Strength Endurance Flashcards
therapeutic exercise definition
Systematic performance or execution of planned physical movements, postures or activities intended to enable pt. / client to:
Remediate or prevent impairments
Improve, restore or enhance physical function
Prevent or reduce health-related risk factors
Optimise overall health status, fitness or sense of well-being (APTA, 2001)
muscle strength
is the ability of the skeletal muscle to develop force for the purpose of providing stability and mobility within the musculoskeletal system so that functional movement can take place
factors determining muscle strength
No. / size of motor units activated Cross-sectional area Type of contraction Length of muscle Speed of contraction Age / fitness of subject
endurance
- ability to perform repeated contractions against a less-than-maximal load / to continue a particular task accurately for a prolonged period of time
endurance is influenced by
Strength Neuromuscular skill Fatty tissue Circulatory/respiratory Lactic acid tolerance
types of exercises
(passive)
assisted exercise
free active exercise
resisted exercise
passive movement
Movement produced entirely be an external force with the absence of voluntary muscle activity on behalf of the patient
who/what supplies force isn passive exercise
force supplied by physio / machine (Continuous Passive Machine - CPM)
assisted active exercise
Movement is produced in part by an external force but is completed by use of voluntary muscle contraction
free active exercise
Movement produced solely by use of the individual’s voluntary muscle action
Used as strengthening for grade 2 and above (Oxford scale) or to mobilise structures
resistance exercise
Any form of active exercise in which dynamic or static muscle contraction is resisted by an outside force applied manually or mechanically
Rehabilitation, injury prevention and training
strengthening principles
Specific exercises (SAID principle: Specific Adaptations to Imposed Demands)
No pain
Attainable goals
Progressive overload
progression
– ‘act of moving forward or advancing toward a specific goal’
If muscle performance is to improve what type of load must be applied
a load that exceeds the metabolic capacity of the muscle must be applied
PRE
→ Progressive Resistance Exercise
repetition maximum
the maximum amount of weight a muscle can lift for that specified number of repetitions
uses of repetition maximum
Document a baseline measurement
Identify an exercise load (weight) to be used during ex for specified no.’s reps
intensity
load / amt of resistance (%1RM)
strength form
high force / low reps
endurance form.
low force / high reps
what must be taken into consideration with repetition maximum
Volume – no. of reps/sets
Frequency – no. of days per week
Duration
Rest
2 types of methods of giving resistance to muscle work
manual resistance
mechanical resistance
manual resistance
Therapist / self resistance
Other person applies resistance diagonal patterns (Proprioceptive Neuromuscular Facilitation-PNF)
examples of mechanical resistance
Suspension therapy Free weights Pulleys Springs Theraband Isokinetic equipment
advantage to manual resistance exercise
Most effective in early rehab
Transition from assisted to mechanically resisted
Resistance adjusted thro’ ROM – ‘ more finely graded’
Muscle works max thro’out ROM
ROM controlled by therapist
manual resistance guidelines
Adjustable plinth
Assume position close to pt to avoid stresses on back & maximise control of extremity
Wide base of support
how do we apply manual resistance and stabilisation
Stabilise proximal attachment of contracting muscle, while applying resistance distally to moving segment
Grade & vary resistance to equal abilities of pt
Smooth, controlled mvmts
verbs to resist isometric contractions
‘hold’ / ‘don’t let me move you’ / ‘match my resistance
verbs to resist concentric contractions
push or pull
verbs to resist eccentric contractions
‘slowly let go as I push or pull you’
disadvantages of manual resistance
Load is subjective Amt resistance limited to strength of therapist Little value for strong m’s Cannot be performed independently by pt Impractical for endurance
advantages of mechanical resistance
Establishes quantitative baseline
Intermediate / advanced phase of rehab
Heavy loads can be used
Adds variety to resistance program
disadvantage of mechanical resistance
Not appropriate when m’s weak or soft tissue in early stage of healing
Max loading at one point in ROM (constant resistance)
Expense for purchase / maintenance
when would suspension be used
Early rehab, m’s 2-3/5
suspension
Parts of the body are supported in slings and elevated by the use of variable length ropes fixed to a point above the body
Suspension frees the body from friction → permits free mvmt without resistance
elements of suspension
Fixed point + suspensory unit (sling & adjustable rope)
types of fixation
vertical
axial
free weights
vertical fixation
Rope fixed vertically above centre of gravity of part to be suspended (junction upper & middle third)
use of vertical fixation
used for support
axial fixation
Ropes attached to ‘S’ hook which is fixed to point immediately above centre of joint to be moved
If resistance is required, whole fixed point moved away from m’s which require resistance
free weights
dumbbells barbells cuff weights weighted vests sandbags
why is patient position important and give example
When the pull of gravity is perpendicular to the lever arm, resistance is at its greatest
Choose optimum position for ex
characteristics of exercise pulley unit
Constant load imposed → maximally challenges the contracting muscle at only one portion of ROM when pt in particular position
advantages of exercise pulley unit
Exercises can be set up in many positions
Dynamic, non-weight bearing positions
Stabilising m’s groups recruited
Resistance ↑small increments
factors to take into consideration when applyingof bands
grade length securing setting up progression
advantages of elastic resistance bands
Portable, relatively inexpensive, ideal HEP
Not gravity dependent → versatile, ex’s in many combinations of mvmt patterns
Moderate to fast velocities safe, inertia of moving wt does not have to be overcome
disadvantages of elastic resistance bands
Refer to table for quantitative info about level of resistance
Difficult to select grade initially
No source of stabilisation, pt use muscular stabilisation
advantages of weight stack machines
Allows progression
Puts user in correct position
Suitable for many muscle groups
Safe for power training
disadvantages of weight stack machines
Not accessible to all
Expensive
Not suitable for frail
Difficult to use with wheelchairs
advantages of air pressure or hydraulic machines
Similar to weight stack machines except that the weight can be more finely tuned
disadvantages of air pressure or hydraulic machines
Similar to weight stack machines but more expensive
advantage of isokinetic training
Isokinetic exercise offers the advantage of a variable resistance which allows the development of maximum effort by the performance throughout full ROM
Equipment for Closed Chain Training
Weight bearing postures Full / partial body wt Total gym – multipurpose ex system Balance boards Slide boards
traits of Reciprocal Exercise Equipment and its purpose
Low-intensity, high repetition resistance training to increase muscular endurance and reciprocal co-ordination of UL / LL
Reciprocal Exercise Equipment for warm ups and cool downs
Portable resisted reciprocal units
Stair-stepping machines
Cross-country ski machines
Upper extremity ergometers
examples of dynamic stabilisation
swiss balls/foam rollers
types of muscle activity
isometric
dynamic
isotonic
isokinetic
traits of isometric training
Static contractions
No change in muscle length
No external work
Maximal or submaximal contraction
isotonic muscle activity
– concentric & eccentric Dynamic contractions Change in length External work Length tension
advantages of isometric strength training
Little or no equipment required
Little danger of causing joint irritation
Can be performed on any muscle
Muscle atrophy is retarded in the case of an immobilised limb
Easy to learn
disadvantages of isometric strength training
Strength increases are specifically at the angle of the joint during exercise
Limited patient feedback - impact on patient motivation
Muscle endurance not enhanced
Eccentric contractions do not occur
advantages isotonic strength training
Strength develops throughout ROM, although not maximally at all points in the range i.e. inner / middle / outer
Motivation by achievement
Enhanced muscle endurance
Eccentric and concentric components
disadvantages isotonic strength training
Muscle may be loaded in weakest part of range
Momentum of weight
Equipment can be expensive
Space requirements
what advantage does isokinetic training offer you?
Isokinetic exercise offers the advantage of a variable resistance which allows the development of maximum effort by the performance throughout full ROM
advantages of kinetic strength training
Maximum overload of muscle throughout ROM
Resistance accommodates to weaker part of range
Exercise at varying speeds
disadvantages of kinetic strength training
Equipment is expensive
Trained personnel to operate and maintain equipment
Time consuming if > one muscle
