1. Intro To Exercise Principles
Kinesiotherapy Clinical Training
Exercise Principles 1

2.
SAID Principle
• SAID principle (Specific Adaptation to Imposed Demands) – specific
adaptations take place in the body in response to specific types of stimuli.;
a certain exercise or type of training produces adaptations specific to the
activity performed, and only in the structures that are stressed by the
activity.
• The SAID principle is the key factor in determining the response that
will occur as a result of an exercise application.
• Persons who train primarily by running long distances become
more efficient distance runners, their bodies generally become
leaner, aerobic metabolism is enhanced and slow twitch fibers are
enhanced.
• Persons who train primarily by lifting heavy weights for low
repetitions become stronger, their bodies becomes more muscular,
and fast twitch muscle fibers are enhanced.
Exercise Principles 2

3. Kinetic Chain Model
• Kinetic Chain - A biomechanical principle that means bones, joints,
muscles, and ligaments work together (as in links in a chain) to
accomplish functional movement.
• Weakness in one link of the chain can alter the function of the total
movement pattern.
• Example – during the act of performing a squat, the torso, knee, and
hip motion are all linked.
• Open Kinetic Chain Exercise – movement patterns in which the distal
segment (hand or foot) is free to move in space.
• Movements occur distal to the moving joint and occur primarily in
non-weight bearing positions.
• Examples – leg extension, leg curl, dumbbell curl or press, swing
phase of gait
Exercise Principles 3

4.
Kinetic Chain Model
• Closed Kinetic Chain Exercise – movement in which the distal segment (hand
or foot) is fixed to a solid surface.
• Movements are performed primarily in weight bearing positions with the
trunk and proximal segments moving over the fixed segment.
• Examples – push up, chin up, squat, lunge, climbing stairs, stance
phase of gait
• During the early stage of rehabilitation when weight bearing is generally
limited, open chain movements are the primary focus.
• Strengthening exercises during this phase are focused on the joints that
are proximal to the injury.
• As stability and mobility are gradually restored, the emphasis shifts
primarily to weight bearing activities which are closed chain.
Exercise Principles 4

5. Resistance
Exercise
• Resistance
Exercise
-­‐
any
form
of
active
exercise
in
which
a
dynamic
or
static
muscle
contraction
is
resisted
by
an
outside
force.
• The
resistance
can
be
applied:
• Manually
(MR
exercise)
-­‐
a
type
of
active
exercise
in
which
resistance
is
provided
either
dynamically
or
statically
by
another
person.
• Mechanically
-­‐
a
type
of
exercise
in
which
resistance
is
provided
by
an
external
apparatus
(ie.
barbells,
weight
machines,
elastic
resistance,
isokinetic
device).
• Resistance
exercises
are
classiCied
as
either:
• Isolated
(single
joint)
-­‐
exercises
that
recruit
smaller
muscle
areas
and
involve
only
one
primary
joint.
• Barbell
curls
–
involve
the
elbow
joint
only.
• Leg
curls
–
involve
the
knee
joint
only.
Exercise Principles 5

6. Resistance Exercise
• Compound (multi-joint) movements - exercises that recruit large
muscle areas and involve 2 or more primary joints.
• Bench press – involves the shoulder and the elbow joint.
• Barbell squat – involves the hip and knee joint.
• Plyometric Exercise – an exercise activity in which a resisted eccentric
muscle action is quickly followed by a rapid concentric muscle action.
• Jump off platform, land on floor, then quickly jump into the air.
• Isokinetic Resistance Exercise – the speed of the movement is controlled
thus allowing accommodating resistance through the complete ROM.
• A special rate limiting device is required to perform isokinetic
contractions.
• There is no eccentric resistance.
• Aquatic resistance movements are a form of isokinetic exercise.
Exercise Principles 6

7. Resistance Exercise
• Repetitions (reps) – the number of times a specific movement is repeated or
the number of muscle contractions performed against a level of resistance.
• Sets – a given number of repetitions.
• Repetition Maximum (RM) – the maximum amount of weight a person can
move through a range of motion for a given number of repetitions.
• Repetition Maximum (RM) examples:
• 1 RM = max weight that can be lifted for 1 rep
• 5 RM = max weight that can be lifted for 5 reps
• 10 RM = max weight that can be lifted for 10 reps
• Training loads are often assigned as a percent of the 1RM (60%, 70%,
80%, etc.) with the individual completing the max reps possible with
that assigned weight.
Exercise Principles 7

8. Resistance Exercise
• The RM selected for an exercise can range from 1-3 reps to 15 or more per
set depending on the specific goal for the client/patient.
• The number of sets performed per exercise can range from 1 to 6 or higher
• Positive results can be achieved with one set for persons who are
debilitated or unconditioned.
• As strength and adaptation occur, extra sets are added to elicit
continued improvements.
• Training Goals/Focus:
• Muscle Strength - - resistance applied to a muscle is increased
progressively.
Exercise
Principles
8

9. Resistance Exercise
• Training Goals/Focus:
• Muscular Hypertrophy - an increase in the size of a muscle’s mass due to
an increase in the length and thickness of each muscle cell without any
increase in the number of cells.
• Muscular Endurance - increase in length of time that a muscle contraction
is sustained, or increase in total number of repetitions performed.
• Target training ranges:
• Strength = 4-6 reps (3-4 minutes rest between sets)
• Hypertrophy = 6-12 reps per set (30-60 seconds rest between sets)
• Muscular Endurance = 12 reps and higher per set (30-60 seconds rest
between sets)
Exercise
Principles
9

10.
Progressive Resistive Exercise
• Progressive Resistive Exercise (PRE) – a systematic increase in
resistance applied to a working muscle, to continually accommodate that
muscle’s force production potential.
• Methods of PRE application include:
• Increasing the amount of weight lifted for a given RM.
• Increasing the number of reps that a weight can be lifted.
• Increasing the number of sets performed.
• Decreasing the time required to perform a given workload volume.
• To determine whether muscles are strengthened by a specific exercise:
• Determine the movement patterns that occur during the performance
of the exercise.
• Determine the muscles that control the movement patterns that are
occurring.
Exercise Principles 10

11.
Components of Exercise Prescription
• Intensity – the amount of resistance imposed on a contracting muscle
during each repetition.
• A person who can bench press 10 reps with 100 pounds progresses to
bench pressing 10 reps with 105 pounds
• Volume – the total of repetitions and sets of exercise performed during a
single exercise session.
• An increase from performing 5 sets of 10 push ups during a workout
session (50 total reps) to 5 sets of 12 (60 total reps).
• Frequency – the number of exercise sessions performed
over
a
given
period
of
time
(per
day
or
per
week,
etc.).
Exercise Principles 11

12. Components of Exercise Prescription
• Duration – the total number of weeks or months in which an exercise
session is carried out.
• Mode – the form or type of exercise, or the manner in which the
exercise is implemented.
• Progression – progressive overload can result from an increase in the
frequency, volume, or intensity of an exercise.
• One or more of these variables may be manipulated at one time.
• Reducing rest intervals between sets of an exercise can also
increase intensity.
Exercise Principles 12

13. Overload Principle
• For muscle performance to improve in strength or endurance, the muscle
must be challenged to perform at a level greater than that to which it is
accustomed.
• There must be an increase in either resistance (work load), work volume, or
intensity of effort.
• Methods of Overload Training:
• Numerous methods of overload training have proven to be effective.
• No specific method has emerged that is superior to the others.
• The therapist must determine the method that is most appropriate for
the needs of the client/patient.
Exercise
Principles
13

14. Delorme Method
• A systematic method of applying progressive resistive exercise.
• Classified as a light to heavy approach.
• Originally referred to as the Delorme-Watkins method.
• Both Delorme and Watkins were orthopedic surgeons who used
resistance training for faster recovery of their patients.
• Delorme Procedure:
• Determine the 10 RM for the client/patient.
• Perform 3 sets:
• 1st set – 10 reps at 50% of the 10 RM
• 2nd set – 10 reps at 75% of the 10 RM
• 3rd set – 10 reps at 100% of the 10 RM
• When 10 reps are exceeded on the 3rd set, establish a new 10 RM.
Exercise
Principles
14

15. Oxford Method
• Developed in England as an alternative to the Delorme method.
• Involves a heavy to light approach.
• Designed to accommodate the cumulative fatigue of each set of maximal
resistance.
• Oxford Procedure:
• Following a brief warm up, determine the 10 RM.
• Perform 3 sets:
• 1ST set – 10 reps at 100% of 10 RM
• 2nd set – 10 reps at 75% of 10 RM
• 3rd set – 10 reps at 50& of 10 RM
• When 10 reps are exceeded on the 1st set, establish a new 10 RM.
Exercise
Principles
15

16.
Single Set System
• Consists of one set of several different exercises, each selected for a
different muscle group.
• One or 2 warm up sets may be performed prior to the work set.
• Single set routines can meet the needs of persons on limited time
schedules, or for athletes involved in high intensity practice sessions.
• Often used for untrained clients/patients who have never done resistance
training; positive results can still be seen, at least initially.
• Several studies indicate that 1 set of 8 -12 reps (performed to voluntary
muscular failure following a warm up), is sufficient to cause gains in
muscular strength and hypertrophy.
Exercise
Principles
16

17.
Single Set System
• Further studies indicate that 1 training set per body part is effective during
the first several months of training, but over time, multiple sets need to be
introduced if gains are to continue.
Multiple
Set
System
• Historically, multiple set approaches consisted of 2 to 3 warm up sets
followed by several sets at the same resistance level.
• Today, numerous adaptations of multiple set approaches have been
developed.
• Numerous combinations of sets, repetitions, and resistance loads have been
found to be effective.
Exercise
Principles
17

18.
Multiple Set System
• One research study revealed that performing 3 sets of 10 repetitions without
going to failure enhances strength gains better than one set of 8 – 12 reps to
failure.
• Based on this premise, multiple set routines will increase muscular strength
faster than the single set routines.
• Most current research indicates that multiple set routines are more effective
than single set routines.
Exercise
Principles
18

19.
Circuit Training System
• Consists of a series of resistance exercises, with one exercise following
another, with minimal rest between sets (15-30 seconds max).
• A 10 to 15 RM workload is maintained for each exercise.
• Circuit training is time efficient and works well when large numbers of
people must be trained in a minimum amount of time.
• The major premise of circuit training is that it can simultaneously improve
muscular strength and aerobic endurance. However, circuit training :
• Does not result in aerobic conditioning equal to conventional aerobic
training.
• Is not as effective in developing strength as conventional methods.
Exercise
Principles
19

20.
Circuit Training System
• Circuit training can be a viable alternative for those with limited time to
exercise.
• Circuit Training program design
• Select a series of exercises that target all of the major muscle/joint
movements of the body.
• Avoid consecutive exercises that target the same area.
• Example - Arm curl, chin up, up-right row
• Keep rest between each exercise to a minimum (15-30 sec. max).
• The circuit can be repeated for one or more series as conditioning
improves.
Exercise
Principles
20

21. Elastic Resistance
• The use of rubber tubing, therabandTM , or other resistance modes that use
an elastic resistance component.
• Can be very useful in the initial stages of therapeutic exercise.
• Advantages:
• Versatile
• Inexpensive
• Adaptable to a wide variety of angles of application
• Joint trauma is minimized
Exercise
Principles
21

22.
Elastic Resistance
• Disadvantages:
• Quantitative measurement is difficult.
• Minimal resistance in the initial phase of the range.
• Elastic materials tend to denature and break down over time.
• Products are susceptible to tearing.
• Unique features:
• Resistance in the initial phase of the movement is minimal.
• Resistance increases progressively as the material is elongated.
• Resistance force is maximal when the material is angled 90 degrees
from the moving bone.
Exercise
Principles
22

23. Aerobic Exercise
• Aerobic Exercise - sub-maximal, rhythmic, repetitive exercise of large
muscle groups; the needed energy is supplied by inspired oxygen.
• Aerobic Endurance - improved by performing exercises that involve large
muscle groups at a percentage of one’s maximal aerobic power.
• Cardiopulmonary (cardiorespiratory, cardiovascular) Endurance - the
ability of the heart and lungs to take in and transport adequate amounts of
oxygen to the working muscle, allowing activities that involve large
muscle mass activity to be performed over long periods of time.
• Cardiopulmonary Conditioning – any rhythmic, continuous, large muscle
activity that promotes a simultaneous increase in heart rate and return of
blood to the heart.
Exercise
Principles
23

24. Aerobic
Exercise
• Maximal
Heart
Rate
-­‐
heart
rate
that
is
reached
at
the
maximum
level
of
physical
exertion.
• The
common
standard
used
for
setting
intensity
for
aerobic
conditioning.
• Exercise
prescriptions
will
range
on
average
from
60%
to
90%
of
max
heart
rate;
percentage
used
will
depend
on
the
client’s/patient’s
current
health
status
and
conditioning
level.
• Age
Predicted
Maximal
Heart
Rate
Method
• Subtract
the
person’s
age
from
220.
• Assign
a
%
of
that
number
as
the
target
heart
rate
to
maintain
during
a
period
of
aerobic
training.
• Example
–
client/patient
age
=
60
years
• 220-­‐60
=
160
• 70%
of
160
=
112
• 112
=
the
target
heart
rate
to
maintain
Exercise
Principles
24

25. Aerobic Exercise
• Arm exercise is associated with max heart rate of approx. 90% of leg
exercise.
• Therefore, when only upper body movements are used for aerobic
exercise, the formula is: 200 minus age.
• Example – Spinal cord injury patients, bi-lateral amputees or
those whose are restricted to a wheelchair.
• Karvonen Formula – a method of determining the target heart rate based
on a percent of the difference between the individual’s maximal and
resting heart rate or heart rate reserve.
(APMH) Age Predicted Maximum Heart Rate = 220 – age
(HRR) Heart Rate Reserve = APMHR – (RHR) Resting Heart Rate
(THR) Target Heart Rate = (HRR x Exercise Intensity) + RHR
BPM = Beats Per Minute
Exercise
Principles
25

26.
Aerobic Exercise
• Karvonen example:
APMHR = 220 – 30 = 190
HRR = 190 – 60 = 130
RHR = 60
THR = (130 X 70%) + 60 = 91 + 60 = 151 bpm
• Talk test – client/patient involved in an aerobic activity should be able to
carry on a conversation during exercise.
• This is a relatively safe level of aerobic exertion.
• As conditioning occurs, the level of exercise intensity should increase,
but conversation can be continued.
Exercise
Principles
26

27.
Aerobic Exercise
• Rate of Perceived Exertion (Borg Scale) - A subjective method of
determining exercise intensity in which the client/patient is taught to
estimate the work intensity level.
• Borg Scale – a numerical rank is assigned to various levels of perceived
exertion.
10 – maximal effort
7 – very strong effort
5 – strong effort
3- moderate effort
2- weak effort
0 – no effort
Exercise
Principles
27

28.
Aerobic Exercise Application
• Volume – 15 to 60 minutes on average, depending on the level of intensity.
• Frequency – 3 to 5 days per week.
• Duration – minimum of 8 weeks on average for conditioning effects to occur.
• Mode – Walking, running, bicycling, rowing, or any activity that involves
large muscle groups.
• Progression – as conditioning occurs, exercises of higher intensities will be
required to maintain target heart rates.
Exercise
Principles
28

29. Aerobic Training Methods
• Continuous Training – maintaining a fixed level of aerobic exertion over an
extended period of time.
• Example - maintaining a heart rate of 70% max during a 30 minute
exercise session.
• As conditioning occurs, the person will be able to cover increasing
distances while maintaining 70% heart rate for a 30 minute session.
• Interval Training –bouts of high intensity exertion are alternated with
periods of low intensive effort.
• The key to interval training is that the high intensive bouts should drive
the heart rate up to 90-95% of the maximal heart rate.
• During the lower intensity workout, the heart rate should recover to
within 60-70% of max heart rate.
• Example: bouts of all out sprints are alternated with bouts of jogging.
Exercise
Principles
29