I am for continuous repetition to the point of fatigue normal breathing rate should be maintained

Increased frequency and intensity improves outcomes within the first six months after/45 minutes of physiotherapy a day

Question 14

Promoting intensity of practice

Answer 14

Create a stimulating learning environment with opportunities to practice

Supervised practice

Self monitor e.g. home exercise program and practice areas in a rehab unit

Group practice

Circuit training

Question 15

Physical activity

Answer 15

Making functional activities more cardiovascular e.g. taking the stairs walking faster

150 minutes of moderate exercise or 75 minutes of vigourous exercise per week but those with the neurological disability are in active and they need to be more physically active to improve their condition

Question 16

Summary

Answer 16

Progressive strength training should be included in rehab program is for those with nuerological weakness

Strength training should be task specific

Promote exercise intensity to the point of muscle fatigue educate the patient and practice

Grade the resistance a number for a petitions to sit there ability of the individual e.g. 60 to 70% of 1RM

Consolidate and refined scale performance by practising in different Contexts

Explore potential barriers to physical exercise and promote physical activity 150 minutes of moderate activity a week