Active Resisted Exercise-part 2

1. Active Resisted Exercise-part 2 MazyadAlotaibi

2. Manual Resistance ExerciseA form of active resistance exercise in which the resistance force is applied by the therapist to either a dynamic or a static muscular contractionPreparation for Manual resistance exercise:1- Select the form of exercise and the appropriate resistance.2- Choose between manual or mechanical resistance.3- Review the goals and functional outcome.4- Explain the plan and procedures of exercise for the patient.5- Place the patient in comfortable position.6- warm up before the starting of exercise.7- Instruct the patient to perform the exercise with his maximum effort.8- Ask the patient not to hold his breathing during exercise.

3. Application during Manual resistance exercise :1- Resistance is usually applied to the distal end of the movement.2- Resistance is usually applied opposite to the direction of motion during concentric exercise and in the same direction during eccentric exercise.3- Provide stabilization to avoid substitution.4- Adjust the intensity of resistance to be equal to the abilities of the muscle.5- In general, for most adult, use 8-12 repetitions of specific motion against a moderate exercise load. Additional repetitions may be carries out after adequate period of rest.

4. Technique of Manual resistance exercise • When applying resistance, 4 basic rules should be observed: 1- The resistance must be given smoothly from the beginning to the end of range. 2- The direction of resistance force must be opposite to the direction of the movement. 3- It should be diminish gradually from the beginning to the end of movement. 4- don’t forget to give enough period of relaxation to avoid fatigue.

5. Mechanical Resistance ExerciseDefinition: is any form of exercise in which resistance is applied by the use of mechanical equipments. They include progressive resistive exercise, active resistive training and overload trainingAdvantages:1- Considered as baseline measurement for muscular performanceprior to exercise..2- Appropriate during the advanced phase of Rehabilitation program.3- Practical and Useful for improving muscle strength, endurance and power.4- Appropriate for independent exercise in a home program.5- Effective source for patient motivation. 6- Objective measurement for patient progress.

6. Equipment used with Resistance ExerciseMany types of mechanical equipments can be used for resistance exercise programs, which include:1- Free weights: as Dumbbells, sandbags, weight boots2- Elastic resistance devices: as Thera-band3- Pulley system4- Isotonic torque arm units5- Exercise bicycle

7. Variables of Mechanical Resistance ExerciseMany variable could be used during Mechanical Resistance Exercise to improve muscle performance1- Intensity of exercise and number of repetitions: - Exercise should be performed with suitable intensity which is directly related to the goals of the exercise program.- The number of repetitions at which exercise is performed against resistance should be gradually increased in order to improve muscle endurance.2- Bouts and frequency of exercise: - Exercise bouts: are the number of sets performed during each exercise session. To gain strength combination of sets and repetitions are used, three bouts of 6 RM, two bouts of 12 RM and six bouts of 3 RM have been used. The fewer the number of repetitions performed per set, the greater the number of sets in exercise session.

8. Exercise frequency: is the number of time is done within a day or a week. Generally exercise performed every other day or four times a week.3- Exercise Duration: Is the total number of exercise program, to increase strength a program must be at least 6 weeks in duration.4- Speed of contraction: the speed of muscle contraction affects the produced muscle tension( force-velocity relationship). As the velocity of muscle shortening increases, the generated muscle force decreases.usually in isotonic training exercise is done at slow speeds.5- Mode of exercise: is the type of muscle contraction, static or dynamic(concentric or eccentric). Isometric exercise can be used in the early stage of REHAB and in case of immobilization or when active movement can’t be tolerated. Eccentric exercise can be used when joint motion must be carefully controlled or the tension is very poor. 6- Range of Motion: Resistance exercise can be done through the entire or a limited ROM.

9. Progressive resisted exercise (PRE) One way to progressively increase muscle performance (strength, power and endurance) is to increase the amount of resistance used in an exercise program. In PRE the contracting muscles are overloaded by a constant mechanical external load that is incrementally progressed. The basis for determining and resistance progression istherepetition maximum (RM). RM is the greatest amount of weight a muscle can move through the ROM a specific amount of time.

10. There are many ways to achieve progressive resistance: 1-Increase the weight you’re lifting. Do the same number of repetitions and sets each week, but increase your weight. 2-Increase the number of repetitions, use the same weight for each workout but increase the repetitions each week. 3-Increase the number of sets each time you workout. 4-Shorten the rest time between the sets. 5-Lengthen the time under tension- or how long your muscle fibers are under stress. Use the same weight and repetitions, but slow down the exercise.

11. Specific Exercise RegimensMany types of resistance training can be utilized as effective and efficient methods to increase muscle performance.Isotonic Regimens1- Delorme techniqueDescribe a system approach by progressively increasing the resistance (weight lifted). a-Determine the 10 RMb- The patient then carries out:1- 10 repetitions at 50% of the 10 RM 2- 10 repetitions at 75% of the 10 RM3- 10 RM at 100% of the 10 RM.c- The patient performs all three bouts at each exercise session with a brief rest between bouts.d- The approach builds in a warm-up period as the patient initially lifts only one-half and three-forth of the 10RM.e- The amount of weight is increased weekly as strength increase.

12. Delorm Technique

13. 2- Oxford Technique 1- This technique was designed to be used in beginning of rehabilitation, and to diminish resistance as muscle fatigue develop (it is the reverse of Delorm). 2- a-Determine the 10 RMb- The patient then carries out:1- 10 repetitions at full of the 10 RM 2- 10 repetitions at 75% of the 10 RM3- 10 RM at 50 % of the 10 RM. 3- This technique works to decrease the effect of fatigue. 4- Prior to beginning the bouts of resisted exercise, nonspecific warm-up period of active exercise is needed.

14. Oxford Technique

15. Resistance Training Techniques Used in Rehabilitation • DeLorme’s method • Based on repetition maximum of 10 • Designed for early rehab • Designed for beginning rehab • Introduced PRE – “progressive loading” • Builds in warm-up period • 50%, 75% and 100% of 10 RM • Oxford method • Used during early, intermediate & advanced levels of rehabilitation • Percentages of 10 RM • Diminishes resistance as muscle fatigues – “regressive load” • 100%, 75%, 50% of 10 RM

16. Definitions of Some Terminology • Repetition: number of times you repeat specific movement. • Repetition Maximum (RM): maximum number of repetitions at a given weight. • Intensity: the amount of weight or resistance lifted. • Recovery Period: the rest interval between repetitions. • One Rep Max, or 1RM: is a measure of how much you can lift for one repetition of an exercise..