1. Copyright © 2013. F.A. Davis Company Part II: Applied Science of Exercise and Techniques Chapter 6 Resistance Exercise for Impaired Muscle Performance

2. Copyright © 2013. F.A. Davis Company  Strength, Power, and Endurance – Strength Strength training – Power Power training – Endurance Endurance training Muscle Performance and Resistance Exercise: Definitions and Guiding Principles

3. Copyright © 2013. F.A. Davis Company  Overload Principle – Description – Application of the Overload Principle  SAID Principle – Specificity of training – Transfer of training  Reversibility Principle Muscle Performance and Resistance Exercise: Definitions and Guiding Principles (cont'd)

4. Copyright © 2013. F.A. Davis Company  Energy Stores and Blood Supply  Fatigue – Muscle (local) fatigue – Cardiopulmonary (general) fatigue – Threshold for fatigue – Factors that influence fatigue  Recovery From Exercise Factors That Influence Tension Generation in Normal Skeletal Muscle

5. Copyright © 2013. F.A. Davis Company  Age – Early childhood and preadolescence – Adolescence – Young and middle adulthood – Late adulthood  Psychological and Cognitive Factors – Attention – Motivation and feedback Factors That Influence Tension Generation in Normal Skeletal Muscle (cont'd)

6. Copyright © 2013. F.A. Davis Company  Neural Adaptations  Skeletal Muscle Adaptations – Hypertrophy – Hyperplasia – Muscle fiber type adaptation Physiological Adaptations to Resistance Exercise

7. Copyright © 2013. F.A. Davis Company  Vascular and Metabolic Adaptations  Adaptations of Connective Tissues – Tendons, ligaments, and connective tissue in muscle – Bone Physiological Adaptations to Resistance Exercise (cont'd)

8. Copyright © 2013. F.A. Davis Company  Alignment and Stabilization – Alignment Alignment and muscle action Alignment and gravity – Stabilization Determinants of Resistance Exercise

9. Copyright © 2013. F.A. Davis Company  Intensity – Submaximal versus maximal exercise loads – Initial exercise load (amount of resistance) and documentation of training effects Repetition maximum – Use of repetition maximum Alternative methods of determining baseline strength or an initial exercise load Training zone Determinants of Resistance Exercise (cont'd)

10. Copyright © 2013. F.A. Davis Company  Volume – Repetitions – Sets – Training to improve strength or endurance: impact of exercise load and repetitions To improve muscle strength To improve muscle endurance Determinants of Resistance Exercise (cont'd)

11. Copyright © 2013. F.A. Davis Company  Exercise Order  Frequency  Duration  Rest Interval (Recovery Period) – Purpose of rest intervals – Integration of rest into exercise Determinants of Resistance Exercise (cont'd)

12. Copyright © 2013. F.A. Davis Company  Mode of Exercise – Type of muscle contraction – Position for exercise: weight-bearing or non- weight-bearing – Forms of resistance – Energy systems – Range of movement: short-arc or full-arc exercise – Mode of exercise and application to function Determinants of Resistance Exercise (cont'd)

13. Copyright © 2013. F.A. Davis Company  Velocity of Exercise – Force-velocity relationship – Application to resistance training  Periodization and Variation of Training  Integration of Function – Balance of stability and active mobility – Balance of strength, power, and endurance – Task-specific movement patterns with resistance exercise Determinants of Resistance Exercise (cont'd)

14. Copyright © 2013. F.A. Davis Company  Static (Isometric) and Dynamic  Concentric and Eccentric  Isokinetic  Open-Chain and Closed-Chain  Manual and Mechanical  Constant and Variable Types of Resistance Exercise

15. Copyright © 2013. F.A. Davis Company  Manual Resistance Exercise  Mechanical Resistance Exercise Manual and Mechanical Resistance Exercise

16. Copyright © 2013. F.A. Davis Company  Rationale for Use of Isometric Exercise  Types of Isometric Exercise – Muscle-setting exercises – Stabilization exercises – Multiple-angle isometrics Isometric Exercise (Static Exercise)

17. Copyright © 2013. F.A. Davis Company  Characteristics and Effects of Isometric Training – Intensity of muscle contraction – Duration of muscle activation – Repetitive contractions – Joint angle and mode specificity – Sources of resistance Isometric Exercise (Static Exercise) (cont'd)

18. Copyright © 2013. F.A. Davis Company  Rationale for Use of Concentric and Eccentric Exercise  Special Considerations for Eccentric Training – Exercise-induced muscle soreness Dynamic Exercise: Concentric and Eccentric

19. Copyright © 2013. F.A. Davis Company  Characteristics and Effects of Concentric and Eccentric Exercise – Exercise load and strength gains – Velocity of exercise – Energy expenditure – Specificity of training – Cross-training effect – Exercise-induced muscle soreness Dynamic Exercise: Concentric and Eccentric (cont'd)

20. Copyright © 2013. F.A. Davis Company  Dynamic Exercise-Constant External Resistance (DCER)  Variable-Resistance Exercise  Special Considerations for DCER and Variable- Resistance Exercise – Excursion of limb movement – Velocity of exercise Dynamic Exercise: Constant and Variable Resistance

21. Copyright © 2013. F.A. Davis Company  Characteristics of Isokinetic Training – Constant velocity – Range and selection of training velocities – Reciprocal versus isolated muscle training – Specificity of training – Compressive forces on joints – Accommodation to fatigue – Accommodation to a painful arc Isokinetic Exercise

22. Copyright © 2013. F.A. Davis Company  Training Effects and Carryover to Function – Limitations in carryover  Special Considerations for Isokinetic Training – Availability of equipment – Appropriate set up – Initiation and progression of isokinetic training during rehabilitation Isokinetic Exercise (cont'd)

23. Copyright © 2013. F.A. Davis Company  Background  Controversy and Inconsistency in Use of Open-Chain and Closed-Chain Terminology  Alternatives to Open-Chain and Closed-Chain Terminology  Characteristics of Open-Chain and Closed-Chain Exercises – Open-chain exercises – Closed-chain exercises Open-Chain and Closed-Chain Exercise

24. Copyright © 2013. F.A. Davis Company  Rationale for Use of Open-Chain and Closed-Chain Exercises – Isolation of muscle groups – Control of movements – Joint approximation – Co-activation and dynamic stabilization – Proprioception, kinesthesia, neuromuscular control, and balance – Carryover to function and injury prevention Open-Chain and Closed-Chain Exercise (cont'd)

25. Copyright © 2013. F.A. Davis Company  Implementation and Progression of Open- and Closed-Chain Exercises – Introduction of open-chain training – Closed-chain exercises and weight-bearing restrictions: use of unloading – Progression of closed-chain exercises Open-Chain and Closed-Chain Exercise (cont'd)

26. Copyright © 2013. F.A. Davis Company  Examination and Evaluation  Preparation for Resistance Exercises General Principles of Resistance Training

27. Copyright © 2013. F.A. Davis Company  Warm Up  Placement of Resistance  Direction of Resistance  Stabilization  Intensity of Exercise/Amount of Resistance  Number of Repetitions, Sets, and Rest Intervals  Verbal or Written Instructions  Monitoring the Patient  Cool Down Implementation of Resistance Exercises

28. Copyright © 2013. F.A. Davis Company  Valsalva Maneuver – At-risk patients – Prevention during resistance exercise  Substitute Motions  Overtraining and Overwork – Overtraining – Overwork Precautions for Resistance Exercise

29. Copyright © 2013. F.A. Davis Company  Exercise-Induced Muscle Soreness – Acute muscle soreness – Delayed-onset muscle soreness (DOMS) Etiology of DOMS Prevention and treatment of DOMS  Pathological Fracture – Prevention of pathological fracture Precautions for Resistance Exercise (cont'd)

30. Copyright © 2013. F.A. Davis Company  Pain  Inflammation  Severe Cardiopulmonary Disease Contraindications to Resistance Exercise

31. Copyright © 2013. F.A. Davis Company  Definition and Use  Guidelines and Special Considerations – Body mechanics of the therapist – Application of manual resistance and stabilization – Verbal commands – Number of repetitions and sets: rest intervals  Techniques: General Background  Upper Extremity Techniques  Lower Extremity Techniques Manual Resistance Exercise

32. Copyright © 2013. F.A. Davis Company  Diagonal Patterns  Basic Procedures With PNF Patterns – Manual contacts – Maximal resistance – Position and movement of the therapist – Stretch Stretch stimulus Stretch reflex Proprioceptive Neuromuscular Facilitation: Principles and Techniques

33. Copyright © 2013. F.A. Davis Company  Basic Procedures With PNF Patterns (cont’d) – Normal timing – Traction – Approximation – Verbal commands – Visual cues Proprioceptive Neuromuscular Facilitation: Principles and Techniques (cont'd)

34. Copyright © 2013. F.A. Davis Company  Upper Extremity Diagonal Patterns  Lower Extremity Diagonal Patterns  Specific Techniques With PNF – Rhythmic initiation – Repeated contractions – Reversal of antagonists – Alternating isometrics – Rhythmic stabilization Proprioceptive Neuromuscular Facilitation: Principles and Techniques (cont'd)

35. Copyright © 2013. F.A. Davis Company  Application in Rehabilitation Programs  Application in Fitness and Conditioning Programs  Special Considerations for Children and Older Adults – Children and resistance training – Older adults and resistance training Mechanical Resistance Exercise

36. Copyright © 2013. F.A. Davis Company  Progressive Resistance Exercise – Delorme and Oxford regimens – DAPRE regimen  Circuit Weight Training Selected Resistance Training Regimens

37. Copyright © 2013. F.A. Davis Company  Isokinetic Regimens – Velocity spectrum rehabilitation Selection of training velocities Repetitions, sets, and rest Intensity – Eccentric isokinetic training: special considerations Selected Resistance Training Regimens (cont'd)

38. Copyright © 2013. F.A. Davis Company  Free Weights and Simple Weight-Pulley Systems – Types of free weights – Simple weight-pulley systems – Characteristics of free weights and simple weight- pulley systems – Advantages and disadvantages of free weights and simple weight-pulley systems Equipment for Resistance Training

39. Copyright © 2013. F.A. Davis Company  Variable-Resistance Machines – Variable resistance weight-cable systems – Hydraulic and pneumatic resistance devices – Advantages and disadvantages of variable- resistance machines Equipment for Resistance Training (cont'd)

40. Copyright © 2013. F.A. Davis Company  Elastic Resistance Devices – Types of elastic resistance – Properties of elastic resistance: implications for exercise Effect of elongation of elastic material Determination and quantification of resistance Fatigue characteristics Equipment for Resistance Training (cont'd)

41. Copyright © 2013. F.A. Davis Company  Elastic Resistance Devices (cont’d) – Application of elastic resistance Selecting the appropriate grade of material Selecting the appropriate length Securing bands or tubing Setting up an exercise Progressing exercises – Advantages and disadvantages of exercise with elastic resistance Equipment for Resistance Training (cont'd)

42. Copyright © 2013. F.A. Davis Company  Equipment for Dynamic Stabilization Training – BodyBlade ® – Swiss balls (stability balls) Equipment for Resistance Training (cont'd)

43. Copyright © 2013. F.A. Davis Company  Equipment for Closed-Chain Training – Body weight resistance: multipurpose exercise systems – Slide boards – Balance equipment – Mini-trampolines (rebounders) Equipment for Resistance Training (cont'd)

44. Copyright © 2013. F.A. Davis Company  Reciprocal Exercise Equipment – Stationary exercise cycles – Portable resistive reciprocal exercise units – Stair-stepping machines – Elliptical trainers and cross-country ski machines – Upper extremity ergometers Equipment for Resistance Training (cont'd)

45. Copyright © 2013. F.A. Davis Company  Isokinetic Testing and Training Equipment – Features of isokinetic dynamometers – Advantages and disadvantages of isokinetic equipment Equipment for Resistance Training (cont'd)

46. Copyright © 2013. F.A. Davis Company  Critical Thinking and Discussion  Laboratory Practice Independent Learning Activities