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 must be able to hold the trunk erect and stabilize the spine while lifting a heavy object. Stability is also necessary to control quick changes of direction during functional movements. Hence, a resistance exercise program must address the static strength as well as the dynamic strength of the trunk and extremities.

Balance of Strength, Power, and Endurance

Functional tasks related to daily living, occupational, and recreational activities require many combinations of muscle strength, power, and endurance. Various motor tasks require slow and controlled movements, rapid movements, repeated movements, and long-term positioning. Analysis of the tasks a patient would like to be able to do provides the framework for a task-specific resistance exercise program.

Task-Specific Movement Patterns During Resistance Exercise

There is a place in a resistance exercise program for strengthening isolated muscle groups as well as strengthening muscles in combined patterns. Applying resistance during exercise in anatomical planes, diagonal patterns, and combined task-specific movement patterns should be integral components of a carefully progressed resistance exercise program. Use of simulated functional movements under controlled, supervised conditions is a means to return a patient safely to independent functional activities. Pushing, pulling, lifting, and holding activities, for example, can first be done against a low level of resistance for a limited number of repetitions. Over time, a patient can gradually return to using the same movements during functional activities in an unsupervised work or home setting. The key to successful self-management is to teach a patient how to judge the speed, level, and duration of tension generation in muscle as well as the appropriate timing that is necessary to perform a motor task safely.

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