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General principles of Strengthening exercises Isokinetic Assessment and Rehabilitation Panagiotis V. Tsaklis, PT, ATC, B.Ed, PhD Professor Dept. Physiotherapy.

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Presentation on theme: "General principles of Strengthening exercises Isokinetic Assessment and Rehabilitation Panagiotis V. Tsaklis, PT, ATC, B.Ed, PhD Professor Dept. Physiotherapy."— Presentation transcript:

1 General principles of Strengthening exercises Isokinetic Assessment and Rehabilitation Panagiotis V. Tsaklis, PT, ATC, B.Ed, PhD Professor Dept. Physiotherapy – ATEI Thessaloniki / Greece Dept Mechanical Engineering Fibers & Polymers Lab Massachusetts Institute of Technology

2 Strengthening exercises… Isometrics > max / sub-max > specific angleº… Isometrics > max / sub-max > specific angleº… Isotonics > concentric > max 1RM / sub-max %1RM > specific ROM Isotonics > concentric > max 1RM / sub-max %1RM > specific ROM > eccentric > max / sub-max > specific ROM > eccentric > max / sub-max > specific ROM Isokinetics > concentric > max / sub-max > specific ROM Isokinetics > concentric > max / sub-max > specific ROM > eccentric > max / sub-max > specific ROM > eccentric > max / sub-max > specific ROM Plyometrics > eccentric---concentric contraction--- t~0 Plyometrics > eccentric---concentric contraction--- t~0 Functional exercises… Functional exercises…

3 Isometric strengthening at specific angle 65 ° Note : Strengthening overflow ± 10º from the point of application 55 55 ° 75 75 ° Max or sub-max N of Sets & Reps Time hold / sec Time between Reps / sec Time between Sets / min

4 Open & Close Kinetic Chain isotonic exercises CKC OKC 1RM test must be perform with a controlled low angular speed, aprox 60º/sec..and sameway when we are practicing using isotonics…

5 The relation between speed of practice and muscle fibers recruitment

6 Isokinetic Exercise  Fixed speed with a variable resistance through the predetermined ROM  accommodation of the resistance proportionally to the effort => max-load /º

7 ISOKINETIC DYNAMOMETER THE ISOKINETIC EXERCISE IS APPLIED IN ALL THE MAIN ARTICULATIONS OF THE BODY AND ACTIVATES THE RELEVANT ANTAGONISTIC MUSCLE GROUPS IN EVERY MOOVING PATERN

8 ISOKINETIC APLLICATIONS TEST EXERCISE

9 ISOKINETIC TESTING DATA  Parameters analysis : strength – time – position strength – time – position  Analysis of the Torque Curve

10 Ergo-physiological parameters assessing by isokinetic testing  Maximal strength (Torque) of the testing muscle groups (Peak Torque - Nm)  Fast contraction strength output (speed-force)  Dynamic relation (ratio %) between the competitive (antagonistic) muscle groups  Total work output (Total Work – Joules) & (Fatigue index), force endurance assessment index  Aveg. Power output of the testing muscles (Power - Watts)

11 Ergophysiological parameters assessing by isokinetic testing

12 Total work – avg. power & Fatigue Index

13 Results: Isokinetic endurance test Vs Wingate 30’’ test Correlation Wigate Vs Isokinetic Median Power MeanStd. Deviati on N WMP683.03 5 128.29 6 20 IMP758.00176.7020 Correlations Correlation Wingate Vs Isokinetic Median Power r =.927 MeanStd. Deviation N WMP683.035128.29620 IMP758.00176.7020 240º/sec * 30’’ 120º ROM P. Tsaklis : “Isokinetic evaluation of the knee extensors and flexors anaerobic capacity” ISOKINETICS AND EXERCISE SCIENCE, Vol.10, No.2, 2002

14 Dynamic relation (ratio) between competitive groups

15 ?

16 Torque curve analysis Joint angle at PT Force decay time Time PT held Time to PT Delay time Reciprocal delay 1/8’’TAE

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20 Biofeedback during Isokinetic practicing

21 Combination of isokinetic exercise & EMG Biofeedback EMG 0°0°

22 Basic rehabilitation principles  Functional rehabilitation as…  …soon as “safely” possible… What’s next…

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24 Main goals for a joint functionality rehabilitation  Protection of the cartilage during healing process…  Retaining and enforcement of muscle activity  Retaining of the joint mobility  Supporting of the healing process using food supplements

25 The proper construction of the rehabilitation program should…  …follow the principles of…  Physiotherapy  Exercise physiology  Training science

26 Should Isokinetics be the unique choice for strengthening during rehabilitation & training

27 Isokinetic strengthening in compare and in combination with isotonics Repeated Thigh circumference measurements repeated maximal Isotonic effort measurements “ACL rehab program using a combined isokinetic and isotonic strengthening protocol” P. Tsaklis, J. Isokinetics & Exercise Science,Vol. 10, No.4, 2002 P. Tsaklis, J. Isokinetics & Exercise Science,Vol. 10, No.4, 2002 groups groups 1RM

28 Isokinetic strengthening in compare and in combination with isotonics Ratio Q/H 60º/sec P. Torque Q 60º/sec P. Torque Hams 60º/sec Ratio Q/H 120º/sec J. Isokinetics & Exercise Science, 2002

29 Conclusions…  Isokinetic testing is the most accurate procedure for strength evaluation and analysis of the parameters which determine the muscle power output  Isokinetic exercise is a practice method for the muscle, who secures and gets the maximal resistance in every degree of the activated ROM  Isokinetic exercise when applicates in combination with the other methods of muscle strengthening, offers the best and functional rehabilitation result

30 …I hope not get hungry yet…

31 Thank you


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