Resistance Exercise

Prepared by: John Lynyrd A. Dela Cruz, PTRP

Resistance Exercise

Resistance Exercise  Any

form of active exercise in which dynamic or static muscle contraction is resisted by an outside force, applied either manually or mechanically.

 A.k.a.

Resistance Training

Resistance Exercise  An

essential element of rehabilitation programs for persons with impaired function.

Resistance Exercise  An

integral component of conditioning program:  Promotion and maintenance of health

and well-being.  Enhance performance of motor skills.  Prevent or reduce risk of injury and disease.

Muscle Performance  Capacity

of a muscle to do work (force x distance).

A

complex component of functional movement

Muscle Performance  Factors

that may affect muscle performance:        

Morphological qualities of muscle Neurological Biomechanical influences Metabolic Cardiovascular Respiratory Cognitive Emotional

Muscle Performance  Key

elements of Muscle Performance

 Strength  Power  Endurance

Strength  The

ability of contractile tissue to produce tension and a resultant force based on the demands placed upon the muscle.  The greatest measurable force that can be exerted by a muscle group to overcome resistance during a single maximum effort.

Strength Functional Strength  Ability of the neuromuscular system to produce, reduce, or control forces, contemplated or imposed, during functional activities, is a smooth, coordinated manner.

Strength Strengthening Exercise  A systematic procedure of a muscle or muscle group lifting, lowering, or controlling heavy loads (resistance) for a relative low number of repetitions or over a short period of time.

Strength  Most

common adaptation to heavy resistance training: increase in the maximum force producing capacity of muscle (increase in muscle strength) due to:  Neural adaptations; and  Increase in muscle fiber size.

Power  Related

to strength and speed of movement.  Work (force x distance) produced by a muscle per unit of time (force x distance/time).  Rate of performing work.

Power  Can

be expressed by a single burst of high-intensity activity (anaerobic power) or by repeated burst of less intense muscle activity (aerobic power).

Power  Can

be enhanced by:

 Increasing the work a muscle must

perform is a specified period of time.  Reducing the amount of time required to produce a given force. (e.g. Plyometric training)

Endurance  The

ability to perform low-intensity, repetitive, or sustained activities over a prolonged period of time.

Endurance Cardiorespiratory Endurance (Total Body Endurance)  Associated with repetitive dynamic motor activities that involve the use of the large muscles of the body.

Endurance Muscle Endurance (Local Endurance)  Ability of a muscle to contract repeatedly against a load (resistance), generate and sustain tension, and resist fatigue over an extended period of time.  Used interchangeably with Aerobic Power.

Endurance Endurance Exercises (Endurance Training)  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.

Endurance  Endurance

training will have a more positive impact on improving function than strength training in patients with impaired muscle performance.

Endurance  Minimize

adverse forces on joints, produce less irritation on tissues, and is more comfortable for patients than heavy resistance training.

Overload Principle A

load that exceeds the metabolic capacity of the muscle must be applied.  The muscle must be challenged to perform at a level greater than that to which it is accustomed.

Overload Principle  If

demands remain constant after the muscle has adapted, the level of muscle performance can be maintained, but not increased.  Intensity (amount of load) or volume (time or repetitions) can be manipulated.

SAID Principle  Specific

Adaptations to Imposed Demands  The framework of specificity is a necessary foundation upon which exercise programs should be built.

SAID Principle  Helps

the therapist determine the exercise prescription and which parameters of exercise should be selected to create specific training effects and best meet specific functional needs and goals.

SAID Principle Specificity of Training (Specificity of Exercise)  The adaptive effects of training are highly specific to the training method employed.

SAID Principle  Should

be considered relative to:

 Mode (type)  Velocity  Limb position  Movement pattern during exercise.

SAID Principle Transfer of Training (Overflow, CrossTraining)  Carryover of training effects from one variation of task to another.

SAID Principle  Occur

on a very limited basis with respect to velocity of training and mode of exercise.  Can occur from an exercised limb to a non-exercised contralateral limb in a resistance training program.

SAID Principle A

program to improve muscle strength has been shown to at least moderately improve muscle endurance.  Overflow effects are substantially less than the training effects resulting to specificity of training.

Reversibility Principle  Adaptive

changes in the body systems as result of resistance training are transient unless training induced improvements are regularly used for functional activities or has exercise maintenance program.

Reversibility Principle Detraining  Reflected by a reduction in muscle performance.  Begins within a week or two after the cessation of resistance exercises.

Factorsthat thatInfluence Influence Factors TensionGeneration Generationof of Tension SkeletalMuscle Muscle Skeletal

Morphological  Cross section and size of the muscle  Fiber arrangement and fiber length

Biomechanical  Fiber-type distribution of muscle  Length-tension relationship of muscle

at the time of contraction  Type of muscle contraction  Speed of muscle contraction (forcevelocity relationship)

Neurologic  Recruitment of motor units  Frequency of firing of motor

units

Metabolic and Biochemical  Energy stores and blood  Fatigue  Recovery from exercise

supply

Other factors  Age  Psychological

Cross Section and Size of the Muscle  The

larger the diameter = greater the tension producing capacity.

Fiber Arrangement and Fiber Length  Short,

pinnate or multipinnate = greater tension  Long, parallel (high rate of shortening) = lesser tension

Fiber-type Distribution  Type

I (tonic, slow-twitch) = slow rate of maximum force development  Type IIA & IIB (phasic, fast-twitch) = rapid, high force production

Length-Tension Relationship  Muscle

length near or at the physiologic resting position = greatest tension

Type of Muscle Contraction  Eccentric

> Isometric > Concentric

Speed of Muscle Contraction (ForceVelocity Relationship)  Concentric:

the faster = the lesser tension; the slower = the greater tension  Eccentric: the faster = the greater tension; the slower = the lesser the tension

Recruitment of Motor Units  Greater

number of motor units recruited = greater tension  Greater synchronization of firing = greater tension

Frequency of Firing of Motor Units  The

higher the frequency = higher the tension produced

Energy Stores and Blood Supply  ATP-PC

system > Anaerobic / Glycolytic / Lactic Acid system > Aerobic system

Fatigue Muscle (local) Fatigue  Diminished response of a muscle to repeated stimulus.  Reflected by a progressive decrement in the amplitude of the motor unit potentials.

Fatigue  Decline

in force-producing capacity of the neuromuscular system.  Considered normal and reversible.

Fatigue  Could

be due to:

 Decrease in energy stores, insufficient

oxygen, or lactic acid build-up  CNS inhibition  Decrease conduction in the NMJ (particularly type II fibers)

Fatigue Cardiorespiratory (general) Fatigue  Diminished response of an individual due to prolonged physical activity.  Related to efficient oxygen usage of the body.

Fatigue  Could

be due to:

 Decrease blood glucose level

(hypoglycemia)  Decrease glycogen stores in muscle and liver  Depletion of potassium (especially in elderly)

Fatigue Threshold for Fatigue  Level of exercise that cannot be sustained indefinitely.  Could be noted as:  Length of time a contraction is

maintained  Number of repetitions of the exercise that can initially be performed

Fatigue Factors that Influence Fatigue  Health status  Diet  Lifestyle (sedentary or active)  Presence of disease

Recovery from Exercise  Recovery

from acute exercise usually takes 3 to 4 minutes.

Recovery from Exercise  Changes

that occur are:

 Energy stores are replenished  Lactic acid is removed approximately 1

hour after exercise  Oxygen stores are replenished  Glycogen is replaced over several days

Age  Muscle

develops for both sexes equally during early stages of life.  Muscles continue to develop until adulthood with the men gaining more muscle mass and strength than women.

Age  Women

reach their peak muscle strength faster than men.  Muscle development declines as we pass late adulthood.  (Others are for your reading pleasure…).

Psychological  Attention

– be able to focus on a given task.  Motivation – patient must be willing.  Feedback – giving cues, results oriented, could have an impact on motivation.

PhysiologicAdaptations Adaptations Physiologic toExercise Exercise to

Neural Adaptations *The initial, rapid gain in the tensiongenerating capacity of a skeletal muscle is largely attributed to neural responses, not adaptive changes in muscle itself.

Neural Adaptations  Increase

number of motor units recruited for firing.  Increase rate of firing (decrease twitch contraction time)  Increase synchronization of firing

Skeletal Muscle Adaptations Hypertrophy  Increase in individual muscle fiber size caused by increase myofibrillar volume.  Occurs usually after 4 to 8 weeks of regular resistance training.

Skeletal Muscle Adaptations  Possibly

2 to 3 weeks with very highintensity resistance training.  Due to:  Increase in protein synthesis and decrease

in protein degradation  Stimulate uptake of amino acids  Minimal

training.

or no change with endurance

Skeletal Muscle Adaptations Hyperplasia  Increase in number of muscle fibers.  Due to longitudinal splitting of muscle fibers.  Does not occur or only to a slight degree

Skeletal Muscle Adaptations Muscle Fiber Type Adaptation  Type IIB becomes type IIA  Making the muscle more fatigue resistant

Vascular and Metabolic Adaptations  Decrease

capillary bed density due to increase number of myofilaments per fiber.  Decrease in mitochondrial density

Vascular and Metabolic Adaptations  Increase  Increase  Increase

ATP and CP storage myoglobin storage triglyceride storage (endurance training)

Adaptations to Connective Tissues  Increase

in tensile strength of tendons, ligaments and connective tissue in muscle (may develop more rapidly with eccentric resistance).  Increase in bone mineral density with no change or possible increase in bone mass.

Changes in Body Composition  Increase

in lean body mass (fat-free mass) with strength training (no change with endurance training)  Decrease fat mass.

Determinants/ /Elements Elements Determinants ofResistance ResistanceExercise Exercise of

Alignment and Stabilization  Purpose

is to effectively strengthen a specific muscle group and avoid substitute motions.

Alignment and Stabilization Alignment  Direction of the muscle fibers and the line of pull of the muscle to be strengthened.  Align with respect to gravity.

Alignment and Stabilization Stabilization  Holding down a body segment or holding the body steady.  Could be in form of:  A stable surface  Body weight

 Could

be external stabilization or internal stabilization.

Intensity  Amount

of resistance (weight or load) imposed on the contracting muscle.  A.k.a. exercise load or training load.

Intensity Choosing Between Submaximal Versus Maximal Exercise Loads  Consider the following:      

Goals and expected functional outcomes Cause of deficit of muscle performance Extent of impairment Stage of healing of injured tissues Patient’s age General health and fitness

Intensity Initial Level of Resistance and Documentation of Training Effects Repetition Maximum (RM)  The greatest amount of weight a specific muscle can move through the available range a specific number of times.

Intensity 1 RM  The greatest amount of load a subject can lift through the full ROM just one time.  Involves a lot of trial and error in obtaining.  10 RM is approximately 75% of 1 RM

Intensity Strength-training Zone  Exercise load to be used is calculated as a percentage of RM

Intensity  It

varies with individuals:

 For healthy but untrained individuals:

70% to 80% of the RM  Lower percentage for beginners, children, and elderly.  30% to 50% for endurance training.

Intensity Additional Methods of Determining Baseline Exercise Load  Cable tensiometry  Isokinetic or Handheld Dynamometry  Percentage of body weight

Volume  The

summation of the total number of repetitions and sets of a particular exercise during a single exercise session.

Volume Repetitions  The number of times a specific movement is repeated.  Number of muscle contractions performed to move a limb through a series of continuous and complete excursions against a specific exercise load.  It is often within a range rather than exact number.

Volume To Improve Muscle Strength  Maximal load performed with less number of repetitions.  6 to 12 repetitions are recommended.

Volume To Improve Muscular Endurance  Many repetitions against a submaximal load.  By maintaining the muscle contraction for long periods of time.  Should be initiated in early rehabilitation phases

Frequency  The

number of exercise sessions per day or per week.  For low volumes and intensities, daily basis several times per day.

Frequency  As

the volume and intensity increases, every other day or five times a week.  Reduced for children and for a maintenance program.  Highly trained athletes usually 6 days a week.

Duration  The

total number of weeks or months which a resistance exercise program is carried out.  For significant changes to occur, at least 6 to 12 weeks of training is required.

Rest Interval (Recovery Period)  Between sets  30 to 60 seconds is  Decreasing periods

common of rest increases the dosage of resistance exercise.

Mode  The

form of exercise or the manner it is carried out.

Mode Forms of Resistance  Manual and Mechanical  Constant or Variable load  Accommodating resistance  Body weight

Mode Type of Muscle Contraction  Isometric or Dynamic  Concentric or Eccentric  Isokinetic

Mode Position During Exercise  Weight bearing or Non-weight bearing  Open-chain or closed-chain

Mode Energy Systems  Anaerobic (high-intensity) or Aerobic (low-intensity)

Mode Range of Movement  Short-arc or Full-arc  Full-arc is necessary to develop strength through the ROM.  Short-arc usually avoids painful ROM, protect joint and tissues after injury or surgery.

Mode Application to Function  Exercise is perform to mimic a functional activity

Mode Speed of Exercise  Force-velocity relationship (concentric and eccentric)  Speed-specific training

Mode Periodization  An approach to resistance training that builds systemic variation in exercise intensity and volume at regular intervals over a specified period of time.

Mode  Prevent

overtraining and psychological staleness prior to competition and maximize performance during competition.

Mode Functional Integration of Resistance Exercise  A Balance of Stability and Active Mobility  A Balance of Strength, Power, and Endurance  Progression of Movement Patterns

End of Part 1 (you may have your break…)

Types of Resistance Types of Resistance Exercise Exercise

Manual and Mechanical Resistance Manual Resistance  Resistance is provided by the therapist or other health professional, or the patient is taught to apply selfresistance.  The amount of resistance can’t be measured quantitatively.

Manual and Mechanical Resistance Mechanical Resistance  Resistance is through equipment or mechanical apparatus.  The amount of resistance can be measured quantitatively

Isometric Exercise (Static Exercise)  Muscle

contracts and produces force without an appreciable change in muscle length and joint motion.

Isometric Exercise (Static Exercise) Types of Isometric Exercise Muscle Setting Exercises  Low intensity isometrics performed against little to no resistance.  It will not improve strength except in very weak muscles.

Isometric Exercise (Static Exercise) Stabilization Exercises  Used to develop a submaximal but sustained level of co-contraction to reduce instability and enhance postural stability.  Rhythmic stabilization, alternating isometrics, dynamic stabilization

Isometric Exercise (Static Exercise) Multiple-angle Isometrics  Resistance is applied at multiple joint positions within the available ROM.  Used if dynamic exercise is painful and not advisable.

Isometric Exercise (Static Exercise) Intensity of Muscle Contraction  Depends upon joint position and length of muscle at the time of contraction.

Isometric Exercise (Static Exercise) Duration of Muscle Activation  Should be held 6 to 10 seconds

Isometric Exercise (Static Exercise) Repetitive Contractions  6 to 10 seconds hold with frequent repetitions decreases muscle cramping and increases effectiveness of the regimen.

Isometric Exercise (Static Exercise) Joint Angle and Mode Specificity  Gains in muscle strength only occur at or closely adjacent to the training angle.  Resistance at 4 to 6 points in the ROM is usually recommended.

Dynamic Exercise: Concentric and Eccentric Ways in which resistance can be applied:  Constant resistance (e.g. body weight, free weights, pulley system)  Variable resistance with a use of specialized equipment  Isokinetic resistance through an isokinetic dynamometer

Dynamic Exercise: Concentric and Eccentric

Dynamic Exercise: Concentric and Eccentric

Dynamic Exercise: Concentric and Eccentric

Dynamic Exercise: Constant Versus Variable Resistance Dynamic Constant External Resistance (DCER)  A limb moves through a ROM against a constant external load.  The contracting muscle is only challenged at one point in the ROM.  The maximum torque resistance matches the maximum torque output of the muscle.

Dynamic Exercise: Constant Versus Variable Resistance

Dynamic Exercise: Constant Versus Variable Resistance

Dynamic Exercise: Constant Versus Variable Resistance Variable Resistance Exercise  Specially designed resistance equipment imposes varying levels of resistance to load the muscle at multiple joint in the ROM.  Examples are pneumatic exercise equipment, elastic resistance, and manual resistance.

Dynamic Exercise: Constant Versus Variable Resistance

Dynamic Exercise: Constant Versus Variable Resistance

Dynamic Exercise: Constant Versus Variable Resistance

Dynamic Exercise: Constant Versus Variable Resistance

Isokinetic Exercise  The

speed of movement is manipulated, not the load.  A.k.a. accommodating resistance exercise.

Isokinetic Exercise Characteristics of Isotonic Exercise  Velocity should be constant through the ROM.  Range of training velocities  Isometric: 0 degrees / sec  Slow: 30-60 degrees / sec  Medium: 60-180 degrees / sec  Fast: 180-360 degrees / sec

Isokinetic Exercise  Evidence

of mode-specific with isokinetic is less clear.  Faster velocities: greater joint compressive force; Slow velocity training: Less joint compression  The patient can still perform additional repetitions even though the force output temporarily diminishes.

Isokinetic Exercise  The

patient can perform less effort when it comes to the painful range.  Muscle co-activation is observed in relatively high-speed movement.

Isokinetic Exercise

Isokinetic Exercise

Open-Chain and ClosedChain Exercise  Kinematic

versus Kinetic chain.

Open-Chain and ClosedChain Exercise

Open-Chain and ClosedChain Exercise

Open-Chain and ClosedChain Exercise Progression of Closed-Chain Exercises Percentage of Body Weight  Partial weight-bearing → full weightbearing → FWB + additional weight

Open-Chain and ClosedChain Exercise Base of Support  Wide → narrow  Bilateral → unilateral  Fixed on support surface → sliding on support surface

Open-Chain and ClosedChain Exercise Support Surface  Stable → unstable/moving  Right → soft  Height: ground level → increasing height

Open-Chain and ClosedChain Exercise Balance  With external support → without external support  Eyes open → eyes closed

Open-Chain and ClosedChain Exercise Exclusion of Limb Movement  Small → large ranges  Short-arc → full-arc

Open-Chain and ClosedChain Exercise Plane or Direction of Movement  Uniplanar → multiplanar  Anterior → posterior → diagonal  Sagittal → frontal or transverse

Open-Chain and ClosedChain Exercise Speed of Movement or Directional Changes  Slow → fast

ResistanceExercise: Exercise: Resistance Principles,Precautions, Precautions, Principles, andContraindications Contraindications and

General Principles  Examination and Evaluation  Preparation for Resistance Exercise  Application of Resistance Exercise

(All are for your reading pleasure… Anyway, it’s just common sense… )

Precautions  Valsalva Maneuver  Substitute Motions  Overtraining and Overwork  Exercise Induced Muscle Soreness  Pathologic Fracture

Valsalva Maneuver Prevention  Caution the patient about breathing holding.  Breathe rhythmically, ask the patient to count.  Exhale with each effort.  Avoid high-intensity for high-risk patients.

Substitute Motions  Proper

stabilization

Overtraining and Overwork Overtraining  A decline in physical performance in healthy individuals participating in high-intensity, high-volume strength and endurance training.

Overtraining and Overwork  Brought

about by inadequate rest intervals between exercise sessions, too rapid exercise progression, and inadequate diet and fluid intake.

Overtraining and Overwork Overwork (overwork weakness)  The progressive deterioration of strength in muscles already weakened by non-progressive neuromuscular disease.  E.g. Polio and post Polio syndrome, Guillain-Barre Syndrome

Overtraining and Overwork  Resistance

exercises for these patients must be progressed slowly.

Exercise Induced Muscle Soreness Acute Muscle Soreness  Develops during or directly after strenuous exercise performed to the point of exhaustion.  Due to diminished blood flow and temporary buildup of metabolites in the exercised muscle.

Exercise Induced Muscle Soreness  Characterized

by burning or aching sensation within the muscle.  Pain felt is transient and subsides quickly after exercise when blood flow and oxygen are restored in the muscle.

Exercise Induced Muscle Soreness Delayed-Onset Muscle Soreness (DOMS)  It begins to develop approximately 12 to 24 hours after the exercise.  It intensifies and peaks 24 to 48 hours after exercise.

Exercise Induced Muscle Soreness  Signs

and symptoms can last up to 10 to 14 days and gradually dissipates.  The underlying cause is unclear.

Exercise Induced Muscle Soreness  Theories

associated were:

 Metabolic waste accumulation theory  Muscle spasm theory  Contraction induced microtrauma to

muscle fibers and/or connective tissues

Exercise Induced Muscle Soreness  May

be prevented by:

 Progressing the intensity and volume of

exercise gradually.  Having a low-intensity warm-up and cooldown.  By gently stretching before and after exercise.  Definitive

treatment has yet to be determined.

Pathologic Fracture A

fracture of bone already weakened by a disease that occurs as a result of a very minor stress.  A precaution for patients with osteoporosis and osteopenia.

Pathologic Fracture  Ways

of prevention are:

 Avoid high-intensity and high-volume

weight training.  Progress gradually.  Avoid high-impact activities.  Avoid high-velocity movements of the spine.

Pathologic Fracture  Avoid trunk flexion (full range) with

rotation.  Avoid LE weight bearing with torsional movements.  Have a stable surface to hold-on for patients with impaired balance.  Have a close contact when guarding your patient.

Contraindications  Pain  Inflammation  Severe Cardiopulmonary

Disease

Manual Resistance Manual Resistance Exercise Exercise

Manual Resistance Exercise  Resistance

is applied by a therapist or by the patient to himself.  Either dynamically or isometrically.

Manual Resistance Exercise  Applied

throughout the available

ROM.  Applied in anatomic planes, diagonal, or functional simulation.

Manual Resistance Exercise Guidelines in Application  Body mechanics of the therapist  Application of manual resistance and stabilization  Verbal commands  Number of repetitions and sets and duration of rest intervals

Mechanical Resistance Mechanical Resistance Exercise Exercise

Mechanical Resistance Exercise  Resistance

is applied using some type of equipment.  A.k.a. Weight Training and Loadresisting Exercise

Mechanical Resistance Exercise Specific Exercise Regimens  Progressive Resistance Exercise (PRE)  Circuit Weight Training  Plyometric Training – StretchShortening Drills  Isokinetic Regimens

Progressive Resistance Exercise (PRE) A

system of dynamic resistance exercise in which constant load is applied to the contracting muscle by mechanical means and incrementally progressed.  RM is the basis of exercise progression.

Progressive Resistance Exercise (PRE) De Lorme Regimen  Use 3 sets of 10 RM with progressive loading.  Builds a warm-up period.

Progressive Resistance Exercise (PRE)  Calculation: Determination of 10 RM 1st set: 10 reps at 50% of the 10 RM 2nd set: 10 reps at 75% of the 10 RM 3rd set: 10 reps at 100% of the 10 RM

Progressive Resistance Exercise (PRE) Oxford Regimen  Use 3 sets of 10 RM with regressive loading.  Calculation: Determination of 10 RM 1st set: 10 reps at 100% of 10 RM 2nd set: 10 reps at 75% of 10 RM 3rd set: 10 reps at 50% of 10 RM

Progressive Resistance Exercise (PRE) Daily Adjusted Progressive Resistance Exercise (DAPRE)  Based on a 6  The adjusted

RM working weight. working weight, which is based on the maximum number of repetitions possible using the working weight in set three, determines the load for the next exercise session.

Progressive Resistance Exercise (PRE) DAPRE Technique

Progressive Resistance Exercise (PRE) Calculation of the Adjusted Working Weight

Circuit Weight Training A

pre-established sequence (circuit) of continuous exercise is performed.  Targets a variety of major muscle groups.  Each exercise is performed at a specific number of repetitions and sets with a minimum amount of rest between sets and stations.

Circuit Weight Training  Exercise Order:  Alternate between upper extremity, lower

extremity, and trunk musculature  Large muscle groups → small muscle groups  Multijoint exercises → muscle group isolation

 Circuit

Training – addresses all aspects of physical fitness rather than strength/endurance only.

Plyometric Training – StretchShortening Drills  High-intensity,

high-velocity

exercises.  Employs reflexive reactions and functional movement.  Emphasis on development of muscular power and coordination.  Reactive Neuromuscular Training

Plyometric Training – StretchShortening Drills  Rapid eccentric – stretch phase  Rapid concentric – shortening phase  Period between stretch and

shortening – amortization phase  Intensity: high-intensity enough not to slow down the activity.

Plyometric Training – StretchShortening Drills  Volume:

increase repetitions as long as proper form (technique) is maintained.  Frequency: increase number of exercises per session or increase number of sessions per week.  Recovery Period: 48 to 72 hours is recommended.

Isokinetic Regimens Velocity Spectrum Rehabilitation (VSR)  Exercises

are performed across a wide range of velocities

Useof ofEquipment Equipmentwith with Use ResistanceExercise Exercise Resistance

Equipment  Free

Weights

Equipment  Simple

Weight-Pulley System

Equipment  Variable

Resistance Machines

 Weight-Cable System  Hydraulic and Pneumatic

Equipment

Equipment

Equipment

Equipment  Elastic

Resistance

Equipment  Equipment

for Closed-Chain Training

 Multipurpose Exercise Units  Balance Boards  Slide Boards  Stepping Machines  Elliptical Trainers and Cross-Country Ski

Machines  Mini-Trampolines

Equipment  Reciprocal

Exercise Equipment

 Exercise Cycle  Portable Resistive Exercise Units  Upper Extremity Ergometer

Equipment  Equipment

for Dynamic Stabilization

Training  Isokinetic Testing and Training Equipment  Equipment for Isometric Training

Equipment

Prescription Prescription

Prescription  Mode

+ Muscle Group or Body Part + Equipment (with intensity) + Duration (isometrics) + Repetitions + Sets + Direction + Frequency

Prescription MREs on (B) UE x 8-12 reps x 3 sets towards AP, OD Muscle settings on (R) Quads x 10 SH x 10 reps, QID

Prescription PREs using De Lorme Regimen on (B) Biceps and Triceps using 40 lb DB at 10 RM Resistance Exercises on (B) LE using LAW x 15 reps x 5 sets towards AP, BID

The End! The End! Thank You for Listening!