Many elements (variables) determine whether a resistance exercise program is appropriate, effective, and safe. This holds true when resistance training is a part of a rehabilitation program for individuals with known or potential impairments in muscle performance or when it is incorporated into a general conditioning program to improve the level of fitness of healthy individuals.

Each of the interrelated elements discussed in this section should be addressed to improve one or more aspects of muscle performance and achieve desired functional outcomes. Appropriate alignment and stabilization are always basic elements of any exercise designed to improve muscle performance. A suitable dosage of exercise must also be determined. In resistance training, dosage includes intensity, volume, frequency, and duration of exercise and rest interval. Each factor is a mechanism by which the muscle can be progressively overloaded to improve muscle performance. The velocity of exercise and the mode of exercise must also be considered.

Determinants of a Resistance Exercise Program
• Alignment of segments of the body during exercise
• Stabilization of proximal or distal joints to prevent substitution
• Intensity: the exercise load (level of resistance)
• Volume: the total number of repetitions and sets in an exercise session multiplied by the resistance used
• Exercise order: the sequence in which muscle groups are exercised during an exercise session
• Frequency: the number of exercise sessions per day or per week
• Rest interval: time allotted for recuperation between sets and sessions of exercise
• Duration: total time frame of a resistance training program
• Mode of exercise: type of muscle contraction, position of the patient, form (source) of resistance, arc of movement, or the primary energy system utilized
• Velocity of exercise
• Periodization: variation of intensity and volume during specific periods of resistance training
• Integration of exercises into functional activities: use of resistance exercises that approximate or replicate functional demands

Consistent with the SAID principle, these elements of resistance exercise must be specific to the patient’s desired functional goals. Other factors, such as the underlying cause or causes of the deficits in muscle performance, the extent of impairment, and the patient’s age, medical history, mental status, and social situation also affect the design and implementation of a resistance exercise program.

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