Strengthening Flashcards
Types of patient populations that may present with muscle weakness
- Neurological Conditions (Central adn peripheral)
– Ex: Central - TBI, Stroke, Peripheral - Ulnar neuopathy, severed nerve - Any period of immobilization
– EX: Femur Fracture -> lower limb weakness - Specific injury to the muscle itself, now healed
– Ex: Hamstring strain, Ligament Tear - Any surgery where the incision is through the muscle
– Ex: Scope through vastus medialis, TKA - quad weakness - Any metabolic disease that leads to muscle disuse or atrophy
Input -> Output -> Return to Function Triangle
When prescribing exercise we cannot forget about ____ of motion and ____ control
- quality
- motor
Common Examination findings associated with Diminished Force Production
- Subjective:
– Symptoms aggravated with ACTIVE motions especially with increased resistance or load
– DESCRIBES WEAKNESS - FUNCTIONAL: Altered movement patterns during functional activities to compensate for muscle weakness (ex: someone with weak quads on the right may shift weight onto the left when sitting in a chair)
- AROM: Impaired QUALITY AND QUANITY of motion
- PROM: May have GREATER PROM than AROM if significant weakness
- End range overpressure: No significant findings
- Palpation: Associated tenderness of weak muscles
- Motor: Weakness and/or pain with MMT
When creating strengthening programs for patients what do we need to remember?
- Take there current status and create a plan to get to acheivable goals.
- Based on this you create appropriate exercise dosage and functional retraining
What are some questions that can guide your thinking for muscle weakness?
Dosage - Muscle Weakness - What to consider?
- Disease/injury/other treatments
- Specificity of training - S.A.I.D. principle
- What’s the objective? Function?
- Optimal load of the tissue
- Pt age and/or previous activity level
- Personal contextual factors: motivation, fear and other psychosocial aspects
Types of Muscle Strengthening to enhance force production
- Isometrics
- Manual resistance exercise
- Isotonic exercise (concentric and eccentric)
- Functional training
Concentric - definition
tension of muscle (force production) > external resistance (muscle shortening)
Eccentric - definition
tension of muscle < external resistance (muscle lengthening)
Things to consider with isotonic exercise
- Internal and external moment arm
- Muscle length
- Constant vs. variable loads
- Eccentric vs. concentric contraction
- Open chain vs. closed chain exercises
- Use of weight machines vs. use of free weights
- Speed of contraction
When considering moment arms with exercises, what do you need to think about?
- Consider the muscle moving and the placement of the resistance
Ex: Bicep Curl - Greatest internal (muscle) moment arm is at 90 degrees
- Greatest external (weight) moment is at 90 degrees
How does the external moment arm change the bicep curl?: weight vs theraband
Weight: Greatest moment at 90
Theraband: Greatest moment at the top of the bicep curl (Muscle is weakest and shortest here
Why is the length tension curve important for exercise development?
- It is the optimal position for active force production
- Example: Bicep Curl at 90 degrees has the most overlap of myosin and actin
Constant vs Varibale resistance
Constant:
* Resistance constant through ROM
* Ex: Hand weights, Cable columns, weight machines
Variable
* Resistance changes throughout the ROM
* Ex: Resistance bands
