There are numerous sources from which to obtain information on training for endurance in athletes and healthy young people and for individuals with coronary heart disease. Information or emphasis on endurance training and the improvement of fitness in the individual who has other types of chronic disease or disability is beginning to emerge. Using the […]

Application of Elastic Resistance
Selecting the appropriate grade of material. The thickness (stiffness) of the material affects the level of resistance. A heavier grade of elastic generates greater tension when stretched and therefore imparts a greater level of resistance. As already noted, corresponding levels of resistance have been published for the different grades of bands […]

Introduction
There seems to be an almost limitless selection of exercise equipment on the market that is designed for resistance training. The equipment ranges from simple to complex, compact to space-consuming, and inexpensive to expensive. An assortment of simple but versatile handheld and cuff weights or elastic resistance products is useful in clinical and home settings, […]

Application and Progression of Plyometric Training
Plyometric training is appropriate only in the later stage of rehabilitation of active individuals who must achieve a high level of physical performance in specific, high-demand activities.
Contraindications. Plyometrics should not be used if inflammation, pain, or significant joint instability is present.
Preparation for plyometrics. Prior to initiation of plyometric training, a […]

Introduction
For the past 50 to 60 years practitioners and researchers alike in rehabilitation and fitness settings have taken great interest in resistance exercise and functional training. As a result, many systems of exercise have been developed to improve muscle strength, power, and endurance. All of these systems are based on the overload principle, and most […]

Introduction
Mechanical resistance exercise is any form of exercise in which resistance (the exercise load) is applied by means of some type of exercise equipment. Frequently used terms that denote the use of mechanical resistance are resistance training, weight training, and strength training.
Mechanical resistance exercise is an integral component of rehabilitation and conditioning programs for individuals […]

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. The term isokinetic refers to movement that occurs at an equal (constant) velocity. Unlike DCER exercise where a specific […]

UPPER EXTREMITY DIAGONAL PATTERNS

NOTE: All descriptions for hand placements are for the patient’s right (R) upper extremity. During each pattern tell the patient to watch the moving hand. Be sure that rotation shifts gradually from internal to external rotation (or vice versa) throughout the range. By mid-range, the arm should be in neutral rotation. Manual […]

I NTRODUCTION

Proprioceptive neuromuscular facilitation (PNF) is an approach to therapeutic exercise that combines functionally based diagonal patterns of movement with techniques of neuromuscular facilitation to evoke motor responses and improve neuromuscular control and function. This widely used approach to exercise was developed during the 1940s and 1950s by the pioneering work of Kabat, Knott, […]

General Background
The manual resistance exercise techniques described in this section are for the upper and lower extremities, performed concentrically in the anatomical planes of motion. The direction of limb movement would be the opposite if manual resistance were applied to an eccentric contraction. The exercises described are performed in non-weight-bearing positions and involve movements to […]

Manual resistance exercise is a form of active resistive exercise in which the resistance force is applied by the therapist to either a dynamic or a static muscular contraction.
• When joint motion is permissible, resistance is usually applied throughout the available ROM as the muscle contracts and shortens or lengthens under tension.
• Exercise is carried […]

Introduction
There are only a few instances when resistance exercises are contraindicated. Resistance training is most often contraindicated during periods of acute inflammation and with some acute diseases and disorders. By carefully selecting the appropriate mode of exercise (static vs. dynamic; weight-bearing vs. non-weight-bearing) and keeping the initial intensity of the exercise at a very low […]

Introduction
Regardless of the goals of a resistance exercise program and the types of exercises prescribed and implemented, the exercises must not only be effective but safe. The therapist’s interpretation of the examination’s findings determine the exercise prescription. Awareness of precautions maximizes patient safety. General precautions for resistance training are summarized below.
General Precautions During Resistance Training
• […]

Introduction
The principles of resistance training presented in this section apply to the use of both manual and mechanical resistance exercises for persons of all ages, but these principles are not “set in stone.” There are many instances when they may or should be modified based on the judgment of the therapist. Additional guidelines specific to […]

The most common system of resistance training used with dynamic exercise against constant or variable resistance is progressive resistance exercise (PRE). A later section of the chapter, which covers systems of training using mechanical resistance, addresses PRE.
Dynamic constant external resistance (DCER) exercise is a form of resistance training where a limb moves through a ROM […]

A dynamic muscle contraction causes joint movement and excursion of a body segment as the muscle contracts and shortens (concentric contraction) or lengthens under tension (eccentric contraction). The term concentric exercise refers to a form of dynamic muscle loading where tension in a muscle develops and physical shortening of the muscle occurs as an external […]

Isometric exercise is a static form of exercise in which a muscle contracts and produces force without an appreciable change in the length of the muscle and without visible joint motion. Although there is no mechanical work done (force × distance), a measurable amount of tension and force output are produced by the muscle. Sources […]

From a broad perspective a load can be applied to a contracting muscle in two ways: manually or mechanically.
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. A patient can be taught how to apply self-resistance to selected muscle groups. Although […]

The types of exercise selected for a resistance training program are contingent on many factors, including the cause and extent of primary and secondary impairments. Deficits in muscle performance, the stage of tissue healing, the condition of joints and their tolerance to compression and movement, the general abilities (physical and cognitive) of the patient, the […]

Balance of Stability and Active Mobility
Control of the body during functional movement and the ability to perform functional tasks require a balance of active movement superimposed over a stable background of neuromuscular control. Sufficient performance of agonist and antagonist muscles about a joint contributes to the dynamic stability of individual joints. For example, a person […]

Periodization, also known as periodized training, is an approach to resistance training that builds systematic variation in exercise intensity and repetitions, sets, or frequency at regular intervals over a specified period of time. This approach to training was developed for highly trained athletes preparing for competitive weight-lifting or power-lifting events. The concept was designed to […]

The velocity at which a muscle contracts significantly affects the tension that the muscle produces and subsequently affects muscular strength and power. The velocity of exercise is frequently manipulated in a resistance training program to prepare the patient for a variety of functional activities that occur across a range of slow to fast velocities.
Force-Velocity Relationship
The […]

The mode of exercise in a resistance exercise program refers to the form of exercise, the type of muscle contraction that occurs, and the manner in which the exercise is carried out. For example, a patient may perform an exercise dynamically or statically or in a weight-bearing or non-weight-bearing position. Mode of exercise also encompasses […]

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. The term isokinetic refers to movement that occurs at an equal (constant) velocity. Unlike DCER exercise where a specific […]

Rest is a critical element of a resistance training program and is necessary to allow time for the body to recuperate from the acute effects of exercise associated with muscle fatigue or to offset adverse responses, such as exercise induced, delayed-onset muscle soreness. Only with an appropriate balance of progressive loading and adequate rest intervals […]

Frequency
Frequency in a resistance exercise program refers to the number of exercise sessions per day or per week. As with other aspects of dosage, frequency is dependent on other determinants, such as intensity and volume as well as the patient’s goals, general health status, previous participation in a resistance exercise program, and response to training. […]

In resistance training the volume of exercise is the summation of the total number of repetitions and sets of a particular exercise during a single exercise session multiplied by the resistance used. The same combination of repetitions and sets is not and should not be used for all muscle groups.
There is an inverse relationship between […]

The intensity of exercise in a resistance training program is the amount of resistance (weight) imposed on the contracting muscle during each repetition of an exercise. The amount of resistance is also referred to as the exercise load (training load), that is, the extent to which the muscle is loaded or how much weight is […]

Stabilization refers to holding down a body segment or holding the body steady. To maintain appropriate alignment, ensure the correct muscle action and movement pattern, and avoid unwanted substitute motions during resistance exercise, effective stabilization is imperative. Exercising on a stable surface, such as a firm treatment table, helps hold the body steady. Body weight […]

Just as correct alignment and effective stabilization are basic elements of manual muscle testing and dynamometry, they are also crucial in resistance exercise. To strengthen a specific muscle or muscle group effectively and avoid substitute motions, appropriate positioning of the body and alignment of a limb or body segment are essential. Substitute motions are compensatory […]