Literature Review Outline Topic: Ankle rehabilitation I. Introduction to topic and general information on ankle injuries A. Prevalence of injury B. Types of ankle injuries C. Clinical importance (missed time playing/practicing, projected time for recovery, re- injury rate, etc.) II. Phases of ankle rehabilitation A. Acute phase 1. General Information 2. Recommended Treatments a. Ice i. Protocol ii. Claims iii. Clinical Evidence b. Compression i. Protocol ii. Claims iii. Clinical Evidence c. Elevation i. Protocol ii. Claims iii. Clinical Evidence d. Gluteus medius i. Claims ii. Clinical evidence B. Fibroblast phase 1. General Information 2. Recommended treatments a. Cryotherapy i. Protocols ii. Claims iii. Clinical Evidence b. Ice bath with ROM i. Protocols ii. Claims iii. Clinical Evidence c. Open –kinetic chain exercise i. Protocols (Alphabet ROM, Toe Curls and marble pickup, Four plane theraband, etc.) ii. Claims iii. Clinical evidence d. Closed kinetic Chain i. Protocols (heel raise, toe raise, lunge steps, etc.) ii. Claims iii. Clinical evidence C. Remodeling phase 1. General information 2. Recommended treatments a. Proprioception i. Protocols and types - Stable surfaces (floor, etc.) - Unstable surfaces (BAPS, Bosu, Aero, Wobble board, etc.) ii. Claims iii. Clinical Evidence b. Plyometric i. Protocols and types (examples below, but not limited to) - Four square hoping - Side to side - Front to back - Triangles - Straight ling hop - Line zig-zag hop - Box jumping ii. Claims iii. Clinical evidence III. Physiological aspects A. Physiology of Ankle Injuries B. Modalities 1. Ice 2. Compression 3. Elevation 4. Cryotherapy C. Rehabilitation 1. ROM 2. Strengthening a. Contractile machinery of skeletal muscle fiber types i. Sarcomere ii. Thick filament: myosin iii. Thin filament; action iv. Troponin v. Tropomyosin b. Cross-bridge cycle i. Myosin walking along action c. Excitation-contraction coupling d. Motor unit i. Synapse ii. Sarcoplasmic reticulum regulates intracellular-calcium e. Muscle fiber Types i. Α-type ii. Β-type IIa, IIb f. Motor unit recruitment i. Energy supply systems g. Aspects of strength metabolism i. Energy storage and transfer ii. Creatine phosphate system iii. Glycolysis 3. Proprioception a. Neurological function i. Motor unit ii. Neural control mechanism iii. Firing on the muscle iv. Spinal reflexes b. Synchronization 4. Plyometric a. Mechanical Model b. Neurophysiological Model i. Potentiation ii. Stretch reflex iii. Muscle spindles c. Stretch-Shorting cycle i. Eccentric Phase - Rapid muscle lengthening ( preload of the agonist) - Storage of elastic energy ii. Amortization phase - Type Ia afferent nerves synapse - Alpha motor neuron - Agonist muscle group - Antagonist muscle group iii. Contractile phase - Use of energy stored ca ...

1. Literature Review Outline
Topic: Ankle rehabilitation
I. Introduction to topic and general information on ankle
injuries
A. Prevalence of injury
B. Types of ankle injuries
C. Clinical importance (missed time playing/practicing,
projected time for recovery, re-
injury rate, etc.)
II. Phases of ankle rehabilitation
A. Acute phase
1. General Information
2. Recommended Treatments
a. Ice
i. Protocol
ii. Claims
iii. Clinical Evidence
b. Compression
i. Protocol
ii. Claims
iii. Clinical Evidence
c. Elevation
i. Protocol

2. ii. Claims
iii. Clinical Evidence
d. Gluteus medius
i. Claims
ii. Clinical evidence
B. Fibroblast phase
1. General Information
2. Recommended treatments
a. Cryotherapy
i. Protocols
ii. Claims
iii. Clinical Evidence
b. Ice bath with ROM
i. Protocols
ii. Claims
iii. Clinical Evidence
c. Open –kinetic chain exercise
i. Protocols (Alphabet ROM, Toe Curls and marble pickup, Four
plane
theraband, etc.)
ii. Claims
iii. Clinical evidence
d. Closed kinetic Chain
i. Protocols (heel raise, toe raise, lunge steps, etc.)
ii. Claims

3. iii. Clinical evidence
C. Remodeling phase
1. General information
2. Recommended treatments
a. Proprioception
i. Protocols and types
- Stable surfaces (floor, etc.)
- Unstable surfaces (BAPS, Bosu, Aero, Wobble board, etc.)
ii. Claims
iii. Clinical Evidence
b. Plyometric
i. Protocols and types (examples below, but not limited to)
- Four square hoping
- Side to side
- Front to back
- Triangles
- Straight ling hop
- Line zig-zag hop
- Box jumping
ii. Claims
iii. Clinical evidence
III. Physiological aspects
A. Physiology of Ankle Injuries
B. Modalities

4. 1. Ice
2. Compression
3. Elevation
4. Cryotherapy
C. Rehabilitation
1. ROM
2. Strengthening
a. Contractile machinery of skeletal muscle fiber types
i. Sarcomere
ii. Thick filament: myosin
iii. Thin filament; action
iv. Troponin
v. Tropomyosin
b. Cross-bridge cycle
i. Myosin walking along action
c. Excitation-contraction coupling
d. Motor unit
i. Synapse
ii. Sarcoplasmic reticulum regulates intracellular-calcium
e. Muscle fiber Types
i. Α-type
ii. Β-type IIa, IIb
f. Motor unit recruitment
i. Energy supply systems
g. Aspects of strength metabolism
i. Energy storage and transfer

5. ii. Creatine phosphate system
iii. Glycolysis
3. Proprioception
a. Neurological function
i. Motor unit
ii. Neural control mechanism
iii. Firing on the muscle
iv. Spinal reflexes
b. Synchronization
4. Plyometric
a. Mechanical Model
b. Neurophysiological Model
i. Potentiation
ii. Stretch reflex
iii. Muscle spindles
c. Stretch-Shorting cycle
i. Eccentric Phase
- Rapid muscle lengthening ( preload of the agonist)
- Storage of elastic energy
ii. Amortization phase
- Type Ia afferent nerves synapse
- Alpha motor neuron
- Agonist muscle group
- Antagonist muscle group

6. iii. Contractile phase
- Use of energy stored capabilities
- Myotonic reflex
- Muscle spindles
- Contractile component
o Primary sources of muscle force during concentric action
o Contractile machinery
-bridge cycle
IV. Conclusion drawn from the literature
V. Implications for future research
Running head: OUTLINE
OUTLINE
Outline: Influence of Strengthening Exercises on Cognition and
Mental Health
Name
Institution Affiliation

7. Influence of Strengthening Exercises on Cognition and Mental
Health
I. Introduction
A. Cognition refers to the process through which people gain
understanding and knowledge through the use of senses,
thoughts, and experience (Anderson-Hanley et al., 2010). It
usually includes processes such as the formation of knowledge,
attention, reasoning, judging, and reasoning, problem-solving,
as well as decision making.
B. According to the World Health Organization, Mental health
is the state of well-being in which one can realize his/her
ability, can cope with the existing stress of life, remain
productive and fruitful and still contribute to the goodness of
the community (Wray et al., 2012).
C. It can also be referred to a state of emotional welfare in
which one has achieved a pleasing integration of one’s intuitive
drives acceptable to both the individual and the society. One is
able to maintain a balance of work, love, and leisure in their
lives.
D. Strengthening exercises include activities such as aerobics
and other flexible exercises. Usually, they involve the use of
resistant methods like free weights, resistant bands, and weight
machines to build muscles and strength.

8. E. Researchers associate the involvement in the vigorous
exercises including walking and running as an alternative way
of dealing with cognitive and mental disorders.
II. Characteristics and benefits of Strengthening Exercise
a) Use of free weights and machines for both the multiple and
single joint exercises.
b) Multiple activities include the bench, leg, shoulder press, as
well as squats.
c) Single exercise is the leg extension, calf raise, and arm curl.
d) Results in muscular strength and power, improved physical
functioning ability, and bone density. They are also said to
reduce the risks of diabetes and heart diseases through the
improvement of the glycemic control and insulin resistance
(Cissik & Dawes, 2015).
III. Types of Mental Disorder
a) Most common is disorders include anxiety, depression, and
chronic pains.
b) Cognition issues include loss of memory and slow to
understand.
c) Fatigue and insomnia slow down one’s engagement in
activities.
IV. Effects of Strengthening Exercises on Different Types of
Disorder
i. Anxiety
a) Anxiety involves the feeling of uncertainty that something
unpleasant might happen. Symptoms include poor sleeping
patterns, mental suffering, poor health, pain, and even reduced
activities.
b) Researchers argue that aerobic exercises are associated with
the reduction of the condition among both healthy and the
adults with chronic illnesses.
c) Strickland & Smith (2014) state that exercise is said to
stimulate the production of the endorphins, a brain chemical
that stimulates sleep thus reducing stress. There is stimulation
of the anti-anxiety effects that stabilize the moods of an
individual.

9. ii. Chronic Pain
a. Prolonged pain including a headache, low back pain, and
osteoarthritis are considered the major problem in the public
health.
b. Engaging in the fitness activities enhance the health of the
back by allowing the exchange of fluids between the discs
(Ishak et al., 2016). Thus the transfer of nutrients.
c. The fluid ensures that there is no swelling in other soft
tissues around the discs. The activities also help the connective
fibers of ligaments and tendons flexible.
d. Back pain is associated with swelling and the malnourishment
together with the degeneration of the discs. Frequent movement
prevents the tearing of the fiber under pressure thus preventing
the pain of injury (Dreisinger, 2014).
e. Healing headache is associated with the natural painkiller
released by the brain; endorphins.
iii. Cognition
a) Vigorous exercises are known to improve the brainpower thus
enhancing the ability to think, retain, memory, and
understanding (Neisser, 2014). They are associated with the
increase in the supply of oxygen through the abundant blood
vessels.
b) With the slightest activities, there is a good circulation of
blood and nutrients that maintain the health of the blood
vessels.
c) The study shows that a high rate enhances neurogenesis
which is the ability to generate new brain cells, especially in
adults.
iv. Depression
a. The release of endorphin enhances the development of the
feeling of happiness and well-being in people (de Camargo
Smolarek et al., 2016). Thus, one is able to move from the
negative thoughts that feed depression and instead become
positive.
b. One becomes triggered to generate well thought and
insightful ideas. Exercises such as running on a treadmill or

10. walking enable one to structure their day thus engaging in
productive activities. Being engaged hinders the chances of
being thoughtful.
v. Fatigue and Sleep
a) Aerobics increases the efficiency of the lungs which lets the
air in and out of the body. More energy is released with the
increase in oxygen in the blood (Ament & Verkerke, 2009).
Enhanced blood circulation allows the spread of oxygen in the
tissues.
b) Resistant exercises promote the building of muscles and
masses thus reducing blood sugar by storing it in the form of
glycogen (Contreras, 2013). As muscles continue building, more
blood sugar burns and hence maintaining the right healthy
weight.
c) Flexibility activities like Yoga focus on the stress relieving
through stretching and breathing. The practice helps in
maintaining stamina through the restoration of the energy,
relieve stress as well as fatigue.
d) A sense of peace that allows one to rest through sleep is
gaining. Energy is generated that reduce the feeling of
tiresomeness.
e) Engaging in exercises promotes the increase in body
temperature and later the drop in the post-exercise temperature
that results in a sleep (Kline, 2014).
f) Sleep relieves depression, stress, and insomnia.
vi. Self-Esteem
a) Exercises improve the well-being of an individual.
b) O'Connor et al. (2010) argue that activities enhances mental
outlook and minimize stress thus a better insight into one ‘self.
c) There is a sudden need for appreciation and self-worth among
people. Individuals start feeling happy about themselves and
what they do.
d) Better body size with improved mood.
V. Conclusion
a) Besides the medical and therapy treatments, strengthening
exercises are a natural way of dealing with mental and cognitive

11. disorders.
b) Most diseases are promoted by lack of body flexibility.
Disorders like depression and anxiety just require distraction
which is provided through exercise.
c) When people engage in constructive activities, they are likely
to remain in a good and happy mood.
d) The secretion of the endorphin enhances the elimination of
all disorders that caused by lack of happiness in life.
e) The greatest number of people suffering from the mental
illnesses are inactive thus engaging in thoughtful activities.
f) Patients should seek the advice of the physicians before
engaging in exercises, particularly those that involve the low
back pain to avoid further complications.
VI. Recommendations
a) Health cares should find a way to educate people on the
importance of engaging in strengthening exercises even before
the development of the complications.
b) Exercising should be included in the therapy and medication
program to enhance healing among the patients.
References
Ament, W., & Verkerke, G. J. (2009). Exercise and fatigue.
Sports medicine, 39(5), 389-422.

12. Anderson-Hanley, C., Nimon, J. P., & Westen, S. C. (2010).
Cognitive health benefits of strengthening exercise for
community-dwelling older adults. Journal of Clinical and
Experimental Neuropsychology, 32(9), 996-1001.
Cissik, J., & Dawes, J. (2015). Maximum Interval Training.
Human Kinetics.
Contreras, B. (2013). Bodyweight strength training anatomy.
Human Kinetics.
de Camargo Smolarek, A., Ferreira, L. H. B., Mascarenhas, L.
P. G., McAnulty, S. R., Varela, K. D., Dangui, M. C., ... &
Souza-Junior, T. P. (2016). The effects of strength training on
cognitive performance in elderly women. Clinical interventions
in aging, 11, 749.
Dreisinger, T. E. (2014). Exercise in the management of chronic
back pain. The Ochsner Journal, 14(1), 101-107.
Ishak, N. A., Zahari, Z., & Justine, M. (2016). The
Effectiveness of strengthening exercises for the elderly with
low back pain to improve symptoms and functions: A systematic
review. Scientifica, 2016.
Kline, C. E. (2014). The bidirectional relationship between
exercise and sleep: implications for exercise adherence and
sleep improvement. American journal of lifestyle
medicine, 8(6), 375-379.
Neisser, U. (2014). Cognitive psychology: Classic edition.
Psychology Press.
O'Connor, P. J., Herring, M. P., & Caravalho, A. (2010). Mental
health benefits of strength training in adults. American Journal
of Lifestyle Medicine, 4(5), 377-396.
Strickland, J. C., & Smith, M. A. (2014). The anxiolytic effects
of resistance exercise. Frontiers in psychology, 5, 753.
Wray, L. O., Mavandadi, S., Klaus, J. R., Tew Jr, J. D., Oslin,
D. W., & Sweet, R. A. (2012). The association between mental
health and cognitive screening scores in older veterans. The
American Journal of Geriatric Psychiatry, 20(3), 215-227.