RESISTANCE

EXERCISES

Dr. Pooja Gulunjkar

Associate Professor
Dept. Of
Kinesiotherapy
 Resistive exercises are a form of active exercises in
which static or dynamic muscle contraction is
resisted by an external force applied manually or
mechanically.
 It is referred to as resistance training.
MUSCLE PERFORMANCE &
RESISTANCE EXERCISES
Muscle performance refers to the capacity of muscle
to do work (force X distance)
The key elements of muscle performance are:
strength, power and endurance which can be
enhanced with some form of resistance exercises.

Alteration in each element depends on -

How principles of resistance training are applied &
How factors like intensity, frequency & duration are
manipulated.
STRENGTH
 It refers to the ability of contractile tissue to
produce tension and resultant force based on
demands placed on the muscle.
 It is the greatest measurable force that can be
exerted by a muscle or group of muscles to
overcome resistance during a single maximum
effort.
 Strength training is defined as a procedure of a
muscle or muscle group lifting, lowering or
controlling heavy loads(resistance) for relatively
low no. of repetitions or over a short period of
time.
 The most common adaptation to heavy
resistance exercise is an increase in maximum
force producing capacity of muscle causing
neural adaptation and increase in muscle fibre
size.
 POWER
 It is related to strength and speed of movement and is
defined as work (Force X Distance) produced by muscle
per unit time (Force X Distance/Time).
 It is the rate of performing muscle work.
 The rate at which a muscle contracts and produces a
resultant force and the relationship of force and velocity
are the factors affecting muscle power.
 Work can be produced over a brief or an extended period
of time, power can be expressed by either a single burst
of high intensity activity (high jump) or repeated bursts
of less intensity muscle activity (climbing flight of stairs)
 Power can be enhanced either by increasing the
work a muscle must perform during a specified
period of time or reducing the amount of time
required to produce a given force.
 The greater the intensity of exercise and shorter the
time taken to generate force, greater the muscle
power.
 Plyometric training.
 ENDURANCE
 It refers to the ability to perform low intensity repetitive
or sustained activities over a prolonged period of time.
 It is the ability of a muscle to contract repeatedly against
a load, generate and sustain tension, resist fatigue over an
extended period of time.
 Endurance training is characterized by having a muscle
contract and lift or lower a light load for many repetitions
or sustain a muscle contraction for an extended period of
time.
 Adaptation occurs by increase in oxidative and metabolic
capabilities which allows better delivery and use of
oxygen
POTENTIAL BENEFITS OF
RESISTANCE EXERCISES
Enhance muscle performance
Increase strength of connective tissue
Greater BMD or reduces bone demineralization
Decrease stress on joints
Reduce risk of soft tissue injury
Improves capacity to repair or heal damaged soft
tissues
Possible improvement in balance
Enhances physical performance during ADLs,
recreational activities & occupation
Improves body composition : increase lean mass & muscle
reduce body fat
Enhance feeling of physical well being & so improve
QOL.
PRINCIPLES OF
STRENGTHENING

 Overload
 SAID (Specific adaptations to imposed demand)
 Reversibility
 OVERLOAD PRINCIPLE
 To improve muscle performance, a load that exceeds
the metabolic capacity of the muscle must be applied,
that is the muscle must be challenged to perform a level
greater than that to which it is accustomed.

APPLICATION-
 Progressive loading of muscle can be done by

manipulating intensity or volume of exercises or

frequency of exercises.
SAID PRINCIPLE
 Specific adaptation to imposed demands
 Exercise program should be built on specificity

principle.
 It’s a extension of Wolf’s law (body systems adapt

overtime to the stresses placed on them)

 This principle helps determine exercise prescription

and parameters to be selected to create specific

training effects best suited for needs and goals.
 Specificity of training is a widely used concept
suggesting that adaptive effects of training, such as
improvement in strength, power and endurance are
highly specific to training method employed.
 It should mimic anticipated function.
 There must be task specificity
 Considered relative to mode & velocity of exercise;
joint angle; movement pattern during exercise.
 Basis of specificity of training is related to
morphological & metabolic changes in muscles &
neural adaptation to the training stimulus with motor
learning.
TANSFER OF TRAINING
 In contrast to SAID principle, carryover effects
from one variation of exercise or task to
another has also been reported. This is called
transfer of training, overflow, or cross-over
training.
 Eg- Strength training improves endurance
moderately but its not true for endurance
training.
REVERSIBILITY PRINCIPLE
 Adaptive changes in body system such as increased
strength or endurance due to resistance exercises
are transient unless training induced improvements
are regularly used for functional activities or as a
maintenance program of resistance exercises.
 Detraining (reduced muscle performance), starts in

a week or two after exercise cessations & continues

until training effect are lost.
SKELETAL MUSCLE FUNCTION AND
ADAPTATION TO RESISTANCE
EXERCISES.
 FACTORS INFLUENCING TENSION GENERATION IN
NORMAL SKELETAL MUSCLES

FACTOR INFLUENCE

Cross section & muscle Larger ms diameter – greater tension producing capacity
size
Fiber length •Short fibers (pinnate/multipinnate) – high force
& producing capacity (quads, deltoid, gastrocnemius)
arrangement •Long parallel fibers –high rate of shortening; less
force production (sartorius)

Fiber type •High % type I – low force production,fatigue

distribution resistant
•High % type II – rapid high force production &
Length tension fatigue tension is produced near or at physiological
Greater
relationship resting position during contraction
CONT…
FACTOR INFLUENCE

Motor unit Greater no & synchronization of motor unit

recruitment firing – greater force production
Frequency of motor Higher frequency of firing – greater the tension
unit firing

Type of muscle Force output from greatest to least :

contraction eccentric, isometric, concentric muscle
contraction
Speed of muscle Concentric contraction - ↑speed -
contraction ↓tension Eccentric contraction - ↑speed
- ↑tension
ADDITIONAL FACTORS
 Energy store & blood supply –
⚫ Adequate energy source is needed to contract,
generate
tension & resist fatigue.
⚫ 3 main energy systems are :
 ATP-PC system

 Anaerobic/glycolytic/lactic acid system

 Aerobic system

 Fatigue complex phenomenon affecting muscle performance.

⚫ Muscle (local) fatigue – the diminished response of
muscle to a repeated stimulus-is reflected in progressive
decrement in amplitude of motor unit potential.
⚫ Cardiopulmonary (general) fatigue – diminished
response of an individual as a result of prolonged physical
activity.`
 Recovery from exs –
⚫ Adequate time of recovery from fatiguing exs must
be
built
⚫ Both inter-session & intra-session
 Age –

⚫ Muscle performance changes through out the life

span.
 Psychological & cognitive factors –

⚫ Positive or negative influence

 Attention

⚫ Patient must focus on given task to perform it

correctly
 Motivation & feedback-
PHYSIOLOGICAL ADAPTATIONS
TO RESISTANCE EXS
VARIABLE STRENGTH TRAINING ADAPTATION

Skeletal muscle •Hypertrophy of muscle fiber (more in type II)

structure •Hyperplasia of muscle fibers
•Fiber type composition: remodelling (type IIB
to IIA; no change in type I)
• Capillary bed density - ↓ or no change
•Mitochondrial density & volume: ↓

Neural system •Motor unit recruitment: ↑

•Rate of motor unit firing: ↑(↓twich
contraction time)
•Synchronization of firing: ↑
Metabolic system •ATP & CP storage: ↑
•Myoglobin storage: ↑
•Stored triglycerides: not known
 STRENGTH TRAINING
VARIABLE ADAPTATION

Enzymes •Creatine phosphokinase: ↑

•Myokinase: ↑

Body composition •Lean body mass: ↑

•% body fat: ↓

Connective tissue •Tensile strength of tendons, ligaments &

connective tissue: ↑
•Bone: ↑BMD; no change or possible ↑ in
bone mass
DETERMINANTS OF
RESISTANCE EXERCISE

 Many elements (variables) determine whether a

resistance exercise program is appropriate,
effective & safe. All elements are interrelated
and should be addressed to improve one or more
aspects of muscle performance and achieve
desired level of functional out comes.
 Alignment – of segments of body during exercise.
 Stabilization –of proximal or distal joint to prevent

substitution.
 Intensity – the exercise load (level of resistance).

 Volume – the total number of repetitions & sets in the

exercise sessions multiplied by the resistance used.

 Exercise order – the sequence in which muscle

groups are exercised during the exercise session.

 Frequency – the number of exercise sessions per day

or per week.
 Rest interval – time allotted for recuperation

between sets & sessions of exercise.

 Duration – total time frame of a resistance training
program.
 Mode of exercise– type of muscle contraction,

position of the patient, form of exercise, arc of

movement, or the energy system utilized primary.
 Velocity of exercise.

 Periodization–variation in intensity & volume

during specific period of resistance training.

 Integration of exercise into functional activities

–use of resistance exercise that approximate or

replicate functional demands.
 TYPES OF
RESISTANCE
EXERCISES
 CONSIDERATIONS FOR SELECTION OF
MODES OF RESISTANCE EXERCISE
 Cause & extent of primary & secondary impairments
 Deficits in muscle performance

 Stage of tissue healing

 Condition of joints & their tolerance to compression

& movement
 General physical & cognitive ability of patient

 Availability of equipments

 Patient’s goal

 Intended functional outcomes of the program

 MANUAL & MECHANICAL
RESISTANCE EXERCISE
Manual resistance exercise –
 Type of active resistive exercise where resistance is

applied manually by therapist, other professional or self

(by patient).
 Resistance cannot be measured quantitatively but

useful in early stage of exercise training.

 Also useful when joint ROM needs to be carefully

controlled.
 Amount of resistance is limited to therapist strength
Mechanical resistance exercises –

 Type of active resistive exercise where resistance is

applied through the use of equipments or
mechanical apparatus.
 Amount of resistance can be measured
quantitatively & increased progressively .
ISOMETRIC EXERCISES (STATIC)
 Static form of exercise in which muscle contracts &
produces force without appreciable change in length of
muscle & without visible joint motion.
 No mechanical work done but measurable amount of

tension & force are produced.

 Sources of resistance –

⚫ Holding against force applied manually

⚫ Holding weight in particular position
⚫ Maintaining position against resistance of body weight
⚫ Pushing or pulling immovable objects
RATIONAL &
INDICATIONS
 To prevent Or minimize muscle atrophy due to
external immobilization
 To activate muscleto begin to res-establish

neuromuscular control but protect healing tissues when

joint movement is not advisable (post surgical)
 To develop postural or joint stability

 To improve muscle strength when dynamic activity

is not permissible
 TYPES
 Muscle setting exs –
⚫ Involve low intensity isometric contractions performed
against
little or no resistance.
⚫ To decrease muscle pain, promote relaxation & circulation
 Stabilization exs –
⚫ Used to develop a sub-maximal but sustained level of
contraction to improve postural or dynamic stability of a
joint by means of mid-range isometric contraction against
resistance in antigravity & weight bearing position.
 Multiple angle isometrics –
⚫ System of isometric exs where resistance is applied
manually or mechanically at multiple joint positions within
available ROM.
CHARACTERISTICS & EFFECTS
 Intensity of muscle contraction –
⚫ Amount of tension generation depends on joint
position &
length of muscle fibers during contraction.
⚫ 60-80%
 Duration of muscle activation–
⚫ Hold for 6-10secs, post 10secs fatigue.
⚫ Sufficient time to develop peak tension & metabolic changes
 Repetitive contractions –
⚫ Repetitive contractions hold for 6-10secs – decrease muscle
cramping & increase effectiveness of isometric regimen.
 Joint angle & mode specificity –
⚫ gain in muscle strength occur only at or closely adjacent to
the training angle.
 Precautions –
⚫ Should be pain free
⚫ Avoid breath holding
 Contraindications –
⚫ High intensity isometrics should be avoided in cardiac &
vascular diseases.
DYNAMIC EXS – CONCENTRIC
& ECENTRIC
 Causes joint movement & excursion of body
segment as muscle contracts under tension.
 Concentric exs – form of dynamic muscle
loading where tension develops in muscle &
physical shortening of muscle occurs as
resistance overcomes. (lifting weight)
 Ecentric exs – dynamic loading of muscle
beyond its force producing capacity, causing
physical lengthening of muscle as it
attempts to control the load. (lowering the
weight)
 Resistance can be applied by –
⚫ Constant resistance (body wt/simple wt/ wt
pulley)
⚫ Weight machine (variable resistance)
RATION
ALE
Concentri contracti acceleratebody
c
wherea on
eccentric segmentdecelerate
contraction
s body
segmen action is evident in countless
t. daily
 Combine

Eccentric contraction –
d⚫ Acts as a source of shock absorption during high
activities
impact activities.
.⚫ Essential component of rehabilitation &
conditioning
program to reduce risk of muscle injury or re-
injury.
⚫ Plyometrics (stretch shortening drills)/ fast
velocity, eccentric isokinetic training – prepare
DYNAMIC EXS – CONSTANT &
VARIBLE RESISTANCE
 The most common system of resistance
training used with dynamic exercise against
constant or variable resistance is progressive
resistance exs.(PRE)
 Dynamic constant external
resistance exs (DCER)
–
⚫ Resistance training where limb moves through a
ROM against constant external load, provided by
free weights like weight cuffs, Pulley system.
⚫ Contracting muscle is challenged maximally at
only one point of ROM, where maximum torque
of resistance matches torque output of muscle.
 Variable resistance exercise –
⚫ Specially designed resistance equipments
imposes varying levels of resistance to
contracting muscle to load the muscle more
effectively at multiple points in ROM. Eg with
elastic tubes or bands.
⚫ Performed against manual resistance, a skilled
therapist can vary the force applied to the
contracting muscle throughout the ROM.
ISOKINETIC EXERCISES
 Its a form of dynamic exs in which velocity of
muscle shortening or lengthening & the
angular limb velocity is predetermined &
held constant by a rate limiting device
known as isokinetic dynamometer.
 Characteristics –

⚫ Constant velocity
⚫ Range & selection of training
velocity
⚫ Reciprocal versus isolated muscle
training
⚫ Specificity of training(speed specific)
⚫ Compressive forces on joints
⚫ Accommodation to fatigue
⚫ Accommodation of painful arc
 Training effects & carryover
function –
⚫ Improves one or more parameters muscl
of performance. e
⚫ Isolate single muscle or opposite muscle
group
⚫ Involves movement of single joint
⚫ Uniplanar movement
⚫ Does not involve weight bearing.
 Special considerations –

⚫ Availability of equipments
⚫ Appropriate set up
⚫ Accommodation to painful
arc
OPEN CHAIN & CLOSED CHAIN
EXS
 Functional activities & exs are commonly
categorized as having weight bearing or non
weight bearing characteristics.
 Also called as “open or closed kinetic chain”
& “open or closed kinematic chain”.
 Open kinetic chain refers to completely
unrestricted movement in space of a
peripheral segment of the body. (waving the
hand, swinging the leg)
 Closed kinetic chain movements – peripheral
segment meets with the considerable
external resistance. One joint motion is
always accompanied by adjacent joint
motions.
 OPEN CHAIN EXS CLOSED CHAIN EXS

Distal segment moves in space Distal surface fixed on

stationary
support
Independent joint movement Interdependent joint movements

Movement of body segmentdistal Movement of body segment distal

to the moving joint &/or proximal to the moving joint
Muscle activation occurs in Muscle activation of multiple
prime movers joint muscles
Performed in non weight Performed in weight bearing
bearing position (typical) position (typically but not always)
Resistance is applied to the Resistance is applied
moving distal segment simultaneously to multiple
moving segments
Use of external rotary loading Use of axial loading

External stabilization usually Internal stabilization by means

required of
GENERAL PRINCIPLES OF
RESISTANCE TRAINING
EXAMINATION &
EVALUATION
Thorough examination of patients
(history, system review, selected tests &
measurements)
 Determine qualitative & quantitative
baseline parameters (strength, endurance,
ROM)
 Implement testing procedures (MMT,
RM,
dynamometry, goniometry, level of disability)
 Interpret the findings

 Establish plan of care integrating resistance

exs
 Periodical re-evaluation.
PREPARA
TION
Select & prescribe form of
resistance exs that are appropriate &
expected to be effective.
 If using mechanicalresistance, determine
what equipment is needed & available.
 Review the anticipated goals & expected
functional outcomes
 Explain the exs plan & procedures.
 Let the patient were nonrestrictive
clothing & supportive shoes appropriate
for exs.
 Select firm but comfortable support surface
 Demonstrate each exs & desired
movement pattern.
APPLICA
TION
Warm up – (5-10mins, non resisted exs)
 Placement of resistance –
⚫ Typically on distal end of segment
⚫ May be applied across intermediate joint
⚫ Revise placement if pressure is
uncomfortable
 Direction of resistance –
⚫ Concentric exs – opposite direction
⚫ Eccentric exs – same direction
 Stabilization –
⚫ Necessary to avoid unwanted or substitute
motion
⚫ Non weight bearing – proximal stabilization
 Intensity of exs / amount of resistance –
⚫ Initially minimal load; progress slowly
 Volume / no of reps & sets & rest intervals –
⚫ Generally, 8-12reps with moderate load; followed
by rest
⚫ For progression initially increase no of reps & sets
then
increase resistance
 Verbal / written instructions –
⚫ Use simple instructions that are easy to
understand
⚫ Avoid medical terminologies
 Monitoring the patient –
⚫ Before, during & after exs
 Cool down –
PRECAUTI
ONS


Select ambient room temperature
Select clothing that facilitate heat dissipation
 Exs should be pain free
 Initiate with low loads/ avoid high intensity
 Do not apply pressure to unstable joint or distal to
fracture site
 Avoid valsalva maneuver
 Avoid uncontrolled ballistic movements
 Prevent incorrect or substitute motion
 Avoid exercise that put excessive, unintended
secondary stress on body
 Be aware of medications a patient is using
 Avoid fatigue
 Discontinue exs if pt experience pain, dizziness or
unusual shortness of breath
 Prevent pathological fractures
CONT
…Overtraining –

⚫ Declined physical performance in healthy
individuals participating in high intensity, high
volume strength training program.
⚫ Other terms are chronic fatigue, staleness,
burnout
⚫ Due to inadequate rest intervals, too
rapid exs
progression, inadequate diet & fluid intake.
⚫ Preventable, reversible phenomenon
 Overwork –
⚫ Termed as overwork weakness
⚫ Progressive deterioration of strength in muscles
already
weakened by nonprogressive neuromuscular
disease
CONT
…
Exs induced muscle soreness –
 Acute muscle soreness –
⚫ During or directly after strenous exs
 Delayed onset muscle soreness (DOMS) –
⚫ DOMS begins to develop 12-24hrs after the
cessation of strenuous activity; intensifies &
peaks 24-48hrs later
⚫ Can be prevented by gradual progression of
intensity & volume of resistance; warm up &
cool down; slow stretches before & after exs
CONTRAINDIC
ATIONS
Acute inflammation / acute
disease
 Pain

 Severe cardiopulmonary

disease
MANUAL
RESISTANC
E
EXERCISES
DEFINIT
ION
 Manual resistance exs is a form of active
resistive exs in which resistance force is
applied by the therapist to either a dynamic
or static muscular contraction.
ADVANT
AGES
Most effective during early stage of
rehabilitation
 Effective during transition from assisted
to mechanically resisted movements
 More finely graded resistance

 Resistance can be adjusted throughout ROM

 Muscle works maximally at all portions of

ROM
 Joint ROM can be carefully controlled

 Useful for dynamic & static strengthening

 Manual stabilization prevents substitute

motions
DISADVAN
TAGES
Exs load is subjective; cannot
be measured to document
 Amount of resistance will be limited to the

strength of therapist
 Little value to strong muscle group

 Speed of movement is slow to moderate

 Cannot be performed independently by the

patient
 Not useful in home program

 Labor- & time- intensive for therapist

 Impractical to improve muscle endurance

GUIDELI
NES
Body mechanics of the therapist –
⚫ Table/patient bed height
⚫ Position close to patient
⚫ Wide standing
 Application of manual resistance & stabilization
⚫ Stabilize proximal attachment
⚫ Vary resistance through out ROM
 verbal commands –
⚫ Coordinate timing of verbal commands with
resistance application
⚫ Simple, direct commands
 No of reps & sets; rest intervals –
⚫ No depends on patient’s response & therapist strength
⚫ Adequate rest interval after 8-12 reps
TECHNI
QUE
For eccentric contraction, direction of limb
movement would be opposite .
 Involves non weight bearing positions &

isolate individual muscle or muscle group

 Variation in therapist position, hand
placement or alternate patient position may
be necessary depending on size & strength
of therapist & patient.
 Opposite motions are often alternately
restricted where strength & balanced
neuromuscular control in both agonist &
antagonist are desired.
MECHANICAL
RESISTANCE
EXERCISE
 Mechanic resistance exercise is any form
al
exercise in which the resistance is of
applied means of some form of exercise by
equipment.
 Integral component of
rehabilitation & conditioning
program.
ADVANT
AGES
Establish quantitative baseline measurement–
improvements
can be monitored.
 Most appropriate in intermediate
& advanced phases of rehabilitation
(muscle strength ≥4/5 or ≥therapist strength)
 Increase in level of resistance can be
incrementally &quantitatively documented.
 Quantitative improvement – effective source of
motivation for
patient.
 Useful for improving static & dynamic muscle
strength.
 Adds variety to resistance training program.
 Some equipments provide variable resistance
throughout the
ROM.
DISADVAN
TAGES
Not appropriate when muscles are very
weak or early stage of soft tissue healing
(exception – equipments that provide
assistance, support or control against
gravity.)
 Equipment that provide constant external
resistance maximally loads the muscle at
only one point in ROM.
 No accommodation for painful arc (except
with hydraulic, pneumatic or isokinetic
equipment).
 Expenses for purchase & maintenance of
equipment.
 With free weights & weighing machine,
gradation depends on manufacturer's
 Use in rehabilitation –
⚫ To eliminate or reduce deficits in muscle strength,
power & endurance caused by an array of
pathological conditions.
⚫ To restore or improve functional abilities.

 Use in conditioning –
⚫ Important component of comprehensive
conditioning program to improve or maintain
physical fitness & health through out most of the
lifespan.
GUIDELINES IN
CONDITIONING
 Prior to training, warm PROGRAM
up followed by flexibility
exs
FOR
 PerformHEALTHY ADULTS
dynamic muscle exs targeting major
muscle
groups of body for total body fitness.
 Balance flexion & extension dominant (pulling /
pushing)exs; concentric & eccentric (lowering /
lifting) exs.
 Use full, available, pain free ROM.
 Use moderate intensity (8-10reps; 1-3sets; 2-
3min rest interval.)
 Use slow, moderate speed, rhythmic,
controlled, non- balliastic movements.
 Exercise should not interfere normal breathing.
 Frequency – 2-3times/wk
 Increase intensity gradually
CHILDREN &
Questionable….
RESISTANCE TRAINING


 Now evidence states that children do achieve

health related benefits & so can safely engage in
supervised weight training program.
 Resistance by using body weight or equipments
designed specifically for children are safe.
 Guidelines :-
⚫ No training below 6-7 yrs age
⚫ Start without weights then with light weights
⚫ Close & continuous supervision
⚫ Focus on proper form, technique & safety
⚫ Emphasize low intensity, short duration, play oriented
exs with low exercise loads & frequency 2-3/wk
⚫ Use warm up & cool down exs
⚫ Initial progression by increasing reps & not resistance.
OLDER ADULTS &
RESISTANCE
 Major goal is toTRAINING
maintain or improve level
functionalindependence
of & risk of
reduce age
related diseases.
 Improves muscle strength, balance, speed
of walking, ability to rise in chair &
minimize risk of fall.
 Guidelines :-
⚫ Secure approval from physician
⚫ Close supervision with vital parameters
monitoring
⚫ 5-10 mins warm up
⚫ Begin with low intensity, low repetitions exs
⚫ Throughout avoid high resistance exs
⚫ Frequency: 2-3 times/wk
SELECTED RESISTANCE
TRAINING PROGRAM
 PROGRESSIVE
RESISTANCE
EXERCISE
 PRE is a system of dynamic resistance
training with constant external load to
contracting muscle by some mechanical
means & incrementally increased.
 RM (repetition maximum) – basis for
determining & progressing the resistance.
 Beneficial in variety of conditio
pathological (muscle injuries, osteoporosi
ns
osteoarthritis,
hypertension, diabetes, COPD, s,
etc)
 Various regimens are:-

⚫ Delorme
⚫ Oxford
⚫ Macqueen
⚫ DAPRE
DELORME
REGIMEN
Introduced around 1945
 Originally known as heavy resistance training &
later as load resisting exercise to describe
system of strength training.
 Uses 3sets of 10 RM with progressive
loading
during each set.
 It builds a warm up period into the protocol

 Incorporate rest intervals between sets,

incrementally increase the resistance over

time & there is training induced strength
gain over time.
SETS REPETITIONS AMOUNT OF RESISTANCE

1 10 50% of 10 RM

2 10 75% of 10 RM

3 10 100% of 10 RM
OXFORD
REGIMEN
Zinovieff regimen
 Regressive loading in each set
 Diminishes the resistance as the muscle

fatigues
 Incorporate rest intervals between sets,

incrementally increase the resistance over

time & there is training induced strength
AMOUNT OF
gainSETS
over time. REPETITIONS
RESISTANC
E
1 10 100% of 10 RM

2 10 75% of 10 RM

3 10 50% of 10 RM
MAC QUEEN
REGIMEN
SETS REPETITIONS
AMOUNT OF

RESISTANC
E
1 10 100% of 10 RM

2 10 100% of 10 RM

3 10 100% of 10 RM

4 10 100% of 10 RM
DAPRE
REGIMEN
Daily adjustable progressive resisted
exercises
 More systematic & takes into account the

different rates at which individuals progress

during rehabilitation or conditioning
program.
 Based on 6RM working weight
SETS REPETITIONS AMOUNT OF RESISTANCE

1 10 50% 6RM
2 6 75% 6RM
3 Max possible 100% 6RM
4 Max possible 100% of adjusted working
weight
CIRCUIT WEIGHT TRAINING
 Pre-established sequence(circuit) of continuous
exercise is performed in succession at
individual exs stations that target variety of
major muscle groups for total body conditioning.
 Exs performed at an exs station for a specified no
of repetitions & sets (high reps, low intensity),
minimum amount of rest interval (15-20secs)
 Progression is by increasingno of sets or reps,
the resistance, no of exs stations, or no of circuit
revolution.
 Exs order is important consideration;exs
should alternate among UL, LL, trunk to minimize
fatigue.
 Large muscle groups before small muscle
groups; multijoint exs before isolated muscle
group.
 Eg. Bench press→leg press/squats→sit ups
→upright
rowing →hamstring curl →shoulder
press →heel raise
PLYOMETRIC TRAINING
 “Plyometric training” / “stretch shortening
drill” / “stretch strengthening drill” is a
system of high velocity training
characterized by rapid eccentric contraction
during which the muscle elongate
immediately followed by rapid reversal of
movement with a resisted shortening
contraction of same muscle.
 Amortization phase – period between stretch

& shortening cycle; should be brief.

 Integrated into advanced phases of
rehabilitation to train neuromuscular system
to react quickly.
 Source of resistance –body
weight/equipment.
 Eg. Catching & throwing ball, dribbling the
NEUROLOGICAL & BIOMECHANICAL
INFLUENCE

Spring like property of

Stretch – shortening
ms tendon
cycle

Create elastic energy

Stimulates
during eccentric
contraction proprioceptors

Releases energy
↑excitability of NM
during concentric
contraction receptors

Improves reactivity of NM
Augment force
system
production
 Effects –  Precautions –
⚫ Enhance ⚫ Don’t include if high
physical stress, shock
performance absorbing activities
⚫ Enhance are not permissible.
muscle’s ⚫ For children or
dynamic elderly do not
restraint include high
capabilities impact heavy load
⚫ ↓LL injury activities
incidence ⚫ Patient should
have adequate
 Contraindication flexibility &
s– strength
⚫ Inflammation ⚫ Warm up & cool
⚫ Pain down
⚫ Joint instability ⚫ Teach safe
 Progression – techniques
⚫ Speed of drill ⚫ Allow adequate
⚫ Intensity time of
recovery (48-
ISOKINETIC REGIMEN
 Should be performedat velocities that
closely match to velocity of specific
movement of task.
 Generally medium or fast velocity

 Speed specific training

 Selection of velocity –

⚫ Medium (60or90 -180 degrees)

⚫ Fast (180-360degrees)
 Repetitions, sets & rest –
⚫ 1-2 sets of 8-10 or maximum 20 repetitions of
agonist & antagonist muscle groups at multiple
velocities
⚫ 15-20sec rest between sets; 60sec rest in exs
velocity
 Intensity –
⚫ Warm up followed by submaximal efforts.
 EQUIPMENTS FOR
RESISTANCE TRAINING
 Limitless selection of exercise equipments
 Range from simple to complex; compact to
space consuming; inexpensive to expensive
 Most equipments are load resisting but few
are load assisting to improve strength of
weak ms.
 Can be used for static or dynamic exs,
concentric or eccentric exs, open or closed
chain exs
 To improve muscle strength, power or
endurance; neuromuscular stability or
control & cardio pulmonary endurance
 Choice of equipment depends on –
⚫ Individuals needs, abilities & goals
⚫ Availability
⚫ Cost of purchase & maintenance
⚫ Ease of use
⚫
FREE WEIGHTS & SIMPLE
PULLEY
 GraduatedSYSTEM
weights or applied to extremities
or trunk
 Dumbbells, barbells, weightedball, cuff

weights, weighted vest, sand bags, simple

weight pulleys
 Can be used for home exs program

 Can be used in various positions

 Can be used isometric/dynamic exs, weight

bearing & non weight bearing exs

VARIABLE
RESISTANCE
Falls in 2 broad categories as :-
⚫ Specially designed weight cables (weight pulley)
MACHINE
– same ms group contracts concentrically &
eccentrically; exs at slow velocity.
⚫ Hydraulic &pneumatic units – concentric work of
agonist & antagonist; no eccentric work;
safe at fast velocities; allow to accommodate
pain free arc.
 Advantages –
⚫ Muscle is loaded maximally at multiple points
⚫ Isolate & exs a specific muscle group
⚫ Mostly allows single plane movements; new
machines dual axis movements
⚫ Provides external stabilization to guide or limit
movements
 Disadvantages – initial expenses &
maintenance cost
ELASTIC RESISTANCE
BANDS & TUBING
 Use is widespread in rehabilitation; effective
method of
providing resistance (variable resistance).
 Two broad categories as elastic bands (available
in various grades & thickness) & tubes (in
graduated diameters & wall thickness)
 Color coding denotes grade of resistance.
 Selection should be based on thickness of
material (level of resistance)
 Length should be sufficient to attach at both
ends & not taut at the beginning of exercise.
 One end should be secured on firm surface &
other end
grasped or tied to limb segment.
 Progression - ↑ no of reps with same resistance
 Advantages –
⚫ Portable
⚫ Relatively inexpensive
⚫ Resistance is not significantly gravity dependant
⚫ Safe to exs at moderate to fast velocities

 Disadvantages –
⚫ Difficult to determine which grade to start with &
to what extent changing grade of band or
tubing changes level of resistance.
⚫ No source of stabilization
⚫ Effects of material fatigue are small, still should
be
replaced on a routine basis to ensure patient
safety.
⚫ Some products contains latex; eliminate use if
allergy to latex.
EQUIPMENTS FOR CLOSED
CHAIN
 TRAINING
Body weight resistance–multipurpose exs
system
⚫ Uses glide board that can be inclined at various
angles
⚫ Enables to perform unilateral or bilateral activities
 Balance boards (wobble board)–
⚫ Proprioceptive training in UL & LL
 Slide boards –
⚫ Moving platform that slides side to side
 Mini trampolines –
⚫ Begin gentle, bilateral or unilateral bouncing
activities on resilient surface
RECIPROCAL EXERCISE
EQUIPMENTS
 Strengthens multiple muscle groups multipl
at joints e
 Appropriate
 cardiopulmonary for low intensity,
fitness. high reps
 training
resistance
Often used to
in warm up & coolincrease
down. muscular
endurance
 Variety of equipments are – & reciprocal improv
coordination
⚫ Stationary exs cycle of UL, LL & e
⚫ Portable resistive reciprocal exs unit
⚫ Stair stepping machine
⚫ Elliptical trainers
⚫ Upper extremity ergometer
EQUIPMENTS FOR DYNAMIC
STABILIZATION
 Swiss ball – TRAINING
⚫ Usually 20-30inches in diameter
⚫ Used for variety of trunk & extremities
stabilization
 Body blade –
⚫ Dynamic, of exs that
reactive form use
produce dynamic resistance
principle of inertia as the source of resistance
stability.
to
ISOKINETIC TESTING &
TRAINING
 Provides EQUIPMENTS
accommodating resistance
during dynamic exs of extremities or trunk.
 The equipment supplies resistance
proportional to the force generated by
person using machine.
 Features –
⚫ Computerized testing capability
⚫ Passive & active modes that permit open
chain, concentric & eccentric testing & training
⚫ Adjustable velocity settings
⚫ Used even for CPM
⚫ Allows limb movement in specific joint range
⚫ Single joint uniplanar movements are common
but some multiplanar movements are possible.