Week 4 - Problem Solving: How to Improve Strength Flashcards
the highest amount of effort exerted by the muscles of the body in order to overcome the most resistance in a SINGLE effort.
muscular strength
the ability of a muscle or group of muscles to sustain repeated contractions against a resistance for an extended period of time.
muscular endurance
ability of muscles to produce force in or at a given time.
muscle power
proportional to the speed at which you can apply the maximal force
muscle power
Name 4 assessments used for determining strength.
- MMT
- Functional Muscle Strength
- Dynamometer
- Pinch Gauge
When does muscular strength improve?
when muscle is stressed (so that an increase # of motor units are recruited).
Muscles must be stressed to the point of ____ in order to ____ and strengthen.
fatigue, hypertrophy
Name 5 exercised parameters that can be manipulated to improve strength.
- type of muscle contraction
- intensity or load
- duration of contraction
- rate or velocity of contraction
- frequency of exercise
Name 2 aspects of using occupations to increase strength.
- may be sufficient for strengthening
- may be more motivating
Name 2 aspects of using exercise to increase strength.
- can be specifically targeted.
- may be “occupation” for some
the systematic performance of planned physical movements, postures, or activities
therapeutic exercise
How does therapeutic exercise differ from traditional exercise programs?
they are designed by rehab professionals to achieve MEASURABLE outcomes.
Describe general guidelines for therapeutic exercises during the acute management phase.
- minimize joint effusion and interstitial edema
- reduce pain
- AROM as tolerated.
Describe general guidelines for therapeutic exercises during the sub acute management phase.
- minimize joint effusion and interstitial edema
- reduce pain
- PROM
- early controlled mobilization (if tendons repaired)
- don’t forget “non-involved” joints.
Describe general guidelines for therapeutic exercises during the rehabilitation management phase.
- restore ROM, muscular strength, endurance
- prepare for return to work, ADLs, leisure
muscles move through ROM
isotonic exercises
Name the 2 types of isotonic contractions.
- concentric
- eccentric
Name the 2 types of isotonic strengthening.
- Delorme technique of PROGRESSIVE resistive exercise
- Oxford technique of REGRESSIVE resistive exercise
Does active range alone strengthen a muscle?
No
Delorme technique
-start low and go up with weights - progressive
Oxford technique
-start high and go up with weights.
static muscle contraction with little/no change in muscle length
isometric
maximum contraction at a constant speed through full ROM usually done with Cybex machine; matched resistance
isokinetic
form of specificity training facilitating rapid strength and endurance, calls into play type II fast twitch muscle fibers.
plyometric
Name 2 contraindications for resistive exercise.
- pain
- inflammation
Name 3 purposes for resistive exercise.
- to strengthen
- to increase endurance
- to increase power
Name 2 precautions for resistive exercise.
- cardiovascular
- fatigue
Describe isometric resistive therapeutic exercise.
- used when muscle grade is zero-trace.
- pt. is asked to hold position 10 times.
- rest in btwn
- OT increases durations of contraction (“hold”) when pt. improves
- pt. may need to be in a gravity eliminated position.
- exercise in which movement is performed by the voluntary effort of the pt. with ASSISTANCE of an external force to complete the ROM.
- assistance given by OT, pt. equipment.
Active Assisted ROM exercise (AAROM)
Describe isotonic active-assistive ROM therapeutic exercises. (when is it used, how is it used, etc.)
- when muscle grade is poor (-) to fair (-).
- pt. moves actively as far as he or she can, OT helps complete the movement.
- can be either concentric or eccentric
- different from PROM bc pt. does some of the muscle contraction.
Describe isotonic active ROM therapeutic exercises (when is it used, how is it used, etc.)
- when muscle grade is poor - fair.
- patient moves through full ROM
- may need to be in gravity free (eliminated) position.
- ex: 10 reps x 3 sets
- can give them more repetitions but not weight
- take break in btwn sets
Describe isotonic active resistive/progressive resistive exercise (PREs) (when is it used, how is it used, etc.)
- muscle grade is poor (+) - good (+)
- pt. moves through full ROM with resistance
- repetitions may need to be increased
How can you change the resistance on a pronation/supination bar?
- add more weight
- change position of weights (changing resistance arm - move weights down towards middle = easier)
- muscle is maximally contracting at the same speed throughout the whole range of the related lever.
- requires the use of special equipment to produce an accommodating resistance.
isokinetic contractions/exercise
How should resistance/repetitions be used to strengthen?
high resistance, few repetitions
How should resistance/repetitions be used to improve endurance?
light resistance, many repetitions (drawback: overuse injury)
How should resistance/repetitions be used to improve power?
- muscle works dynamically against resistance within a specified period.
- can use plyometric exercise, usually for lower extremities.
- exercises that are explosive, fast-acting movements to develop muscular power and to improve overall speed.
- muscles exert maximum force in the shortest amt of time possible
- generally used for athletes, fitness training.
plyometric exercise
Describe the Delorme technique in numbers.
- Determine the 10 RM
- 10 reps at 50% of 10 RM
- 10 reps at 75% of 10 RM
- 10 reps at 100% of 10 RM
Describe the Oxford technique in numbers.
- Determine the 10 RM.
- 10 reps at 100% of 10 RM
- 10 reps at 75% of 10 RM
- 10 reps at 50% of 10 RM
the weight an individual could lift 10 times before temporary failure of the muscle occurs
10-rep maximum (10 RM)
Is the Oxford or Delorme method better?
both work - one is not necessarily better than the other.
Name 6 clinical indications for eccentric exercise.
- mechanical, reproducible joint pain.
- unidirectional joint crepitus or pain arc
- deconditioned or low endurance pt. (ex: recent distal radius fracture)
- plateaus in strength gains
- tendonitis
- late-stage rehab and performance training
Name 5 types of external resistance.
- gravity
- cuff weights
- dumbbells
- surgical tubing (Elastic resistance - ex: theraband)
- manual applied resistance
ability of muscle group to perform repeated contractions against a load
endurance
Impaired ____ can lead to limits in IADLs.
endurance
- ability of cardiovascular system (heart, lungs, blood) to take in, extract, deliver and use oxygen to remove waste products
- supports performance of repetitive activities using large muscle groups over time ex: jogging, walking
cardiovascular endurance
What can happen to individuals with deficits in both muscular and cardiovascular endurance?
deconditioning or loss of general endurance
Name a modality to help muscle retraining, strength.
NMES (neuro-muscular electrical stimulation)
