2. DEFINITION
Resisted exercise is any form of
active exercise in which dynamic
or static muscle contraction is
resisted by an outside force
applied manually or
mechanically.
3. MUSCLE PERFORMANCE &
RESISTANCE EXERCISES
Muscle performance refers to the capacity
of a muscle to do work (force x distance).
3 elements of muscle performance –
strength, power & endurance – can be
enhanced by some form of resistance
exercises.
4. STRENGTH
Ability of a contractile tissue to produce
tension & resultant force based on
demands placed on the muscles.
Strength training –controlling heavy loads
(resistance) for a relatively lower number of
repetitions or a short period of time.
5. POWER
Muscle power is related to strength &
speed of movement & is defined as work
produced by muscle per unit time (force ×
distance/time).
Power training –
By increasing work of muscle for specific
time or reducing time for specific work of
muscle.
6. ENDURANCE
Muscle endurance is the ability to
contract repeatedly against a load,
generate & sustain tension & resist
fatigue over an extended period of
time.
Endurance training – low intensity
muscle contraction, large number of
repetitions for prolonged time period.
10. EXAMINATION & EVALUATION
Determine the baselines:
a. General physical examination
b. Strength: MMT, RM
c. ROM: Goniometry
d. Functional performance
Decide if strengthening is needed and
appropriate at this point
Periodic reassesment
11. APPLICATION
Warm up
Placement of resistance
Stabilization
Intensity of exs / amount of resistance
Volume / no of reps & sets & rest intervals
Verbal / written instructions
Monitoring the patient
Cool down
12. PRECAUTIONS
Overtraining
Overwork
Exercise induced muscle soreness –
Acute muscle soreness –
During or directly after strenuous exercise
Delayed onset muscle soreness (DOMS) –
DOMS begins to develop 12-24hrs after the cessation of
strenuous activity; intensifies & peaks 24-48hrs later
Can be prevented by gradual progression of intensity &
volume of resistance; warm up & cool down; slow
stretches before & after exercise
15. MANUAL AND MECHANICAL
RESISTANCE EXERCISES
Manual resistance:
Resistance is provided by hand.
Can be provided by a therapist or self resisted.
Can not quantify resistance
Useful for weak muscles in the early stages of rehab
or conditions which needs careful control.
Mechanical resistance:
Resistance is applied through the use of equipment
or mechanical apparatus.
Amount of resistance can be measured and can be
increased progressively.
Useful when strong exercises needed.
30. TYPES OF MECHANICAL RESISTANCE
Weights:
Sandbags, metal weights, medicine balls, weight
cuffs, dumbbells etc.
Weight and pulley circuit
Elastic resistive devices:
Spring, theraband, theratubes
Malleable resistance:
Putty, clay, wax, plasticines etc.
Water:
Hyrotherapy unit
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42. ISOMETRIC EXERCISES
(STATIC)
Sources of resistance –
Holding against force applied manually
Holding weight in particular position
Maintaining position against resistance of body
weight
Pushing or pulling immovable objects
Prevent or minimize muscle atrophy due to
external immobilization
Develop postural or joint stability
Improve muscle strength when dynamic activity
is not permissible
43. DYNAMIC EXS – CONCENTRIC &
ECCENTRIC
Resistance can be applied by –
Constant resistance (body wt/simple wt/ wt pulley)
Weight machine (variable resistance)
Isokinetic device (controls velocity)
Acts as a source of shock absorption during high
impact activities.
Essential component of rehabilitation & conditioning
program to reduce risk of muscle injury or re-injury.
44. DYNAMIC EXS – CONSTANT & VARIBLE
RESISTANCE
Dynamic constant external resistance exs (DCER)–
free weights like weight cuffs, Pulley system, torque arm
units.
Contracting muscle is challenged maximally at only one
point of ROM
Variable resistance exercise –
Specially designed resistance equipments imposes varying
levels of resistance to contracting muscle to load the muscle
more effectively at multiple points in ROM. Eg with elastic
tubes or bands or lever arm system.
Performed against manual resistance, a skilled therapist
can vary the force applied to the contracting muscle
throughout the ROM.
47. OPEN CHAIN & CLOSED CHAIN
EXERCISES
Functional activities & exc.’s are commonly
categorized as having weight bearing or non weight
bearing characteristics.
Also called as “open or closed kinetic chain”
Open kinetic chain refers to completely unrestricted
movement in space of a peripheral segment of the
body. (waving the hand, swinging the leg)
Closed kinetic chain movements – peripheral
segment meets with the considerable external
resistance. One joint motion is always accompanied
by adjacent joint motions.
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49. ISOKINETIC EXERCISES
Its a form of dynamic exs in which velocity of
muscle shortening or lengthening is
predetermined & held constant by a rate limiting
device known as isokinetic dynamometer.
Characteristics –
Constant velocity
Range & selection of training velocity
Specificity of training(speed specific)
Compressive forces on joints
Accommodation to fatigue
Accommodation of painful arc
53. PROGRESSIVE RESISTANCE EXERCISE
PRE is a system of dynamic resistance training with
constant external load to contracting muscle by
some mechanical means & incrementally
increased.
RM (repetition maximum) – basis for determining &
progressing the resistance.
Beneficial in variety of pathological conditions
(muscle injuries, osteoarthritis, osteoporosis,
hypertension, diabetes, COPD, etc)
Various regimens are:-
Delorme
Oxford
Macqueen
DAPRE
57. SETS REPETITIONS AMOUNT OF RESISTANCE
1 10 10 RM
2 10 10 RM minus 1 lb (453g)
3 10 10 RM minus 2 lbs
4 10 10 RM minus 3 lbs
5 10 10 RM minus 4 lbs
6 10 10 RM minus 5 lbs
7 10 10 RM minus 6 lbs
8 10 10 RM minus 7 lbs
9 10 10 RM minus 8 lbs
10 10 10 RM minus 9 lbs
100 lifts 5 times weekly
Progress 10 RM daily
58. MAC QUEEN REGIMEN
SETS REPETITIONS
AMOUNT OF
RESISTANCE
1 10 100% of 10 RM
2 10 100% of 10 RM
3 10 100% of 10 RM
4 10 100% of 10 RM
40 lifts 3 times weekly
Progress 10 RM every 1-2 weeks
59. DAPRE REGIMEN
Daily adjustable progressive resisted exercises
More systematic & takes into account the different rates at
which individuals progress during rehabilitation or
conditioning program.
Based on 6RM working weight
SETS REPETITIONS
AMOUNT OF
RESISTANCE
1 10 50% 6RM
2 6 75% 6RM
3 Max possible 100% 6RM
4 Max possible
100% of adjusted working
weight
60. CRITERIA TO FIND ADJUSTED WORKING
WEIGHT
REPETITIONS
IN SET 3
SET 4 NEXT EXC. SESSION -
3
0 – 2 Dec. 5 – 10 lbs Dec. 5 – 10 lbs
3 – 4 Dec. 0 – 5 lbs Same weight
5 – 6 Keep same weight Inc. 5 – 10 lbs
7 – 10 Inc. 5 – 10 lbs Inc. 5 – 15 lbs
11 or more Inc. 10 - 15 lbs Inc. 10 - 15 lbs
64. “Plyometric training” / “stretch shortening drill” /
“stretch strengthening drill” is a system of high
velocity training characterized by rapid eccentric
contraction during which the muscle elongate
immediately followed by rapid reversal of
movement with a resisted shortening contraction of
same muscle.
Integrated into advanced phases of rehabilitation to
train neuromuscular system to react quickly.
Source of resistance –body weight/equipment.
Eg. Catching & throwing ball, dribbling the ball,
jumping forward or sideways, etc.