THER EX LECTURE 7A: RESISTANCE EXERCISE FOR IMPAIRED MUSCLE PERFORMANCE (EXAM II)

____ ___ is the muscles ability to perform work

Muscle performance

Components of ___ ___:

- strength

- power

- endurance

Muscle performance

AROM is moving a body segment ____ resistance

Without

RROM is moving a body segment ____ resistance

With

High reps (>/= 30 reps) of ____ can improve muscle performance for people who:

- have a very weak body segment

- have generalized weakness throughout the body

- do not have full AROM

- fatigue when performing non resistive exercises

AROM

_____ exercise improves muscle performance when done correctly

Resistance

_____ exercise involves muscle resisting external force

Resistance

____ exercises can be done via open or closed chain exercises

Resistance

_____/____ force may come from:

- manual resistance applied by a PT

- mechanical resistance (dumbbell)

- gravity (body weight)

Resistance/external

Pros of ____ resistance:

- heavier loads can be applied

- not as labor intensive as manual resistance

Mechanical

Pros of ____ resistance:

- can vary amount of resistance throughout the ROM to account for patients area of pain or weakness

- can apply manual resistance in any position

Manual

Mechanical resistance can be ____ or ____

Constant or variable

The external load for constant resistance is ____

Constant

With constant resistance, ____ and ____ torques change throughout the ROM (muscle works harder at certain points in the movement)

External and internal

With variable resistance, resistance is ___ throughout ROM

Altered

_____ resistance attempts to load muscles more effectively at multiple points in the ROM

Variable

A skilled therapist can do ____ resistance manually

Variable

Open kinetic chain requires ____ sensory input than closed kinetic chain

Less

____ chain contractions are typically isolated agonist contractions

Open

Joint forces are typically shear during ____ chain exercise

Open

Joint forces are typically approximation (compression) during ____ chain exercises

Closed

____ chain contractions are typically co-contractions (promotes dynamic stability)

Closed

____ chain exercises train balance and postural control

Closed

Benefits of ____ ____:

- increased strength of CT

- increased bone mineral density

- decreased joint stress during movement

- reduced risk of soft tissue injury during physical activity

- improved capacity for healing and tissue remodeling

- improved body composition

- increased balance

- increased quality of life

Resistance exercise

___ ____ is the ability of muscle to produce tension and a resultant force

General strength

____ ____ is the ability of muscle to produce tension and a resultant force with control during functional activities

Functional strength

____ strength example:

- produce enough muscle force to safely lift/lower with control

Functional

____ ___ uses loads heavy enough to cause fatigue after relatively low number of reps

Strength training

load should be heavy enough that it can be lifted only ___-__ times or less

8-12

___ ___ results:

- increase maximum force producing capacity of that muscle

- increased muscle fiber size

Strength training

_____ is the ability of contractile tissue to produce tension and a resultant force over time

Power

____ refers to the rate or speed at which the muscle can produce force

Power

_____ is strength used quickly

Power

____ is a prerequisite for power

Strength

For power training regimens, ____ is the most commonly manipulated variable

Speed

2 ways to do ____ ___:

1. Specify a duration then progressively increase work done during that predetermined duration

2. Specify amount of work to be done then progressively increase how fast you can do the pre determined amount of work

Power training

____ ____ results:

- improved speed during strength movements

Power training

_____ example:

- fedex worker quickly & safely lifting a heavy box

Power

____ ____ is the ability of contractile tissue to resist fatigue over time

Muscle endurance

Muscle performance includes ____ & _____ muscle endurance

Cardiopulmonary & skeletal

Almost all daily activities require some degree of _____ ____

Muscular endurance

____ ____ is performing work for an extended time

Endurance training

For endurance training, choose a load that is light enough to lift at least __-__ reps or hold a contraction for as long as possible with correct form

12-15

___ ____ results:

- increased oxidative and metabolic capacities of muscle

Endurance training

____ produces a rotational force

Torque

The ____ ____ progressively overloads the muscle by manipulating intensity, volume & frequency of strength, power, and/or endurance

Overload principle

In order to increase muscle performance, you must increase the _____ beyond what the person is accustomed to doing

Workload

The SAID principle is an extension of ____ ____ (body systems react to stress placed on them)

Wolff's law

What is the SAID principle?

Specific Adaptations to Imposed Demands

After cessation of exercise, ______ (reduced muscle performance) begins and continues until all training effects are lost

Detraining

The _____ _____ deals with detraining

Reversibility principle

Impaired ___ ___ may be due to:

- MSK problems (immobilization)

- neurological problems (ALS)

- metabolic problems (diabetes)

- other medical problems (CHF)

Muscle function

Avoid closed kinetic chain exercises in the ____ phase of healing

Acute

Muscle can produce the greatest force when it is near ____ ____ or is pulled into a slight ____ (pulling your leg back before kicking a ball)

Resting length; stretch

___ ___ ____ is negatively altered due to:

- passive & active insufficiency

- contractures

- loss of ROM

- inflexibility

Length tension relationship

Greater tension is produced with a ___ moment arm

Longer

More motor unit recruitment = ____ force production = a stronger contraction

More

Type ___ muscle twitch fibers are recruited first

I

Type ___ muscle twitch fibers are recruited when activity demands it

II

The higher the rate of motor unit firing, the ____ the contraction will be due to more force production

Stronger

Types of ___ ___:

- eccentric

- isometric

- concentric

Muscle contraction

_____: as speed increases, force production decreases

Concentric

_____: as speed increases, force production initially decreases then levels off

Eccentric

Muscles need ____ to contract and resist fatigue

Energy

____ ___ are affected by:

- glycogen stores

- blood supply

Energy stores

The ____ the muscle diameter, the larger the capacity to produce force

Larger (a larger muscle is a stronger muscle)

Short fibers with pennate design are found abundantly in muscles that can produce a lot of ____

Force

Long fibers with parallel design are found abundantly in muscles that can produce a lot of ____

Speed

Type ____ fibers are aerobic

I

Type _____ fibers are anaerobic

II

Type ___ fibers are found abundantly in muscles that have high endurance but cannot produce as much force

I

Type ____ fibers are found abundantly in muscles that can produce a lot of force but fatigue quickly

II

Type ____ fibers are faster than type I fibers

IIA

Type ___ fibers are faster than type ___ & ____ fibers

IIB; I & IIA

Type ___ fibers are slow twitch

I

Type ____ fibers are fast twitch

II

Type ___ muscle fibers are found in you endurance and postural muscles

I

_____ contraction is capable of producing the least force output

Concentric

_____ contraction is able to produce the greatest force output

Eccentric

_____ contraction is able to to produce the next greatest force output

Isometric

Speed and force are inversely proportional for _____ contractions and are proportional for ____ contractions

Concentric; eccentric

____ ____ is the diminished response of muscle to repeated stimulus

Muscle fatigue

s/sx of ____ ____:

- uncomfortable sensation in the muscle (pain & cramping possible)

- shaking or trembling of contraction velocity

- unintentional slowing of contraction velocity with successive repetitions of an exercise

- active movements are jerky or inconsistent

- unable to continue through the full AROM

- use of substitute motions (incorrect movement patterns) to complete the activity

- inability to continue low intensity physical activity

- decline in peak torque during is kinetic testing

Muscle fatigue

Options when _____ _____ occurs:

- decrease load

- work a different muscle group

- rest before continuing

- combo of 1-3

- stop exercising completely

Muscle fatigue

After intense exercise, how long does it take for the muscles force producing capacity to return to 90-95% of the pre exercise capacity?

1-3 minutes

If muscles does not return to 90-95% of pre exercise capacity during the recovery time, that muscle may be ____ for that session

Fatigued

Increases in muscle mass and strength occur from _____ throughout ____

Birth; puberty

Decreases in muscle mass and strength may begin to occur as early as age ___

25

Typically ____ have more muscle mass and are therefore stronger than ____

Males; females

How the neural system responds to ____ training:

- motor learning and improved coordination

Endurance

How the neural system responds to ____ training:

- motor learning and improved coordination

- increased rate of firing of motor neurons

- increased motor unit recruitment

- increased synchronization of movement

Strength

How the muscular system responds to ____ training:

- hypertrophy of muscles

- fiber type remodeling

Strength

How the muscular system responds to ____ training:

- increased capillary density

- increased mitochondrial density

- zero to minimal hypertrophy of muscles fibers and no fiber type remodeling

Endurance

How CT responds to ____ training:

- increased tensile strength of tendons, ligaments, and intramuscular fascia

- increase bone mineral density

Strength

How CT responds to ____ training:

- increased tensile strength of tendons, ligaments, and intramuscular fascia (not to the same degree)

- increased bone mineral density (must be land based and weight bearing)

Endurance

Elements that determine whether an ____ ____ is effective, appropriate and safe:

- alignment

- stabilization

- modes of exercise

- dosage (intensity, volume, duration, frequency)

- exercise order

- recovery interval

- velocity/speed of exercise

Exercise program

The purpose of ____ is to maintain proper alignment, ensure correct muscle action, and avoid substitute movements

Stabilization

Types of ____:

- external ( UE support with LE exercises)

- internal (proximal stability for distal mobility)

Stabilization

___ ____ ____ include:

- type of resistance exercise (manual, mechanical, isometric, etc.)

- patient position (supine, prone, etc.)

- source of resistance (manual, mechanical, body weight)

- arc of movement (short arc, full arc, etc.)

- primary energy source used (aerobic or anaerobic)

Modes of exercise

____ exercises can preserve some neuromuscular control and minimize muscle atrophy even when active exercise is prohibited

Isometric