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Resisted exercises
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Resisted Exercises
What is Resisted exercise?
• It is any form of active exercises in which dynamic or
static muscle contraction is resisted by an outside
force applied manually or mechanical.
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Resisted Exercises
Principles of resistance
External force:
• It may be applied to the body levers
• To oppose the force of muscular contractions.
Tension:
• It is increased within a muscles by the opposing
force (or resistance)
• Muscle respond by ↑ in
i. Power
ii. Hypertrophy
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Resisted Exercises
Amount of resistance
• Sufficient to increase the intramuscular tension
• Co-ordinated movement
Isotonic
contraction
• Maximum increase in the intramuscular
tension
• Resistance= muscles ability to maintain the
Isometric
hold
contraction
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Resisted Exercises
Overload principle: muscle must be challenged to
perform at a level greater than that to which it is
accustomed.
SAID(Specific Adaptation to Imposed Demand)
principle: parameters of exercise should be selected
to create specific training effect.
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Resisted Exercises
Factors contribute to the development of muscular
efficiency
1. Power
2. Endurance
3. Volume
4. Speed of contraction
5. Co-ordination
• Power, endurance and volume are inter-related and
imp factors.
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Resisted Exercises
POWER
• It develops in response to,
Application of the maximum resistance
Consistence with the ability of the muscle to
overcome it
• Essential factor for power development is,
Magnitude/great size, of the resistance
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Resisted Exercises
• The method used to promote is,
PROGRESSIVE RESISTANCE- LOW
REPETATION EXERCISES
• The number of times the movement being relatively
few to allow the resistance to be as great as possible.
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Resisted Exercises
Endurance
• That develops in response to repetitive contraction….
• So the method used is
LOW RESISTANCE- HIGH REPETITIONS
EXERCISE
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Resisted Exercises
VOLUME
It can be,
• Observed or measured as an indications of
hypertrophy
• Usually it is in proportion to POWER.
• It indicates progression of the patient.
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Resisted Exercises
Variability of the power
• The power of the muscles will not be equal at all the
parts of their range.
• Variations in the power will always be there in
different parts of their range.
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Resisted Exercises
• Capable of exerting max
Physiologicall
y strength in the outer range
• Force diminishes as they
shortened
• Like angle of pull of tendon
Mechanical insertion
factors • Effect will be greatest, angle
of pull approaches right angle
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Resisted Exercises
• It is different in diff muscle groups.
• Mostly each group found to be most powerful in the
part of range where it is habitually used.
• Eg. Shoulder flexors in outer range,
Hip extensors in inner range.
• So when we are giving resistance we should adjust
accordingly.
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Resisted Exercises
Technique of Resisted Exercises
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Resisted Exercises
Starting position
• Comfort and stability of the whole body is imp
• So patients whole attention concentrated,
1. On the pattern of movement
2. Efforts require to overcome the resistance.
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Resisted Exercises
The pattern of movement
i. Well known by patient
ii. Taught as passive or free exercise
iii. One which allows the contractions in full range
iv. Based on natural pattern
v. Purposeful movement
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Resisted Exercises
Stabilization
• It improves muscles efficiency
• It is rarely static when natural pattern of movement is
used
• If there is a tendency for the movement to be
transferred to the neighboring joints, then means of
fixation such as manual pressure or a strap must be
used to ensure movement at the required joints.
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Resisted Exercises
Traction
• Traction maintained through out the range facilitates,
i. Joint movement
ii. Maintained tension in the muscles
iii. Elicits the stretch reflex provides powerful
stimulus to contraction
iv. It augments the effect of resisting force
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Resisted Exercises
Resisting force
• Various means used to provide the force used to resist
the contraction,
1. Manual pressure
2. Mechanical resistance
i. Weights
ii. springs
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Resisted Exercises
Mechanical
Manual resistance
resistance
• It can be adjusted • Usually measurable
accurately in every • So useful for
part of the range measuring progress
• Disadvantage is
that it not easily
measurable
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Resisted Exercises
• The amount of resistance varies according to the
purpose.
• Maximal resistance used to develop,
Power
Hypertrophy
• Resistance given to develop muscular endurance is
less than the maximal resistance.
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Resisted Exercises
Character of the movement
• It should be smooth and controlled through out
• Speed of the movement should be according to the group
of muscle to be resisted and the amount of resistance
used.
• The ROM should be full whenever possible
• Resistance can be applied in any part of the range which
is convenient or desirable
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Resisted Exercises
Repetitions
• It is the number of times the muscles are thrown into
action against a resistance.
• Varies acc to the condition and individual patient
• No rule of thumb
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Resisted Exercises
• LOW RESISTANCE HIGH REPETITIONS
exercises suitable for weak or elderly patients.
• It is proved to be effective in such conditions like
Osteoarthritis.
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Resisted Exercises
• HIGH RESITANCE-LOW REPETATIONS exercises
build up power and hypertrophy
• So it is useful for muscles suffering from disuse as a
result of traumatic injury or orthopaedic surgery eg.
menisectomy
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Resisted Exercises
• In case of RA, when there is effusion or joint
changes,
Static resisted contractions , high repetitions are
useful for retaining the muscular efficiency in any
part of the range.
• The number of repetitions depends on the specific
conditions.
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Resistances
Resisted Exercises
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Resisted Exercises
• The two main resistive forces are gravity and
friction, other than that are,
1. The physiotherapist
2. The patient
3. Weights
4. Weight and pulley circuits
5. Springs and other elastic structures
6. Substances which are malleable
7. Water
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Resisted Exercises
Resistance by the physiotherapist(PT)
• Physiotherapist’s hand placed on the surface of the
skin
• Applied manually in line with the movement
• PT stance must be in line of the movement
to prevent waste of effort
To ensure smooth controlled pressure
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Resisted Exercises
• Traction or approximation may be maintained
throughout the movement
• Resistance varied according to the variations in
power in diff parts of the muscle’s range.
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Resisted Exercises
Resistance by the patient
• Can be done by,
Sound limb
Own body weight(free exercises)
• Eg. Moving of a trunk over limb
• Here the quantity of resistance is more
• Unreliable as it can’t be measured or felt by the PT
• And it requires careful instruction, co-operation and
understanding of the pt.
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Resisted Exercises
Resistance by the weight
• Direct application of,
Sand bags
Metal weight
Medicine ball
• Applied by,
Held in the hand
Attachment to the shoes or any other part
Suitable straps
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Resisted Exercises
• It is essential that the means of resistance should be
comfortable and efficient
• Resistance must be given in the direction of gravity
• Its effects increases progressively if the weight is moved
away from the central axis of the body.
• Suitable and convenient for home practice after suitable
instruction
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Resisted Exercises
Progressive resistance exercises(PRE)
• System of dynamic resistance training
• Constant external load applied to the contracting
muscles
• By mechanical means
• Incrementally increased
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Resisted Exercises
• The use of PRE was first described by Delorme in
1945.
• The repetitions maximum(RM) is used as the basis
for determining and progressing the resistance.
• 10 RM- It is the maximum weight which can be
lifted 10 times at a natural speed without rest between
the lifts.
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Resisted Exercises
• Two frequently used regimens are:
1. Delorme regimen
2. Oxford regimen
Method:
• Metal weights applied to the part of the body
• By means of bar-bell held in the hand or by
delorme metal boot
• The poundage is determined by testing the RM for
given number of repetitions
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Resisted Exercises
• 3 sets of 10 repetitions are used in both the methods.
• Delorme – progressive loading
• Oxford – regressive loading
• In both,
Rest interval between the sets
Increase the resistance incrementally over time to
apply progressive overload
Result in training induced strength gains.
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Resisted Exercises
Comparison of two PRE regimens
Delorme Regimen Oxford Regimen
Determination of a 10 RM Determination of a 10 RM
10 reps @ 50 % of the 10 RM 10 reps @ 100 % of the 10 RM
10 reps @ 75 % of the 10 RM 10 reps @ 75 % of the 10 RM
10 reps @ 100 % of the 10 RM 10 reps @ 50 % of the 10 RM
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Resisted Exercises
DAPRE(Daily Adjustable Progressive Resisted
Exercise)
• When and how much to increase the resistance in a
PRE program to overload the muscle is imprecise
and arbitrary.
• DAPRE is more systematic
• The system is based on 6 RM of the Working
weight.
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Resisted Exercises
Adjustable Working Weight:
It is based on the maximum number of repetitions
possible using the working weight in set #3 of the
regimen, determines the working weight for the next
exercise session
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Resisted Exercises
DAPRE Technique
Sets Repetitions Amount of Resistance
1 10 50% 6-RM
2 6 75% 6-RM
3 Maximum Possible 100% 6-RM
4 Maximum Possible 100% adjustable working
weight
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Resisted Exercises
Calculation of the Adjustable working weight for the DAPRE
Regimen
Adjustment of the working weight
Repetitions in set 3 Set 4 Next exercise session 3
0-2 ↓ 5-10 lb ↓ 5-10 lb
3-4 ↓ 0-5 lb Same weight
5-6 Keep same weight ↑5-10 lb
7-10 ↑5-10 lb ↑5-15 lb
11 or more ↑10-15 lb ↑10-20 lb
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Resisted Exercises
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Resisted Exercises
Resistance by weight and pulley circuits
• The use of rope and pulley allows,
the force exerted by a weight to act in any direction
therefore the muscles need not be required to work
against the resistance of both the gravity and the
weight.
• Provides a useful method of arranging resistance for
weak muscles when the limb is heavy
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Resisted Exercises
• The angle of pull of the rope by which it is applied
must vary during the course of a movement.
• Eg if perticular muscle group is more powerful in the
mid range , the resistance should be applied at a right
angle.
• Pt must be able to see the weight moving as a result
of his work
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Resisted Exercises
Resistance by spring and other elastic substances
• The resistance of spring increases as it is stretched or
compressed according to the type of the spring used
• Speed of movement must be carefully controlled as
accumulated energy in the extended spring makes its
natural speed of recoil very great
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Resisted Exercises
• Other substances like,
rubber elastic of various widths and thickness
Rubber sponges
Rubber balls
Mostly useful for gripping muscles of the hands
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Resisted Exercises
Resistance by the substances which are malleable
• Various substances like,
Putty
Clay
Some kind of wax
Plasticine
Wet sand
• Used both for strengthening and mobilizing the hands
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Resisted Exercises
Resistance by Water
• It increases with speed and the surface area of the
part moved
• When the movement is vertical, buoyancy adds to the
resistance on the way down and cancel out much of
the resistance on the way up
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Resisted Exercises
Progression
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Resisted Exercises
• As the power increases the resistance must
increased.
• Four ways,
1. ↑ weight
2. ↑ leverage of the resisting force
3. Alteration in the speed of movement
4. ↑ in the duration of exercise.
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Effect and uses of resisted
exercises
Resisted Exercises
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Resisted Exercises
1. Increase the power and endurance
2. Increase the blood flow to the working muscles
3. A general increase of blood pressure
4. Heat produced causes vasodilatation
