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 availability of equipment, and of course the patient’s goals and the intended functional outcomes of the program must be considered. A therapist has an array of exercises from which to choose to design a resistance exercise program to meet the individual needs of each patient. There is no one best form or type of resistance training. Prior to selecting specific types of resistance exercise for a patient’s rehabilitation program, a therapist may want to consider the questions listed below.

Application of the SAID principle based on the concept of specificity of training is key to making sound exercise decisions. In addition to selecting the appropriate types of exercise, a therapist must also make decisions about the intensity, volume, order, frequency, rest interval, and other factors discussed in the previous section of this chapter to progress selected resistance exercises effectively.

The types of exercise presented in this section are static (isometric) and dynamic, concentric and eccentric, isokinetic, and open-chain and closed-chain exercise, as well as manual and mechanical and constant and variable resistance exercises. The benefits, limitations, and applications of each of these forms of resistance exercise are analyzed and discussed. When available, supporting evidence from the scientific literature is summarized. Specific regimens or systems of resistance training, such as progressive resistive exercise (PRE), circuit weight training, velocity spectrum rehabilitation, and plyometric training, are addressed in a later section of the chapter.

Considerations for Selection of Modes of Resistance Exercise

• Based on the results of your examination and evaluation, what are the type and extent of the deficits in muscle performance?
• Based on the underlying pathology causing the deficits in muscle performance, would one form of resistance training be more appropriate or effective than another?
• What are the goals and anticipated functional outcomes of the resistance training program?
• Which types of resistance exercise are more compatible with those goals?
• Are there any limitations on how the patient is permitted or able to be positioned during exercise?
• Is weight bearing contraindicated, restricted, or fully permissible?
• Is there hypomobility of affected or adjacent joints (due to pain or contracture) that could affect how the patient is positioned during resistance exercise?
• Is there a portion of the ROM in which the patient cannot safely or comfortably perform resistance exercises due to hypermobility?
• Are there cardiorespiratory impairments that could affect positioning during exercise?
• Will the patient be expected to perform the exercises independently using mechanical resistance, or would manual resistance applied by the therapist be more appropriate at this point in the rehabilitation program?
• What types of equipment will be available or needed for exercises?


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