Resistance
Exercises For
impaired Muscle
Performance
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.
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
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.
Muscle Architecture
1.
The force the muscle can produce is directly
proportional to the cross-sectional area (more
sarcomeres in parallel).
2.
The velocity and working excursion of the
muscle are proportional to the length of the
muscle (more sarcomeres in series).
More Factors Affecting Muscle
Performance
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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).
Muscle Fibers
I
Tonic
SO
Slow Oxidative
S
Slow
II A
FO
Fast Oxidative
FR
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.
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.
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
Determination of resistance

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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.
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.
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
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)
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
•
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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
Types of resistance exercises
1- Manual Resistance Exercise
Manual resistance exercise is a type of activeresistive 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
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.
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

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
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.
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 contro
the load, as when lowering a weight.
Characteristics and Effects of
Concentric and Eccentric
A maximum concentric contraction
produces less force than a maximum
eccentric contraction under the same
conditions
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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
Characteristics of Isokinetic Training
Constant velocity.
Range and selection of training
velocities.
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
• 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