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 the form of resistance, that is, how the exercise load is applied. Resistance can be applied manually or mechanically.

As with other determinants of resistance training, the modes of exercise selected are based on a multitude of factors already highlighted throughout this section. A brief overview of the various modes of exercise is presented in this section.

Type of Muscle Contraction
• Isometric (static) or dynamic muscle contractions are two broad categories of exercise.
• Dynamic resistance exercises can be performed using concentric (shortening) or eccentric (lengthening) contractions, or both.
• When the velocity of limb movement is held consistent by a rate-controlling device, the term isokinetic contraction is sometimes used. An alternative perspective is that this is simply a dynamic (shortening or lengthening) contraction that occurs under controlled conditions.

Position for Exercise: Weight-Bearing or Non-Weight-Bearing

The patient’s body position or the position of a limb in non-weight-bearing or weight-bearing positions also alters the mode of exercise. When a non-weight-bearing position is assumed and the distal segment (foot or hand) moves freely during exercise, the term open-chain exercise is often used. When a weight-bearing position is assumed and the body moves over a fixed distal segment, the term closed-chain exercise is commonly used.

Forms of Resistance
• Manual resistance and mechanical resistance are the two broad methods by which resistance can be applied.
• A constant or variable load can be imposed using mechanical resistance (e.g., free weights or weight machines).
• Accommodating resistance can be implemented by use of an isokinetic dynamometer that controls the velocity of active movement during exercise.
• Body weight or partial body weight is also a source of resistance if the exercise occurs in an antigravity position. Although an exercise performed against only the resistance of the weight of a body segment (and no additional external resistance) is defined as an active rather than an active-resistive exercise, a substantial amount of resistance from the weight of the body can be imposed on contracting muscles by altering a patient’s position. For example, progressive loads can be placed on upper extremity musculature during push-ups by starting with wall push-ups while standing, progressing to push-ups while leaning against a countertop, push-ups in a horizontal position, and finally push-ups from a head-down position on an incline board.

Energy Systems

Modes of exercise can also be classified by the energy systems used during the exercise. Anaerobic exercise involves high-intensity (near-maximal) exercise carried out for a very few number of repetitions because muscles rapidly fatigue. Strengthening exercises fall into this category. Aerobic exercise is associated with low-intensity, repetitive exercise of large muscle groups performed over an extended period of time. This mode of exercise primarily increases muscular and cardiopulmonary endurance.

Range of Movement: Short-Arc or Full-Arc Exercise

Resistance through the full, available range of movement (full-arc exercise) is necessary to develop strength through the ROM. Sometimes resistance exercises are executed through only a portion of the available range. This is known as short-arc exercise. This form of exercise is used to avoid a painful arc of motion or a portion of the range where the joint is unstable or to protect healing tissues after injury or surgery.

Mode of Exercise and Application to Function

Mode-specific training is essential if a resistance training program is to have a positive impact on function. When tissue healing allows, the type of muscle contractions performed or the position in which an exercise is carried out should mimic the desired functional activity.

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