1. Resistance Exercises For impaired Muscle Performance

2. Overload Principle It focuses on the progressive loading of muscle
1 – In Strength training the amount of resistance progressively increased.
2 – For endurance training,
increasing the time a muscle contraction or
the number of repetitions.

3. Physiological Adaption to Resistive exercises
Muscle – in fiber size and mitochondrial density
Connective tissue – ligament and tendon strength and collagen content may
Bone – density may
Cardiovascular system – HR, systolic and diastolic BP, cardiac output and VO2 max, cholesterol

4. Factors infulence Tension Generation of Skeletal Muscle
1. Fiber type
2. Fiber diameter
3. Muscle size
4. Force – velocity relationship:
Active force continually adjusts to the speed at which the contractile system moves.

5. Muscle Architecture
The force the muscle can produce is directly proportional to the cross-sectional area (more sarcomeres in parallel).
The velocity and working excursion of the muscle are proportional to the length of the muscle (more sarcomeres in series).

6. More Factors Affecting Muscle Performance
Training Specificity – Muscle responds to the specific ROM, posture, type in which it’s trained.
Neurologic Adaptation – Initial increase in strength is neural adaptation (2–4 weeks).
Muscle Fatigue – Dosage of resistive exercise is limited to “form fatigue” (sacrifice of technique).

7. Muscle Fibers I Tonic SO Slow Oxidative S Slow II A FO Fast OxidativeFR
Fast Fatigue Resistant
II AB
FOG
Fast Oxidative plus Glycolytic FI
Fast Intermediate Fatigueability
II B FG
Fast Glycolytic FF
Fast Fatigue ability
Strength is related to fiber diameter, not type. Type I fibers typically have smaller diameter than type II fibers.

8. Fatigue :This acute physiological response to exercise is normal
and reversible. It is characterized by a gradual decline
in the force of the neuromuscular system to a decrease in muscle strength.

9. Signs and Symptoms of Muscle Fatigue
pain and cramping
• Tremulousness in the contracting muscle
• Active movements jerky, not smooth
• Inability to complete the movement
• Use of substitute patterns—to complete the movement pattern
• Inability to continue low-intensity physical activity
• Decline in torque during isokinetic testing

10. Determination of resistance
Intensity – Perform exercise to substitution of form fatigue.
Duration – Vary rest intervals dependent upon volume (total repetitions) and rest intervals.
Frequency – Depends on rehab goals.
Sequence –Affects the development of strength. Rehab generally specific isolation training and graduate to multi-joint exercises, small-large movements.

11. Dosage Varies Strength Training – 60–70% of 1RM, 8–12 reps.
Power Training – 1–3 sets 30–60% of 1RM.
Endurance Training – 10–15 reps, 10–25 reps (advanced). Shorter rest periods.

12. Examination and Evaluation of Muscle Performance
Tests include an analysis of functional muscle strength
Manual muscle testing (consider imbalances, length–tension relationships, and positional weakness when choosing positions)
Handheld dynamometers
Isokinetic dynamometers
Dynamic strength test
AND MORE

13. Types Of Muscle Contractions
Isometric Exercise (provides strength base for dynamic exercise)
Dynamic Exercise (weight machine exercise, free-weight exercise, plyometric exercise)
Isokinetic Exercise (provides maximum resistance throughout entire ROM)

14. Determination of resistance exercises
Alignment of segments of the body
• Stabilization of proximal or distal joints to prevent substitution
• Intensity: the exercise load
• Volume: the total number of repetitions multiplied by the resistance used
• Exercise order: the sequence in which muscle groups are
exercised during an exercise session •

15. Frequency: the number of sessions per day
• Rest interval: time between sets
• Duration: total time frame of resistance training program
• Mode of exercise: type of muscle contraction
• Velocity of exercise
• Periodization: variation of intensity and volume during

16. Types of resistance exercises
1- Manual Resistance Exercise
Manual resistance exercise is a type of active-resistive exercise in which resistance is provided by a therapist or other health professional.
The amount of resistance cannot be measured quantitatively, it is useful in the early stages of an exercises need minimal to moderate resistance. It is
also useful when the range of joint movements needs to be inceased

17. Mechanical Resistance Exercise
It is a form of active-resistive
exercise in which resistance is applied through the use of equipment or mechanical apparatus.
The amount of resistance measured quantitatively and incrementally progressed
over time. It is also useful when the amount of
resistance necessary is greater than what the therapist can apply manually.

18. Isometric Exercise (Static Exercise)
Isometric exercise is a static form of exercise in which muscle contracts and produces force without change in the length of the muscle and without visible joint motion.
Indications
prevent or minimize muscle atrophy
re-establish neuromuscular control but protect healing tissues
Maintain postural control

19. Types of isometric exercises
1-Muscle-setting exercises involve low intensity isometric contractions against little to no resistance.
2- Stabilization exercises. a submaximal sustained level of co contraction improve postural stability or dynamic stability
of a joint by means of mid-range isometric contractions

20. 3- Multiple-angle isometrics.
Resistance applied at multiple joint positions within the available ROM.
Characteristics of Isometric exercises
1-Intensity of muscle contraction.
2-Duration of muscle activation
3-Repetitive contractions.
4-Joint angle and mode specificity.

21. Dynamic Exercise Concentric and Eccentric
concentric exercise refers to a form dynamic
muscle loading where physical shortening of the muscle occurs as an external
resistance is overcome, as when lifting a weight.
eccentric exercise involves causing physical
lengthening of the muscle as it attempts to control the load, as when lowering a weight.

22. Characteristics and Effects of Concentric and Eccentric
A maximum concentric contraction produces less force than a maximum eccentric contraction under the same conditions

23. 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

24. Characteristics of Isokinetic Training
Constant velocity.
Range and selection of training velocities.

25. pain should not occur during exercise.
• Do not initiate resistance training at a maximal level of resistance,
• Avoid use of heavy resistance during exercise for children , older adult
• Do not apply resistance across an unstable joint or distal to a fracture site .
• Have the patient avoid breath-holding during resisted exercises

26. • Avoid uncontrolled, ballistic movements
• Prevent incorrect or substitute motions by adequate stabilization
• Avoid exercises that place excessive,
secondary stress on the back.
• Avoid cumulative fatigue due to excessive frequency of exercise