This document provides information on resistance exercise for impaired muscle performance. It defines key elements of muscle performance like strength, power, and endurance. When muscle performance is impaired, resistance exercise can help by overloading muscles in a progressive manner based on principles like specificity of adaptation and reversibility. The document discusses factors that influence tension generation and fatigue in muscles. It also outlines general guidelines for implementing a safe and effective resistance exercise program, including determining the appropriate intensity, sets, repetitions, and other variables.
This PPT contains a detailed explanation about resisted exercises, different types of exercise, indications & contraindications, manual & mechanical techniques.
Cardio and muscle endurance
Aerobic exercise (also known as cardio) is physical exercise of low to high intensity that depends primarily on the aerobic energy-generating process. Aerobic literally means "relating to, involving, or requiring free oxygen", and refers to the use of oxygen to adequately meet energy demands during exercise via aerobic metabolism. Generally, light-to-moderate intensity activities that are sufficiently supported by aerobic metabolism can be performed for extended periods of time
Neuromuscular Adaptations to Sports Training Jill Costley
Neuromuscular Adaptations to Sports Training from my Undergrad Strength and Conditioning placement at the Sports Institute of Northern Ireland. Outcomes: 1) Understand the role of the brain and nervous system in relation to motor control 2) Understand the basic structure of a muscle fibre 3) Appreciate the implications and effects of training on the neuromuscular system. Hope it's useful to someone. Any critical feedback is welcome.
A chronicle on muscle strengthening:
MMT is a procedure for the evaluation of strength of individual
muscle or muscles group, based upon the effective performance of a movement in relation to the forces of gravity or manual resistance through the available ROM.
This PPT contains a detailed explanation about resisted exercises, different types of exercise, indications & contraindications, manual & mechanical techniques.
Cardio and muscle endurance
Aerobic exercise (also known as cardio) is physical exercise of low to high intensity that depends primarily on the aerobic energy-generating process. Aerobic literally means "relating to, involving, or requiring free oxygen", and refers to the use of oxygen to adequately meet energy demands during exercise via aerobic metabolism. Generally, light-to-moderate intensity activities that are sufficiently supported by aerobic metabolism can be performed for extended periods of time
Neuromuscular Adaptations to Sports Training Jill Costley
Neuromuscular Adaptations to Sports Training from my Undergrad Strength and Conditioning placement at the Sports Institute of Northern Ireland. Outcomes: 1) Understand the role of the brain and nervous system in relation to motor control 2) Understand the basic structure of a muscle fibre 3) Appreciate the implications and effects of training on the neuromuscular system. Hope it's useful to someone. Any critical feedback is welcome.
A chronicle on muscle strengthening:
MMT is a procedure for the evaluation of strength of individual
muscle or muscles group, based upon the effective performance of a movement in relation to the forces of gravity or manual resistance through the available ROM.
This Presentation is about Mitchell relaxation technique also known a physiological relaxation technique Mitchell’s physiological relaxation technique is based on reciprocal inhibition and involves diaphragmatic breathing and a series of ordered isotonic contractions.
Rebox electrotherapeutic method is based on non-invasive transcutaneous application of specific electric currents to a living tissue. Main indications for using the Rebox include treatment of acute and chronic pain, immobility, musculoskeletal and neurological disorders and oedema.
Diadynamic currents are also called Bernard's currents based on a sine wave with a frequency of 50Hz. Due to the ease of generation of this current shape, they have been known almost from the beginning of electrotherapy, and their influence on the human body has been thoroughly studied.
every exercise can not be performed by all the individuals. there occurs a lot of difference between exercise to be performed by health individuals, geriatric subjects and patients. so here are some guidelines to differentiate to test the exercise before prescribing them to subjects
This Presentation is about Mitchell relaxation technique also known a physiological relaxation technique Mitchell’s physiological relaxation technique is based on reciprocal inhibition and involves diaphragmatic breathing and a series of ordered isotonic contractions.
Rebox electrotherapeutic method is based on non-invasive transcutaneous application of specific electric currents to a living tissue. Main indications for using the Rebox include treatment of acute and chronic pain, immobility, musculoskeletal and neurological disorders and oedema.
Diadynamic currents are also called Bernard's currents based on a sine wave with a frequency of 50Hz. Due to the ease of generation of this current shape, they have been known almost from the beginning of electrotherapy, and their influence on the human body has been thoroughly studied.
every exercise can not be performed by all the individuals. there occurs a lot of difference between exercise to be performed by health individuals, geriatric subjects and patients. so here are some guidelines to differentiate to test the exercise before prescribing them to subjects
OBJECTIVES
Identify the anatomical structures, indications, and contraindications of therapeutic exercise.
Describe the equipment, personnel, preparation, and technique in regard to therapeutic exercise.
Review the appropriate evaluation of the potential complications and clinical significance of therapeutic exercise.
Summarize inter-professional team strategies for improving care coordination and communication to advance therapeutic exercise and improve outcomes.
Your body is a segmented, or jointed, system designed for potentially powerful and efficient movement. Coordinated
and efficient movements require a give and take between mobility and stability of the involved joints, as well as the
surrounding muscles, tendons, and ligaments. These components, together with muscular fitness, are necessary to achieve functional movement, which is integral in performance- and sport-related skills.
IDEA 2009 Personal Trainer Institute Presentation- SOLD OUT; Purchase a copy of the video here: http://www.ideafit.com/fitness-products/exercise-programming-for-obese-and-weight-loss-clients
Weight training is a type of strength training that uses weights for resistance on your muscles. Check out this quick presentation about muscular strength, fitness, and endurance. Get information about lifting weights and building muscles fast.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
2. Muscle Performance and Resistance Exercise:
Definitions and Guiding Principles:
1. Strength.
2. Power.
3. Endurance.
4. Overload Principle.
5. SAID Principle.
6. Reversibility Principle.
3. • Muscle performance refers to the capacity of a muscle
to do work (force × distance).
• The key elements of muscle performance are strength,
power, and endurance.
4. When there is a deficit of muscle
performance
Impairment of function
Resistance exercise is any form of active exercise in which dynamic
or static muscle contraction is resisted by an outside force applied manually
or mechanically.
5.
6. Muscle strength
It is a broad term that refers to the ability of contractile tissue to
produce tension and a resultant force based on the demands
placed on the muscle.
Functional strength relates to the ability of the neuromuscular
system to produce, reduce, or control forces, contemplated or
imposed, during functional activities, in a smooth, coordinated
manner
7. Strength training (strengthening exercise)
is defined as a systematic procedure of a
muscle or muscle group lifting, lowering,
or controlling heavy loads (resistance)
for a relatively low number of repetitions
or over a short period of time
8. Muscle power
It is related to the strength and speed of movement and is
defined as the work (force × distance) produced by a muscle
per unit of time (force × distance/time).
The greater the intensity of the
exercise and the shorter the
time period taken to generate
force, the greater is the muscle
power.
9. Muscle endurance (Aerobic Power)
It is the ability of a muscle to contract repeatedly against a
load (resistance), generate and sustain tension, and resist
fatigue over an extended period of time.
The key parameters of endurance
training are low-intensity muscle
contractions, a large number of
repetitions, and a prolonged time
period.
10. Overload Principle
If muscle performance is to improve, a load that exceeds the
metabolic capacity of the muscle must be applied—that is,
the muscle must be challenged to perform at a level greater
than that to which it is accustomed.
11. ■ In a strength training program, the
amount of resistance applied to the
muscle is incrementally and progressively
increased.
■ For endurance training, more emphasis
is placed on increasing the time a muscle
contraction is sustained or the number of
repetitions performed than on increasing
resistance.
12. SAID Principle
The SAID principle (specific adaptation to imposed demands)
suggests that a framework of specificity is a necessary
foundation on which exercise programs should be built.
13. Reversibility Principle
Adaptive changes in the body’s systems, such as increased
strength or endurance, in response to a resistance exercise
program are transient unless training-induced improvements
are regularly used for functional activities or unless an
individual participates in a maintenance program of resistance
exercises.
15. Factors that Influence Tension Generation in
Normal Skeletal Muscle
1. Energy Stores and Blood Supply
2. Fatigue
3. Age
4. Psychological and Cognitive Factors
17. Muscle (local) fatigue: The diminished response of muscle to
a repeated stimulus is reflected in a progressive decrement in
the amplitude of motor unit potentials
18.
19. Factors that influence fatigue.
1. A patient’s health status,
2. diet,
3. Lifestyle
4. In patients with neuromuscular, cardiopulmonary, inflammatory,
cancer-related, or psychological disorders, the onset of fatigue is
often abnormal.
20. Cardiopulmonary (general) fatigue. This type of fatigue is the diminished
response of an individual (the entire body) as the result of prolonged physical
activity, such as walking, jogging, cycling, or repetitive lifting or digging. It is
related to the body’s ability to use oxygen efficiently. Cardiopulmonary fatigue
associated with endurance training is probably caused by a combination of the
following factors.
■ Decrease in blood sugar (glucose) levels.
■ Decrease in glycogen stores in muscle and liver.
■ Depletion of potassium, especially in the elderly patient.
21. Threshold for fatigue:
It is the level of exercise that cannot be sustained indefinitely.
A patient’s threshold for fatigue could be noted as the length
of time a contraction is maintained or the number of
repetitions of an exercise that initially can be performed.
This sets a baseline from which adaptive changes in physical
performance can be measured.
22.
23.
24.
25.
26.
27.
28. Determinants of a Resistance Exercise Program
■ Alignment of segments of the body during exercise
■ Stabilization of proximal or distal joints to prevent substitution
■ Intensity: the exercise load (level of resistance)
■ Volume: the total number of repetitions and sets in an exercise session
■ Exercise order: the sequence in which muscle groups are exercised during an exercise session
■ Frequency: the number of exercise sessions per day or per week
■ Rest interval: time allotted for recuperation between sets and sessions of exercise
■ Duration: total time frame of a resistance training program
■ Mode of exercise: type of muscle contraction, position of the patient, form (source) of resistance, arc of
movement, or the primary energy system utilized
■ Velocity of exercise
■ Periodization: variation of intensity and volume during specific periods of resistance training
■ Integration of exercises into functional activities: use of resistance exercises that approximate or
replicate functional demands
29.
30. Initial Exercise Load (Amount of Resistance)
• Repetition Maximum
• A percentage of body weight
31. Training Zone
After establishing the baseline RM, the amount of resistance
(exercise load) to be used at the initiation of resistance training
often is calculated as a percentage of a 1-RM for a particular
muscle group. At the beginning of an exercise program the
percentage necessary to achieve training-induced adaptations in
strength is low (30% to 40%) for sedentary, untrained individuals
or very high (>80%) for those already highly trained. For healthy
but untrained adults, a typical training zone usually falls between
40% and 70% of the baseline RM. The lower percentage of this
range is safer at the beginning of a program to enable an
individual to focus on learning correct exercise form and
technique before progressing the exercise load to 60% to 70%.
32. Percentage of Body Weight as an Initial Exercise
Load for Selected Exercises
Universal bench press: 30% body weight
Universal leg extension: 20% body weight
Universal leg press: 50% body weight
33.
34.
35.
36. Types of Resistance Exercise
Type of resistance
Manual and Mechanical Resistance Exercise
Type of muscle contraction
• Isometric Exercise (Static Exercise)
• Dynamic Exercise: (Concentric and Eccentric)
(Constant and Variable Resistance)
37. Eccentric Versus Concentric Exercise:
■ Greater loads can be controlled with eccentric than concentric exercise.
■ Training-induced gains in muscle strength and mass are greater with
maximum effort eccentric training than maximum effort concentric
training.
■ Adaptations associated with eccentric training are more mode- and
velocity-specific than adaptations as the result of concentric training.
■ Eccentric muscle contractions are more efficient metabolically and
generate less fatigue than concentric contractions.
■ Following unaccustomed, high-intensity eccentric exercise, there is
greater incidence and severity delayed-onset muscle soreness than after
concentric exercise.
38.
39. Characteristics of Open-Chain and Closed-Chain Exercises
Open-Chain Exercises Closed-Chain Exercises
Distal segment moves in space.
Distal segment remains in contact with or stationary
(fixed in place) on support surface.
Independent joint movement; no predictable joint
motion in adjacent joints.
Interdependent joint movements; relatively
predictable movement patterns in adjacent joints.
Movement of body segments only distal to the moving
joint.
Movement of body segments may occur distal and/or
proximal to the moving joint.
Muscle activation occurs predominantly in the prime
mover and is isolated to muscles of the moving joint.
Muscle activation occurs in multiple muscle groups,
both distal and proximal to the moving joint.
Typically performed in non-weight-bearing positions.
Typically but not always performed in weightbearing
positions.
Resistance is applied to the moving distal segment.
Resistance is applied simultaneously to multiple
moving segments.
Use of external rotary loading. Use of axial loading.
External stabilization (manually or with equipment)
usually required.
Internal stabilization by means of muscle action, joint
compression and congruency, and postural control.
40. Isokinetic Exercise
Isokinetic exercise is a form of dynamic exercise in
which the velocity of muscle shortening or lengthening
and the angular limb velocity is predetermined and
held constant by a rate-limiting device known as an
isokinetic dynamometer.
41.
42.
43. Manual Resistance Exercise: Advantages and
Disadvantages
Advantages
■ Most effective during the early stages of rehabilitation when muscles are weak
(4/5 or less).
■ Effective form of exercise for transition from assisted to mechanically resisted
movements.
■ More finely graded resistance than mechanical resistance.
■ Resistance is adjusted throughout the ROM as the therapist responds to the
patient’s efforts or a painful arc.
■ Gives the therapist an opportunity for direct interaction with the patient to
monitor the patient’s performance continually.
44. ■ Muscle works maximally at all portions of the ROM.
■ The range of joint movement can be carefully controlled by the therapist to
protect healing tissues or to prevent movement into an unstable portion of the
range.
■ Useful for dynamic or static strengthening.
■ Direct manual stabilization prevents substitute motions.
■ Can be performed in a variety of patient positions.
■ Placement of resistance is easily adjusted.
45. Disadvantages
■ Exercise load (amount of resistance) is subjective; it cannot be measured or
quantitatively documented for purposes of establishing a baseline and exercise-
induced improvements in muscle performance.
■ Amount of resistance is limited to the strength of the therapist; therefore,
resistance imposed is not adequate to strengthen already strong muscle groups.
■ Speed of movement is slow to moderate, which may not carry over to most
functional activities.
■ Cannot be performed independently by the patient to strengthen most muscle
groups.
■ Not useful in home program unless caregiver assistance is available.
■ Labor- and time-intensive for the therapist.
■ Impractical for improving muscular endurance; too time-consuming.
46. General principle for application
1. Examination and evaluation.
2. Preparation for resistance exercise.
3. Implementation of resistance exercise.
47. Implementation of resistance exercise
1. Warm up
2. Resistance placement
3. Direction of resistance
4. Stabilization
5. Intensity of exercise
6. Number of Repetitions(8-12),
Sets(3), and Rest Intervals.
7. Verbal or Written Instructions
8. Monitoring the Patient
9. Cool-Down
48. General Precautions During Resistance Training
1. Keep the ambient temperature of the exercise setting comfortable for
vigorous exercise. Select clothing for exercise that facilitates heat dissipation
and does not impede sweat evaporation.
2. Caution the patient that pain should not occur during exercise.
3. Do not initiate resistance training at a maximal level of resistance,
particularly with eccentric exercise to minimize delayed-onset muscle soreness
(DOMS). Use light to moderate exercise during the recovery period.
49. 4. Avoid use of heavy resistance during exercise for children, older adults, and
patients with osteoporosis.
5. Do not apply resistance across an unstable joint or distal to a fracture site that is
not completely healed.
6. Have the patient avoid breath-holding during resisted exercises to prevent the
Valsalva maneuver; emphasize exhalation during exertion.
7. Avoid uncontrolled, ballistic movements as they compromise safety and
effectiveness.
8. Prevent incorrect or substitute motions by adequate stabilization and an
appropriate level of resistance.
50. 9. Avoid exercises that place excessive, unintended secondary stress on the
back.
10. Be aware of medications a patient is using that can alter acute and chronic
responses to exercise.
11. Avoid cumulative fatigue due to excessive frequency of exercise and the
effects of overtraining or overwork by incorporating adequate rest intervals
between exercise sessions to allow adequate time for recovery after exercise.
12. Discontinue exercises if the patient experiences pain, dizziness, or unusual
or precipitous shortness of breath.
52. Proprioceptive Neuromuscular Facilitation
• PNF is an approach to therapeutic exercise that
combines functionally based diagonal patterns of
movement with techniques of neuromuscular
facilitation to evoke motor responses and improve
neuromuscular control and function.
53. • PNF techniques can be used to develop muscular
strength and endurance; to facilitate stability,
mobility, neuromuscular control, and coordinated
movements; and to lay a foundation for the
restoration of function.
54. Diagonal Patterns
• The patterns of movement associated with PNF are composed of
multi-joint, multiplanar, diagonal, and rotational movements of the
extremities, trunk, and neck. Multiple muscle groups contract
simultaneously. There are two pairs of diagonal patterns for the
upper and lower extremities: diagonal 1 (D1) and diagonal 2 (D2).
Each of these patterns can be performed in either flexion or
extension. The diagonal patterns can be carried out unilaterally or
bilaterally.
56. Basic Procedures with PNF Patterns
• Manual Contacts
• Maximal Resistance
• Position and Movement of the
Therapist
• Stretch
• Normal Timing
• Traction
• Approximation
• Verbal Commands
• Visual Cues