KINESIOLOGY

CHAPTER 5
ACTIVE MOVEMENNTS (1)
Dr. IQRA
KARAMAT PT
 RANGE OF
MOTION
ACTIVE
■ TOPIC OUTLINE:
MOVEMENT
■ Voluntary movements
■ Definition, classification
■ Free exercises
■ Definition
■ Classification
■ Techniques
■ Effects and uses
VOLUNTARY
MOVEMENTS
 DEFINITION:
Movements performed or controlled
by the voluntary action of muscles, working in
opposition to an external force.

 CLASSIFICATION:
1.FREE EXERCISES:
The working muscles are subject only to the
forces of gravity acting upon the part moved or
stabilized.
2.ASSISTED EXECISES:
When muscles strength or co-ordination is
inadequate to perform a movement an external
force is applied to compensate for the deficiency.
VOLUNTARY
MOVEMENTS
3.ASSISTED-RESISTED EXERCISES:
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.

4.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.
 1. FREE
EXERCISES
 DEFINITION:
Free exercises are those which are performed by the
patient’s own muscular efforts without the assistance or
resistance of any external force, other than that of gravity.
 ADVANTAGE:
The great advantage of free exercises lies in the fact
that once the patient has mastered the technique of
their performance and is aware of their purpose, they are
his own, to practice when and where he pleases.
 DIS-ADVANTAGE:
The disadvantage of free exercises is that they
frequently make insufficient demands on the patient’s
neuromuscular system to elicit the maximal response
required for the rapid re-development or re-enforcement
of weak muscles.
■ When there is muscular imbalance ,
compensatory rather than normal patterns of
movements may be used unless movements are
carefully taught and supervised .

■ Patients who have suffered brain damage or who

are unable to initiate movements cannot co-
operate in doing these exercises until their
performance has been facilitated and voluntary
control has been established.
CLASSIFICATION OF
FREE EXERCISES
■ Free exercises may be classified according to the extent of
the area involved they may be:
1.Localized
2.General

1.Localised exercises:
Localised exercises are designed primarily to
produce some local and specific effect, for example, to mobilise
a particular joint or to strengthen particular muscle group.
Movement is localised to one or more joints, either by the use
of a suitable starting position, or by voluntary fixation of
other areas by the patient’s own muscular effort.
2.General exercises:
General exercises usually involve the use of
many joints and muscles all over the body and
the effect is widespread, e.g. As in running.
The character of a particular exercise may be:
a) Subjective
b) Objective
(a) SUBJECTIVE:
Exercises which are subjective are
usually formal and consist of more or less
anatomical movements performed in full range.
The attention of the patient is deliberately focused
on the form and pattern of the exercise to ensure
accuracy of performance.
(b)Objective:
Objective exercises are those during the
performance of which the patient’s attention is
concentrated on the achievement of a particular
aim which will result from his efforts, e.g. standing;
arm stretching upwards, to touch a mark on the
wall, or to throw a ball.
■ The presence of a goal to be reached is
stimulating to effort, the accuracy of the
movement is not sacrificed to the achievement of
the aim; e.g. in walking across a room to get a
cup of tea, the quality of the walking must not be
allowed to deteriorate.
 TECHNIQUES FOR FREE
EXERCISE
1. The starting position is selected and taught with care
to ensure the maximum postural efficiency as a basis
for movement.
2. Instruction is given in a manner which will gain the
interest and co-operation of the patient and lead him to
understand both the pattern and the purpose of the
exercise.
3. The speed at which the exercise is done depends on the
effect required. It is usually slow during the period of
learning and later the patient is either allowed to find
his own natural rhythm , or the speed required is dictated
by the ohysiotherapist.it often helps the patient to
maintain his natural rhythm at home if, during practice
under supervision he is encouraged to count aloud.
4. The duration of the exercise depends very largely on
the patient’s capacity. Usually three bouts of practice for
each exercise, with short rest periods, or a change of
activity, b/w, ensure sufficient practice without undue
fatigue.
 Effects and uses

■ Relaxation
■ Joint mobility
■ Muscle power and tone
■ Neuromuscular co-ordination
■ Confidence
■ Circulatory and respiratory co-operation
 RELAXATION

■ Rhythmical swinging movements and those which are

pendular in character assist the relaxation of
hypertonic muscles in the region of the joint moved.
■ The alternating and reciprocal contraction and
relaxation of the opposing muscle groups, which is
required to sustain the movements helps to restore the
normal state of relaxation which follows contraction.
This type of exercise is used in conjunction with other
methods which induce relaxation to reduce a state of
wasteful tension in muscles, which limits the range of
joint movement and reduces the efficiency of
neuromuscular co-ordination.
 JOINT MOBILITY

■ The normal range of joint movement is

maintained by exercises performed in full range.
If and when the range of movement is limited,
rhythmical swinging exercises incorporating
over pressure at the limit of the free range and
may serve to increase it.
MUSCLE POWER AND
TONE
■ Power and endurance of the working muscles
are maintained or increased as a result of
tension and tension is greater when exercise is
performed at a slower or more rapid speed than
the natural speed of movement and also increases
with the duration.
■ Under abnormal conditions, for example, during
fixation of joints, the power can only be
maintained or improved by repeated static
contractions , which the patient must practice
through out the day.
NEUROMUSCULAR CO-
ORDINATION

■ Co-ordination is improved by the repetition of an

exercise. As the pattern of movement is
established it is simplified and becomes more
efficient, and the conduction of the necessary
impulses along the neuromuscular pathways is
facilitated.
■ Exercises and activities which at one time
required concentration and much effort, become
with practice more or less automatic in
character, and skill is developed, as for example
in walking or playing the piano.
 CONFIDENCE

■ The achievement of co-ordinated and efficient

movement assures the patient of his ability to
maintain subjective control of his body, giving
him confidence to attempt other and new
activities. For example jumping a rope, shooting a
goal.
■ Objective exercises and activities are usually
used for this purpose.
CIRCULATORY AND RESPIRATORY
CO-OPERATION

■ During vigorous and prolonged exercises it is

apparent that the speed and depth of
respiration is increased, that the heart beat is
faster and more forceful, and that heat is
produced, where as in light exercises these
changes are so slight that they are not noticed.
a) The needs of the active tissues:
The active tissues involved during
muscular exercise require a free supply of
oxygenated blood and the removal of metabolic
products to enable them to continue their activity.
b) Preparation for activity:
■ Cerebral cortex, which initiates the muscular
contraction, also prepares the body to supply the
needs of the tissues concerned, by communicating
with the respiratory, cardiac and vaso-motors centers
which form part of the Autonomic nervous system
■ Sympathetic fibers from these centers convey
impulses to the appropriate organs which with the
help of adrenaline which is released into the blood
stream, produce widespread results.
■ The results includes increased respiration, increased
frequency of the heart beat, a rise in the arterial blood
pressure , and a redistribution of blood, so that the
volume of blood in the muscles is increased at the
expense of that in the splanchnic area in the skin.
Circulatory and respiratory co-
operation
c) LOCAL CIRCULATORY CHANGES IN THE MUSCLES
During active exercise the capillaries in the
working muscles dilate and their permeability is increased.
Many capillaries that were closed when the muscle was at
rest become open and blood flows through them. So, that the
capacity of the muscles to contain blood is markedly
increased and the interchange of he fuel and waste products
b/w the blood and the tissue fluids is facilitated.
d) REGULATION OF CIRCULATORY AND RESPIRATORY
FUNCTION:
The venous return is increased during exercise and
results in an increase in cardiac output. The increased venous
return is caused partly by the pressure variations in the
abdominal and thoracic cavities resulting from increased
respiratory movements which exerts a pumping action upon
the large veins in the direction of the heart, and partly by the
pressure of the contracted muscles on the thin walls of the
peripheral veins. Valves in these veins prevent regurgitation
during relaxation of the pressure.
Circulatory and respiratory co-
operation

■ Muscular contraction increases both the

carbondioxide content and temperature of the blood,
and both these factors stimulate the circulatory and
respiratory systems to further activity.
■ The rise in temperature of the body is kept with in
normal limits by dilation of the skin capillaries and
stimulation of the sweat glands, thus enabling heat
to be lost from the surface.
■ Active exercises can therefore be used to increase
respiration, to increase both local and the general
circulation and to provide work for the heart muscles.