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UNIT 4
LEARNING OBJECTIVES:
At the end of the class the student will be able to

1.To Define exercise.

2.To understand the uses of exercises.
3.To classify exercises.
4.To understand the different active exercises.
5.To Define resisted exercises.
6.To List the types of resisted exercises.
7.To Identify the material used to give resistance in exercises.
8.To State the techniques of performing resisted exercises.
9.To Discuss the indications, contra indications and effects and uses of resisted exercises.
10.To Describe different regimes of resisted exercises.
DEFINITION:
Exercise is physical activity that is planned, structured, and repetitive
for the purpose of conditioning any part of the body to improve general health
and fitness of a person.
USES:
1. To improve Muscle Performance
A. Strength.
B. Power.
C. Endurance.
D. Flexibility.
2. To improve Cardio- Pulmonary Endurance.
3. To Improve the strength of connective tissues.
4. To Improve the bone mineral density.
5. To Improve muscle co-ordination and balance.
6. To Improve the posture and gait.
7. To Increase physical performance during daily activities.
8. To Improve overall health and fitness.
Exercise

Active ex’s To Improve/Increase muscle performance

Passive ex’s To maintain/improve muscle flexibility and

joint ROM
 Exercise Types

ACTIVE PASSIVE
1. Assisted Ex’s 1. Passive Ex’s
2. Assisted Resisted Ex’s 2. Passive Stretching Ex’s
3. Active Free Ex’s
a. Localized.
b. Generalized.
4. Resisted Ex’s
ACTIVE EXERCISES are performed or controlled by the voluntary action of muscles,
working in opposition to an external force .

ASSISTED EXERCISE - when the muscle strength or co-ordination is inadequate to

perform a movement an external force is applied to compensate the deficiency.

ASSISTED RESISTED EXERCISE - Muscles may be strong enough to work against

resistance in part of the range and not in others. This type of exercise ensures that the
external forces applied are adapted in every part of the range to the abilities of the
muscles.

FREE EXERCISE – The working muscles are subject only to the forces of gravity acting
upon the part moved or stabilized.

RESISTED EXERCISES – The forces of resistance offered to the action of the working
muscles are artificially and systematically increased to develop the power and
endurance of the muscles.
 GUIDELINES FOR CHOOSING EXERCISES
Muscle 0 1 1+ 2- 2 2+ 3- 3 3+ 3- 4 4+ 5
Power
Grade

Type of PASSIVE MUSCLE RE- EDUCATION ACTIVE ASSISTED ACTIVE PROGRESSIVE RESISTED EXERCISES
Exercise MVT 1. MANUAL EX’S FREE ISOMETRIC REGIMENS
2. RE-EDUCATION (OR) EX’S 1. BRIME
BOARD ACTIVE EX’S 2. MULTIPLE ANGLE ISOMETRICS
3. SUSPENSION ELIMINATING ISOTONIC REGIMENS
GRAVITY 1. DELORME TECHNIQUE
2. MCQUEEN TECHNIQUE
3. ZINOVIEFF TECHNIQUE
4. DAPRE
5. CIRCUIT WEIGHT TRAINING
6. PLYOMETRIC TRAINING
ISOKINETIC REGIMENS
1. VELOCITY SPECTRUM
REHABILITATION
2. ECCENTRIC ISOKINETIC TRAINING
ACTIVE FREE EXERCISES
ACTIVE FREE EXERCISES
ACTIVE FREE EXERCISES
ACTIVE FREE EXERCISES
ACTIVE FREE EXERCISES
RESISTANCE EXERCISES are any form of exercise in which the dynamic
or static muscle contraction is resisted by an outside force. The external
force can be manual or mechanical.
1.MANUAL RESISTANCE EXERCISE
2.MECHANICAL RESISTANCE EXERCISE.

Resistance may be provided by

a.Apparatus: weight-and-pulley circuits, weights, springs and elastic
substances;
b.Malleable materials;
c.Water;
d.The Therapist; and the Patient.
INDICATIONS: CONTRA- INDICATIONS:
Decreased Muscular Performance/Muscular 1. Acute Inflammation.
Weakness 2. Pain.
a.Decreased Muscle Strength.
b.Decreased Muscle Power.
c.Decreased Muscle Endurance.

PRECAUTIONS:
1.Cardiovascular disorders
2.Fatigue
3.Recovery from exercise
4.Overwork/ Overtraining.
5.Substitute motions
6.Osteoporosis
7.Exercise induced muscle soreness.
 PRINCIPLES OF RESISTANCE EXERCISES:
FITT Principle:
F- FREQUENCY (refers to the number of times per week)
I- INTENSITY refers to the difficulty or exertion level
T- TIME refers to the duration of a single workout
T- TYPE refers to the particular type of physical activity or exercise

Principles for Progression of strengthening exercise:

The strength of contraction of a muscle can be increased by
1.Increase the load/ weight
2.Increase the leverage
3.Increase the range of muscle contraction
4.Increase the time of contraction
5.Decrease the speed of contraction.
1.PRINCIPLES OF APPLYING MANUAL RESISTANCE EXERCISES:

1.Evaluate the patient’s ROM and strength.

2.Explain the therapy plans and procedures to the patient.
3.Place the patient in comfortable position
4.Verbal instructions to the patients
5.Demonstration on self
6.Demonstration on the patient
7.Explain the patient that the exercises must be pain free or nearly pain free
8.Ensure the patient does not hold the breath during the exercise.
9.Provide stabilization.
10.Apply appropriate resistance.
11.Change the site of application of resistance or reduce the resistance if
a. The patient is unable to complete the full ROM
b. The site of application of resistance is painful
c. Muscular tremor develops
d. Substitute motion occurs
2. PRINCIPLES OF MECHANICAL RESISTANCE EXERCISES:

Follow the principles of Manual Resisted Ex’s and ALSO

Identify the EXERCISE LOAD ( Refers to the amount of resistance imposed on the
contracting muscle during exercise which is the 10 RM/1 RM) before starting with any of the
resistance training program.
Repetition Maximum- A repetition maximum is the greatest amount of weight a muscle can
move through the full ROM a specific number of times.
10RM- 10 repetitions maximum with the greatest amount of weight the muscle can move
through the full ROM.
1RM- 1 repetitions maximum with the greatest amount of weight the muscle can move
through the full ROM.
 EXERCISE REGIMENS
ISOMETRIC REGIMENS:

BRIME( Brief Resisted Isometric Exercises):

20 Maximum contractions
6 Secs hold
20 secs rest period.

Multi angle Isometrics:

10 SETS Of
10 maximum contractions
10 sec hold
10 degree of motion
10 secs rest
 ISOTONIC REGIMENS:

1. De Lorme & Watkins Technique: 2. Oxford Technique:

1st set: 50% of 10 RM load
2nd set: 75% of 10 RM load
3rd set: 100% of 10 RM load
Progression: Increase the exercise
load once weekly (Every 3 days).
1st set: 100% of 10 RM load
2nd set: 75% of 10 RM load
3rd set: 50% of 10 RM load
Progression: Increase the exercise load every day.

3. Mac Queen Technique:

1st set: 10 lifts with 10RM
2nd set: 10 lifts with 10 RM
3rd set: 10 lifts with 10 RM
4th set: 10 lifts with 10 RM

Forty lifts are carried out three times a week.

Progression: Increase the exercise load every 1-2 weeks.
ISOKINETIC REGIMENS:

VELOCITY SPECTRUM REHABILITATION

Designed to develop strength, endurance, or power performing execises on a isokinetic
unit at slow, medium, and fast angular velocities.
ECCENTRIC ISOKINETIC TRAINING
The principles of velocity spectrum training are applied to eccentric regimen.
PRACTICAL CLINICAL GUIDELINES FOR RESISTANCE TRAINING

1. Warm up
2.Choose the correct equipment
3.Exercise large muscle groups first
Legs or large muscles in the upper body
4.Begin any resistive training program slowly and with lower intensities Ultimately, you must
overload
5.Strengthen your weak side:
Working arms and legs independently
6.Isolate the muscle group
7.Protect the back
8.Total body workout
1. Should be done no more than 2 - 3 times per week
2. May alternate days
3. May alternate equipment to save time
9.Allow adequate rest period in between the sets of exercises.
10.Beware of the precautions
11.Choose the exercise program suitable for the patient.
12. PROGRESSION of patients in a therapeutic program is individually determined.

Design strengthening program according to the four principles (SNAP)

S- Specific exercises
N- No pain
A-Attainable Goals
P- Progressive overload
Start with open chain exercises and then progress to close chain exercises
Start with short arc exercises and then progress to full arc exercises
Start with isometric contractions and then proceed to isotonic and isokinetic
contractions.
Start with manual resisted exercises and then progress to mechanical resisted
exercises.
REFERENCES:

1.Kissner, C., and Colby, L.A. (2000). Therapeutic Exercise Foundations

and techniques. Info Access and Distributions Pte. Ltd.
2.Gardiner, D. (2001). The principles of Exercise Therapy. G. Bells and
Sons Ltd.