strength and endurance Flashcards
what is the definition of therapuetic exercise?
- execution of planned physical movements, postures or activities intended to enable the client to
- prevent impairments
- improve, restore or enhance physical function
- optimise overall health status, fitness etc
what is muscle strength?
- muscle strength is the ability of the skeletal muscle to develop force for the purpose of** providing stability and mobility** within the MSK system **so that functional movement can take place **
- capacity to exert force and the ability to do work against resistance
what are examples of factors that determine muscle strength?
- **age / fitness **of subject
*** psychological factors ** - strength or stiffness of connective tissue
- type of contraction - eg eccentric creates more force
- **length of muscle **- rememeber optimal length produces max force
- **speed of contraction **- depends on eccentric and concentric
- no and size of motor units activated
- **cross sectional area **of muscle - ie no of sarcomeres
what is endurance?
- the ability to perform** repeated contractions against a sub maximal load** or to continue a particular task accurately for a **prolonged period of time **
what is endurance influenced by?
- strength
- fatty tissue
- circulatory / respiratory system
- lactic acid tolernace
- body type
- gender
- age
what is ‘passive’ exercise?
give example
- movement produced entirely by an external force with the absense of voluntary muscle activity performed by the patient
- ie patient is not contracting muscle themselves
- eg continous passive machine
what is assisted active exercise?
- movement is produced in part by an external force but is complemented by use of voluntary muscle contraction
- ie the patient performs the exercise to the best of their ability, only requiring the assistance of a helper to complete the full ROM, or reduce resistance by support etc
what is free active exercise & what number on the oxford scale is it used for?
- movement that is produced solely by use of the individuals voluntary muscle contraction
- used as strengthening for grade 2 and above or to mobilise structures
what is resistance exercise?
- any form of active exercise in which dynamic or static muscle contraction is resisted by an outside force applied either **manually or mechanically **
why is exercise safety extremely important for rehab?
- we want to prevent any further injury
- the patient needs to know exactly what they are doing - correct form etc
- environment must be safe - eg no weights on floor or fall risks etc
what is the acronym for remembering the strengthening principles?
- SNAP
what are the strengthening principles?
SNAP
- S- specific exercises - adaptions are specific to the muscles trained
- No pain
- Attainable goals - realistic and achievable goals
- P- progressive overload
what is the progressive overload principle?
- progression - act of moving forward or advancing toward a specific goal
- a load that exceeds the metabolic capacity of the muscle must be applied - ie the muscle must be challanged
- gradually increasing the weight, frequency or intensity of training
what is the repeptition maximum (RM)?
- The maximum amount of weight a muscle can lift for that specified number of repetitions
compare 1RM vs 10RM
- 1RM - max weight that can be lifted once
- 10RM - max weight that can be lifted ten times
what kind of intensity and volume are needed in strength vs endurance training?
- strength - high force / low reps
- endurance - low force and high reps
what are examples of manual resistance?
- therapist gives resistance
- other person applies resistance
what is proprioceptive neuromuscular facilitation (PNF)?
- a stretching technique utilised to to improve muscle elasticity - has a positive effect on AROM and PROM
what are examples of mechanical resistance?
- suspension therapy (all or part of the body is suspended in air by ropes and slings)
- free weights (free objects that arent attached to anything)
- pulleys
- springs
- theraband
- isokinetic equipment
- aquatic physiotherapy
what are advantages of manual resistance exercise applied by the physio?
- most effective in early rehab
- ROM is controlled by the physio
- useful for dynamic and static strengthening
- muscle works max throughout ROM
what are the guidelines for the physio for manual resistance?
- adjustable plinth
- assume position close to pt to avoid stresses on back
- wide base of support
- stabilise proximal attachment of contracting muscle while applying resistance distally to moving segment
what are verbal commands that the physio should use for resisting isometric, concentric and eccentric exercise?
- isometric - hold / dont let me move you
- concentric - push or pull
- eccentric - slowly let go as i push or pull you
what are the disadvantages of manual resistance supplied by the physio?
- the load is subjective - depends on the strength of the physio
- cannot be performed independently by patient
- labour and time intensive for therapist
what is self resistance?
- when the patient** uses their own body weight **
- no equipment
- can be performed anywhere
what are the advantages of mechanical resistance?
- intermediate or advanced phase of rehab
- heavy loads can be used
- practical for muscular endurance
- establishes a quantitative baseline - ie what weight can they use etc
- HEP - home exercise program
what are the disadvantages to mechanical resistance?
- not appropriate when muscles are weak or soft tissue is in the early stage of healing
- max loading at one point in rom - constant resistance
- expensive for purchase and maintenance
what is suspension therapy?
- parts of the body are** supported in slings and elevated** by the use of variable length ropes fived to a point above the body
- frees the body from friction
- permits free movement without resistance
- used in early rehab
what are the 2 types of fixation for suspension therapy?
- vertical
- axial fixation
Describe **vertical fixation **for suspension therapy
- rope is fixed vertically above the centre of gravity of part to be suspended
descrive** axial fixation** in suspension
- rope is attached to ‘S’ hook which is fixed to a point immediately above the centre of joint to be moved
what are examples of free weights?
- dumbbells
- barbells
- cuff weights
- weighted vests
- sand bags
what is the optimal patient position for free weights?
- when the pull of gravity is perpendicular to the lever arm, resistance is ar its greatest
what are the characteristics of an exercise pulley unit?
- constant load imposed - maximally challeneges the contracting muscle at only 1 portion of rom when patient is in particular position
what are advantages and disad’s of exercise pulley systems?
advans - exercises can be set up in many positions
disadvans- may only allow limited progression
what are the advantages of using a theraband?
- inexpensive
- ideal for home exercise program
- not gravity dependent - exercises in many combinations of movement patterns
- moderate to fast velocities are safe
what are the disadvantages to using therabands?
- difficult to select grade initially
- material fatigue
- allergy to latex
- no source of stabilisation
what are the advantages and disadvans of weight stack machines?
- advans - allows progression, puts user in correct position, suitable for many muscle groups
- disadvantages - expensive, not accessible to all, difficulty to use with wheelchairs
what are hydrualic or air pressure machines?
- Hydraulic resistance exercise equipment uses cylinders filled with a liquid to generate resistance.
- The resistance generated is equal to the force applied across the full range of movement. This equipment is usually very low cost.
what is isokinetic training?
- Isokinetic training is a type of exercise training that uses a special machine.
- The exercise machine creates different levels of resistance. That way, your movements are at a constant speed, no matter how much force you apply.
- Whatever your strength level is, the machine can always match the amount of force you apply.
what are closed chain exercises & give examples ?
- the segment furthest away from the body** is fixed to an object **
eg squat, deadlift, lunges, leg presses
what are open chain exercises?
- the segment furthest away from the body (eg the foot) is free and not fixed to an object
- are good for isolating movements
- eg seated knee extension, glute kick back, seated leg curl
what is isometric contraction?
- static contraction - no movement
- no change in muscle length (iso metric = same length)
- no external work
- maximal or submaximal contraction
what is isotonic (concentric and eccentric) muscle contraction?
- dynamic contractions - there is movement
- change in length - concentric involves shortening and eccentric involves lengthening of muscle
- external work involved
- length tension - greatest force produced in mid range of movement
- muscle is weaskest at extremeties of range
what are advantages of isometric strength training?
- little or no equipment needed
- little danger of causing joint irritation
- can be performed on any muscle
- easy to learn
what are the disadvantages of isometric strength training?
- limited patient feedback
- muscle endurnace do not occur
- not related to function
- strength increases are specifically at the angle of the joint during the isometric exercise - not going through the full rom - only really within 20 degrees
what are the advantages of isotonic strength training?
- strength develops maximally throughout the ROM, although not maximally at all points in range eg inner, outer etc
- enhanced muscle endurance
- eccentric and concentric components
- equipment is easy to use
what are the disadvantages of isotonic strength training?
- equipment can be expensive - eg weights
- difficult to control exercise
- there is a danger of overloading or overexerting the muscle
- muscle may be loaded in the weakest part of range
what are advans and disadvans of isokinetic strength training?
- advans - max overload of muscle throughout ROM, exercise at varying speeds, accomocates to pain and fatigue
- disadvans- equipment is expensive, need a trained person to operate equipment and also time consuming
