Lecture 10 - Therex part II

must do something above and beyond what pt normally does to strengthen and prevent injury

static
dynamic

isometric

isotonic
eccentric
isokinetic
plyometric

When joint motion painful or contraindicated during immobilization
when weakness exists at a specific ROM
to enhance joint stability
No special equipment, limited difficulty in performance

begin to introduce movement to the joint
altering length tension to facilitate improvement in performance through ROM
can be performed in gravity minimized positions and include multi-planer motion

stability of the joint is necessary
sensorimotor integration is necessary to carry over functional tasks

more tension can be generated at a low metabolic cost
important component in functional tasks
develop the greatest tension of all muscle contractions
are clinically proven effective in the repair/tissue healing of tendinopathy

may result in greater post exercise muscle soreness
may result in further damage in muscular strains if performed too early in healing process

protein synthesis
hypertrophy at high volume moderate resistance

provides an ability to activate more muscle fibers for longer periods of time
allows training at a variety of speeds
faster speed training can decrease joint compression forces
some evidence to support co-activation of agonist and antagonist at end range of movement

costly equipment and large equipment
most training is done in a single place with limited carryover to function
cannot accommodate all joints and angular motion

develop explosive reactice power rapidly
Enables a muscle or group of muscles to reach maximum strength in the shortest time possibe
Can increase the GTO threshold increasing its tolerance to stretch loads

high level of flexibility and strength necessary to perform
Associated with delayed onset muscle soreness

1-5 reps, low volume longer rest

2-8 reps, moderate volume, moderate rest

8-15 reps, moderate-high volume, short-moderate rest

>15-20, high volume, shorter rest

painfree movement without soreness the next day

greatest measurable force that can be exerted by muscle or group of muscles to overcome resistance during a single maximum effort (1RPM)

systematic procedure of a muscles lifting and lowering or controlling heavy loads for low number of reps over short period of time

the abilty to perform repeated contractions or a sustained contraction over time without loss of form
measured as accuracy of performance usually with time as indicator

60-75% max effort muscle contractions
a large number of repetitions or sustained contractions for prolonged time period with reduced rest time

strength and spped of movement
can be brief burst in activity, or sustained activity

the greater the intensity of the exercise and the shorter the time period taken to generate force, the greater the muscle power

training
decreases

improve a muscles ability to produce force can facilitate increases in strength, power or endurance

Respect irritability
Individual should have pain free movements
Individual should have optimal movement strategies of the entire Upper quarter/lower kinetic chain. address scapula bt don't be hypervigilant on dyskinesis
Select appropriate exercise including both open and closed chain exercise
Introduce plyometrics early in rehab
Consider traiing the brain as part of exercise
Improve capacity to enhance specific activities, single plane strengthening early progress to multi segment and task based

Prone Y
Prone ER at 90/90
Prone T with ER
Scaption > 120
Prone GH Ext

push up with plus
dynamic hug
D1 flexion
Supine punch
wall slide on ball

supine scapula depression with pulley
seated deloaded lower trap depression (looks like lat pull down)
Assisted shoulder flexion
Assisted shoulder abduction
prone deloaded lower trap depression (pull ball back without bending elbow)
prone deloaded elevation with lower trap depression

deloaded serratus punch in sitting (hand on ball on table)
supine serratus punch (Y shape of arm)

maximize performance of RTC in varying angles of Elevation to promote
can be done with increase load and reduced repetitions or for increase reps and varied
dependent of needs of patient for optimal return to function

Ex dosed at high volume low load 3 sets of 30 repetitions painfree, with Rest between each repetition..need 6-8 ex per session. Don’t forget optimal stress for tissue involved

Ex dosed with lower load high volume where coordination of movement is maintained successfully at least 75% of the time. 3-4 sets of greater than 15 repetitions with rest between sets. These should be prescribed as part task activities that retrain better movement strategies. Need to consider OPTIMAL Theory

External force needs to be pulling limb into new ROM, with sustained hold into the stretch. Follow up with holding into new ROM, can do this isometrically. Typically prescribed for a total stretch time of 90 sec so can do 10 reps into each new position with 10 sec hold if tolerated. Also need to consider stabilization of ST in presence of Adhesive Capsulitis.

Ex dosed at higher intensity, so increase load decrease repetitions.
Patient should be working to fatigue so performing >60% maximum.
Rest between each set.
Need to also be sure painfree and quality movement throughout.
Rest will increase as load and intensity increase

Ex goal is typically to increase either number of repetitions over time or sustained hold over time.
Usually dosed high volume with lower load, rest is shorter than with Motor Control and patient should work to fatigue

glucose

24 hours after it is completed

systolic and diastolic BP after PRE

HDL

oxygen consumption values improved

pain
activity

lean muscle mass
strength
walking speed
fat mass in adults with rheumatoid arthritis

reduction in pain and improving shoulder function in pts with head/neck cancer