2. Active Movement (b) kinesiology slide.pptx

2. Active Movement
Dr. Tooba Asif, PT
Lecturer
DPT (RIU), MS-OMPT (RIU)
Certified Kinesio Taping Practitioner (CKTP, USA)
Certified Dry Needling Practitioner (CDNP, UK)

3. • DEFINITION:
Exercises performed by a person with the help of an
external force are called as assisted exercises.
This external assistance may be manual or
mechanical.
ASSISSTED EXERCISES

4. • When muscular action is insufficient.
• The external force must be applied in direction of
muscle action.
• Magnitude of this external force must be to augment
only not act as its substitution.
• As power of muscle increases, assistance given
should be decreased proportionally.
PRINCIPLES OF ASSISTANCE

5. • Make ensure that inefficient muscles exert their maximum effort.
1. Starting Position:
• Ensure that patient’s whole attention is concentrated on pattern of
movement.
2. Pattern Of Movement:
• Known to patient
3. Fixation:
• Fixation of bone; prime movers origin
• Should be achieved actively to reinforce the weak muscles
TECHNIQUE

6. • Controlled or ‘held back’ so that movement is pivoted at required joint.
4. Support:
• Reduce excessive weight on weak muscles by :
• Physio hand
• Suspension sling
• Re-education board
• Buoyancy of water
• Ball bearing skates
TECHNIQUE

7. 5. The Antagonist Muscles:
• Reduce tension in antagonist muscles
• Assisted dorsiflexion when knees are flexed.
5. Traction:
• Stretching of weak muscles to elicit myotatic stretch reflex.
6. The Assisting Force:
• In direction of movement
• ROM is as full as possible.
TECHNIQUE

8. • Different assistance at different level; possible only by
manual mean not mechanical.
8. The Character Of Movement:
• Smooth
• Speed of movement depends on muscles involved ;
fusiform contract rapidly while multi pennate slowly.
TECHNIQUE

9. 9. Repetitions:
• Depends on the condition
10. The Cooperation Of Patient:
• Very essential
• Target is controlled active movement without
assistance.
TECHNIQUE

10. • Used in the early stages of neuromuscular re-
education.
• Memory of the pattern
• Confidence in the ability
• ROM is increased.
Effects & Uses

11. • Combination of assistance & resistance during a
single movement.
ASSISTED-RESISTED EXERCISE

12. • External resistance is applied which produces
• Tension in muscles
• Power
• Hypertrophy
• So application of max. resistance cause maximum development
• Amount Of Resistance:
must be good enough to raise intra muscular tension.
RESISTED EXERCISE
Principles Of Resistance:

13. • Five factors contribute in the development
of muscle efficiency.
1. Power:
• Develops in response of maximum resistance.
• Progressive resistant-low repetition exercises.
Factors

14. 2. Endurance:
develops in response to repetitive contractions method used is low resistant-
high repetition exercise.
3. Volume:
measured as an indication of hypertrophy although it is not a reliable method.
4. Speed Of Contraction:
depends on muscles
5. Coordination:
Important for fine movement.
Factors

15. • VARIATION OF THE POWER OF MUSCLE IN DIFFERENT PARTS
OF THEIR RANGE:
• Physiologically muscles exerts their greatest force in their
outer range.
• Mechanically in the mid range when angle of pull is at right
angle.
• In rough estimation it is max. in outer part of middle range.
• Broadly speaking each group is found to be most powerful in
the part of range in which it is habitually used.

16. 1. Starting Position:
• Comfort & stability
• Ensure that patient’s whole attention is concentrated on pattern of movement.
2. Pattern Of Movement:
• Known to patient
• Taught as passively or free exercise
3. Stabilization:
• Stabilization of bone of origin of muscles
• Controlled or localized so that movement is pivoted at required joint.
Technique

17. 4. Traction:
• Stretching of weak muscles to elicit myotatic stretch reflex.
5. The Resisting Force:
• Variety of ways can be used like;
o manual pressure
o weights
o springs
o pulleys
• In the direction of movement
• ROM is as full as possible
• Magnitude of resistance depends on muscle
Technique

18. • Max. resistance elicits max. power & hypertrophy
• Manual pressure is of great advantage as it can be varied
in circumference of range.
6. The Character Of Movement:
• Smooth
• Speed of movement is consistent
• Full ROM
Technique

19. 7. Repetitions:
• Depends on the condition
• Low Resistance-High Repetition for weak or elderly
patients i.e osteo-arthiritis.
• High Resistance-Low Repetition to build up power after
surgery or disuse i.e menisectomy.
• Static resisted contraction in effusion & rheumatoid
conditions.
Technique

20. 8. The Cooperation Of Patient:
• Patient’s interest is very essential
• Movements should be precise
• Regular measurements & recording of progress.
• Verbal encouragement.
Technique

21. Other than friction & gravity can be provided by
i. Physiotherapist
ii. Patient
iii. Weights
iv. Weight & Pulley circuits
v. Springs
vi. Substances which are malleable
vii. Water
RESISTANCES

22. • Applied manually in the line of movement.
• Physiotherapist's stance must be in the line of
movement
• Maintain traction & approximation throughout the
movement
• Resistance can be varied in range according to the
muscle power.
1. Resistance By
The Physiotherapist:

23. • With the sound limb e.g. knee extension in
high sitting
• Free movement i.e. by own body weight e.g.
press ups.
2. Resistance By
The Patient

24. • Weights used in the form of:
o sand bags
o metal weights
o medicine balls
• This can be used in progressive resistance
exercises.
3. Resistance By Weights