1

ACTIVE MOVEMENT

2

ACTIVE MOVEMENT ARE: Movements performed within the unrestricted ROMROM controlled by the voluntary contraction of the muscles

3

Classification of Active Movement

1- Free exercise: in which the working muscles are subjected only to the forces of gravity acting upon the part moved or stabilized.

2- Assisted exercise: in which the muscle strength is inadequate to perform a movement, an external force ( manually or mechanically) is applied to compensate for the movement.

3- Resisted exercise: the forces of resistance offered to the action of the working muscle are manually or mechanically and systematically increased to develop the strength and endurance of the muscles.

4

Active ASSISTED EXERCISE

The principles of assistance:The principles of assistance:• When the voluntary muscular action is

insufficient for the production or control of movement, an external force may be added to augment it.

5

The principles of assistance• This external force must be applied

in the direction of the muscle action but not necessarily at the same point, as a mechanical advantage of this assisting force must be sufficient only to augment the muscular action and must not be allowed to act as a substitute for it, for if the muscle increases, the assistance given must decrease proportionally.

6

Technique of Assisted Exercise

The purpose is to ensure that insufficient muscles exert their maximum effort to produce movement under conditions designed to facilitate their action.

1- Starting position: stability of the body is important to ensure that the patient’s attention is concentrated on the pattern of the movement and the effort required performing it.

7

Technique of Assisted Exercise

2- Pattern of movement: this can be explained to the patient by performing it passively or actively on the sound limb.

3-Fixation: fixation of the proximal part of the prime movers improves their efficiency. However possible, this fixation should be achieved by the active means in order that the weak muscles may receive reinforcement from the action of the muscle helping or associating in the production of the movement. Avoid trick movements to occur by proper fixation.

8

Technique of Assisted Exercise

5- Support: the moved part should be supported to reduce the load on the muscle. Support may be provided by PT hand, suspension slings, body buoyancy of water or a smooth surface. However, manual support is more effective since it can be provided in any plane suitable for the movement and the assistance can be adjusted in each successive part of the range.

9

Technique of Assisted Exercise

5- The antagonistic muscle: a proper starting position should be selected to reduce the tension in the antagonistic muscles, e.g. a position in which the knee flexed is suitable for assisted dorsi-flexion of the foot.

6- Traction: preliminary stretching of the weak muscle provides a powerful stimulus to contraction because it elicits the myotatic reflex which helps in the initiation of movement.

10

Technique of Assisted Exercise

7- The assistance force: the force used in assisting the action of the muscle must be applied in the direction of the movement by the PT hands. Patient may assist the movement himself so he can thoroughly understand the procedure. The movement should be possible in full range. The assisting force may vary in different parts of the range, since more assistance will be necessary in some parts than in others. Assistance is mostly required at the beginning of the movement to overcome initial inertia and at the end to complete the range.

11

Technique of Assisted Exercise

8- The character of the movement: movement is performed smoothly and its efficiency depends on the patient’s full attention. The speed of contraction depends on the type of muscle whether fusiform or pennated, etc.

12

Technique of Assisted Exercise

9- Repetitions: repetition of the movement depends on the rate of fatigability. Therefore, the condition which caused the weakness must be known and understood.

10-The cooperation of patient: this is essential during this type of exercise with the aim to achieve controlled active movement without assistance. The patient should be encouraged to exert maximum effort.

13

Indications and uses of assisted exercise

1- In the early stages of neuromuscular re-education. When a patient has weak musculature ( poor to fair minus MTG), active assistive exercise is used to provide sensory feedback from the contracting muscles.

2- Maintain the physiological properties of the muscle to increase muscle strength and hypertrophy.

14

Indications and uses of assisted exercise

3- Coordination training : The memory of the pattern of coordinated movement is stimulated. By frequent repetition of the pattern with decreasing assistance the patient may relearn to control the movement himself as the conduction of impulses is facilitated in the neuromuscular pathways.

15

Indications and uses of assisted exercise

4- Confidence in the ability to move is established with the performance of the movement. The feeling of the patient that the limb is supported encourages him to produce a maximum effort. These exercises are helpful in case with painful joints such as rheumatoid arthritis.

5- Increase and maintain ROM.6-Provide stimulus for bone integrity.

16

Contraindications

1- acute tears and fractures.2- Gross swelling, fever and redness.3- Acute intolerable pain during movement

17

Active Free ExerciseActive Free Exercise

• 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 gravity.

18

Indications and Uses of Active Free Exercise

• This type of exercise can be used to obtain the following:

1- Relaxation: can be induced by exercises which are rhythmical or pendulum in character.

19

Indications and Uses of Active Free Exercise

2- Joint mobility: the normal range of joint motion is maintained by exercises performed in full range. Limited range is increased by rhythmical swinging exercises incorporated and performed with pressure at the limit of free range.

20

Indications and Uses of Active Free Exercise

3- Muscle power and tone: the power and endurance of the working muscles are maintained or increased in response to the tension developed in them. Tension is greater when the exercise is performed at a speed slower or faster than the natural speed of movement and also greater with the duration of exercise. A high degree of tension and low sequent increase in power is developed by free exercises when muscles work against the resistance of the body weight and increased leverage arm. During fixation of a joint the power can only be maintained or improved by repeated static contraction.

21

Indications and Uses of Active Free Exercise

4- Neuromuscular co-ordination: co-ordination is improved by the repetition of an exercise. As the pattern of movement is established the conduction of the necessary impulses along the neuromuscular pathways is facilitated.

5- Confidence: the achievements of coordinated and efficient movement assure the patient of his ability to maintain subjective control of his movements, giving him confidence to attempt other and new activities.

22

Uses Indications and Uses of Active Free ExerciseActive Free Exercise

6- Circulatory and respiratory improvement: during vigorous or prolonged exercise, the speed and depth of respiration is increased leading to the production of heat.

23

Technique of free exerciseTechnique of free exercise

• The starting position is selected and taught with care to ensure the maximum postural efficiency as a basis for movement.

• Instruction is given to gain interest and cooperation of the patient.

• The speed at which the exercise is done depends on the effect required.

• The duration of the exercise depends very largely on the patient’s capacity.

24

Technique of free exercise

• Free exercise may be: • localized localized to produce a local or specific effect

i.e. to mobilize a particular joint or strengthen a particular muscle group.

• GeneralizedGeneralized involving use of more joints and muscle groups.

Active Resisted Exercise-part 1

Introduction Introduction • Resistance exercise is an essential element of Rehab

programs for person with impaired function and for those who wish to promote and maintain health and physical well-being.

• It can be defined as any form of active exercise in which a dynamic or static muscle contraction is overloaded (resisted) by an external force (manually or mechanically). The resistance must be sufficient to increase the intra-muscular tension to the maximum without interfering with the ability of the muscle to do coordinated movements.

A comprehensive examination and evaluation is the basis upon which a program of resisted exercise is warranted and will improve a person's current level of function.

Factors affect the appropriate resistance training:

1- Underlying pathology.2- Extent and severity of impairment.3- The presence of other deficits.4- The stage of tissue healing after injury of surgery.5- Patient's age6- Overall level of fitness.7- Cooperation of the patient with the program.

Forms of resistance:• Free weights (dumbbells, weight machines).

• Pulley circuit• Springs• Water• The patient• The physiotherapist • Strong elastic bands, and even the body itself.

N.B. In resistance training, intensity is determined by the amount of weight against which subjects are working. It is very important to start at a low level to avoid injury

Types of Resistance Exercise• Isometric resistance exercise: In which a muscle contracts without change in length or visible

motion.• Dynamic (Isotonic) exercise: In which a muscle contracts against load which may be- Manual: in which the resistance force is applied by the therapist- Mechanical: in which the resistance force is applied by

mechanical equipment.• Isokinetic exercise: In which the velocity of muscle contraction is controlled by a

rate-limiting device that controls the speed of movement of a body part.

I. Isometric (Static) Exercise- Is static form of exercise during which muscle contracts and produces

tension without change in the length of the muscle or visible joint motion.

- During isometric contraction a great amount of tension and force output produced from the muscle, which will increase strength if it is sustained against resistance for at least 6 seconds.

- Capable of increasing muscle strength at specific joint angles- May produce spikes in systolic blood pressure

• Could cause life-threatening cardiovascular accident• To reduce this event to occur - REMIND the person to breath.

• Widely used in rehabilitation• Attempt to use positional or functional exercise – work at multiple

angles throughout the range if possible

• Contractions should be held for 10 seconds at frequency of 10 or more per hour

– Utilized to enhance lift or activity at “sticking point”

Types of Isometric (Static) Exercise :1- Muscle-setting exercises: low –intensity, isometric exercises performed against little to no resistance. It will not improve strength but retard muscle atrophy in early stage of rehabilitation. Quadriceps and Gluteal muscles are common examples for Muscle-setting exercises.

2- Resisted isometric exercise: isometric exercises performed against manual or mechanical resistance to increase strength when active movement is painful. - The amount of tension produced during isometric exercise, is directly affected by the length of muscle at the time of contraction. Therefore, the amount of resistance also must be vary at different angles in the range.

33

3- Stabilization exercise: joint or postural stability can be developed by isometric exercise through activating co-contraction, that is, the contraction of antagonist muscles that surround proximal joints. Co-contraction is achieved by mid-range isometric holding against manual resistance or against gravity, in which emphasis is placed on isometrically controlling trunk musculature and proximal muscle of the extremities.4- Multiple-angle isometric exercise: in which the resistance ( manual, mechanical), is applied at multiple joint positions within the available ROM.

II. Dynamic Exercise

• When a muscle contracts dynamically against a fixed resistance, the tension produced from the muscle varies as the muscle contracts and shortens (concentric) or lengthens under tension (eccentric).

Types of Dynamic ExerciseTypes of Dynamic Exercise

1- Manual or mechanical resistance: the Dynamic Exercises are performed against manual or mechanical resistance.

2- Concentric and Eccentric exercise: in which the resistance is applied to a muscle as it shortens or lengthens.

■

Concentric exercise involves dynamic resistance of a muscle while muscle shortening occurs as in lifting a weight.

■ Eccentric exercise involves dynamic resistance of a muscle while muscle lengthening occurs in an attempts to control the resistance. It involves negative work as in lowering a weight, descending stairs and provide a source of shock absorption during closed-chain functional activities.

■ Eccentric contraction produces more tension than an isometric or concentric contraction.

■ Eccentric contraction consumes less oxygen, fewer energy stores, fewer motor units fire to control the same load than concentrically.

■ Concentric muscle contractions accelerate body segment, while while eccentric muscle contraction decelerate body segment.

35

3-Open and Closed Kinematic chains exercises: they were used to describe how forces occur during human motion and how segments of the body are linked together.Open Kinematic chain exercise refers to movement in which the distal segment (the foot or hand) moves freely in space.- Traditionally most manual and mechanical resistance exercise have been applied using Open Kinematic chain exercise.- Open Kinematic chain exercise can be used if weight bearing is contraindicated. - Also Open Kinematic chain exercise can be performed in a dynamic or static manner.

• Closed Kinematic chain exercise refers to movement where the body moves over a fixed distal segment.- Closed-chain exercise are performed in a weight-bearing position when the foot is planted on the ground and the muscle action lifts or lowers the body as in stair climbing or squatting activities.- Closed-chain exercise occurs in upper limb when a person performs a push-up.- Closed-chain exercise are used to stimulate mechanoreceptors in and around joints more effectively than open-chain exercise.- Closed-chain activities improve stability, balance, coordination and

agility in functional weight-bearing posture.

37

III. Isokinetic Exercise- Is a form of dynamic exercise in which the velocity of muscle shortening or lengthening is controlled by a rate-limiting device that control the speed of movement.- The resistance met during Isokinetic Exercise accommodate to the tension-producing capabilities of the muscle and loads the muscle to capacity throughout the ROM, and that is why called accommodation resistance exercise.accommodation resistance exercise.- Isokinetic training can occur in either concentric or eccentric mode.- Speeds of exercise may range from a slow velocity (15-30o/ sec) to a very fast velocity (300-400o/ sec). - Isokinetic training can be used safely to increase muscle strength, endurance and power.

Uses and indicationsThe main purposes of resistance exercise is to

improve muscle performance which refers to, the capacity of a muscle to do work (force x distance), this muscle performance can be enhanced by some form of resisted exercise.

Elements of muscle performance:1- Strength: the greatest measurable muscle

tension exerted by a muscle or muscle group to overcome resistance during a single, maximum effort.

In order to increase the strength of a muscle, muscle contraction should be loaded for a relatively low number of repetition or over a short period of time.

2- Endurance: the ability to perform low-intensity, repetitive, or sustained activities over an extended period of time without fatigue. Unlike strength, endurance develops by increase the oxidative and metabolic capacities due to low-intensity muscle contractions, high repetitions, and a prolonged time period.Endurance can be classified into:

Muscular endurance (local endurance).■Cardiorespiratory endurance (total body endurance), is ■

characterized by having a muscle contract and resist a light load for many repetitions or sustain a muscle contraction for an extended period of time.

3- Power: is the work produced by a muscle per unit of time (force x distance).

Power can be improved by either increasing the work that a muscle must perform in a specified period of time or by reducing the amount of time required to produce a given force.

Factors That Determine Levels of Strength, Endurance & Power

• Size of Muscle– Proportional to cross-sectional diameter of muscle

fibers– Increased cross-sectional area = increased strength

and force production– Hypertrophy

• Increase in muscle size– Atrophy

• Decrease in muscle size

Factors That Determine Levels of Strength, Endurance & Power

• Number of Muscle Fibers

Factors That Determine Levels of Strength, Endurance & Power

• Neuromuscular Efficiency– Strength is directly related to efficiency of the

neuromuscular system– Initial increases in strength during first 8-10 weeks

are attributed to neuromuscular efficiency

Factors That Determine Levels of Strength, Endurance & Power

• Age– Men & women increase strength throughout

puberty & adolescence– Peaks at age 20-25– After age 25, max strength declines 1% annually– Decline is related to physical activity– Able to retard decline in performance through

activity

• Overtraining– Imbalance between exercise and recovery

• Training exceeds physiological and psychological capacity of individual

– Can have negative effect on strength training– May result in psychological or physiological

breakdown• Injury, illness, and fatigue can be indicators

Fast-Twitch vs. Slow Twitch• Slow Twitch Fibers

– Type I or slow oxidative (SO)– More resistant to fatigue– Time required to generate force is greater in slow twitch fibers– Primarily associated with long duration, AEROBIC activities

• Fast Twitch Fibers– Type IIa (fast oxidative glycolytic- FOG)

• Moderately resistant to fatigue– Type IIb (fast glycolytic - FG)

• Fatigues rapidly – true fast twitch– Type IIx – fatigue resistant with force capacity (a<x<b)– Produce quick, forceful contractions – Short-term, high intensity activities, ANAEROBIC activities

•Ratio in Muscle▫Both fiber types exist in individual muscles▫Ratio varies by muscle and by individual▫Postural muscles = % primarily type I fibers▫Power, explosive strength muscles = % type II

fibers

Physiology of Strength Development

• Muscle Hypertrophy – 3 theories– Hyperplasia – in number of muscle fibers

• Genetically determined & does not seem to increase with training

• Evidence exists of fibers splitting – conducted in animals

– Hypothesized increased number of capillaries – partially correct

• No new capillaries• Increase in dormant capillary activity to meet needs

of muscle

Physiology of Strength Development– Reversibility – adaptations of muscle due to training

can begin to reverse within 48 hours of removing training

Other Physiological Adaptations to Resistance Exercise

• Strength of non-contractile structures– Tendons and ligament increase– Increased bone-mineral content

• Improved oxygen uptake– If resistance training is high enough to elicit a

cardiovascular response/adaptation

• Increased metabolic enzymes

Overload Principle– To improve strength, muscle must be worked at a level

higher than it is accustomed to– Muscle will maintain strength if it is trained against a

consistent resistance that it is accustomed to• Existence of current strength & will result in increased muscle

endurance

– Effective training requires a consistently increasing effort against progressively more resistant loads

– In rehabilitation, rate of progression is determined by athlete’s response to specific exercise

• Be mindful of pain when dealing with progression

Aims of Resisted exercise

1- Improvement and maintenance of muscle strength, power and endurance.

2- Increase strength of connective tissues, ligament and tendons.

3- Increase bone mineral density4- improve coordination and balance.4- Increase muscle mass (hypertrophy) and

decrease body fat.5- Increase blood flow of the working muscle.6- Enhance physical performance during ADL .7- Increase heat production and improve repair

and healing process.8- Decrease stress on joint and reduce risk of

soft tissue injury during physical activities.

Precautions for Resistance exercise

1- Cardiovascular precautions which include▲The Valsalva maneuver: which is an expiratory effort against a closed

glottis, should be avoided during resistance exercise, especially during isometric and heavy resistance exercise.

Sequences:Deep inspiration, closure of the glottis, contraction of abdominal muscles,

increased in the intra-abdominal pressures, decreased in venous return leads to a decreased in in cardiac output, a temporary drop in ABP leads to an increase in the H.R.

When the expiration occurs, there is a pronounced increase in blood pressure due to rapid venous blood flow into the heart that leads to a forceful contraction of the heart.

Prevention:- Patient should not hold his breath- Have the patient exhale during the exercise- Ask the patient to count or talk during exercise

2- Fatigue: is the diminished response of a muscle or muscle groups to repeated stimulus. The therapist should be aware of the pattern of fatigue that occur either during the static or dynamic exercise and gear the exercise program accordingly to avoid its occurrence.3- Recovery from exercise: the body must be given time to restore itself to the existed state before the exhaustive exercise.4- Overwork and Overtraining: in heavy resisted training, exercise program must be progressed cautiously to avoid acute muscle fatigue induced individual to stop exercising. Overtraining: a decline in physical performance in healthy subjects due to high-intensity, inadequate rest intervals between training sessions or too rapid progression of exercise. Overwork: progressive deterioration of strength in already weakened muscles by non-progressive neuromuscular disease.

5-Muscle soreness: - Acute Muscle soreness: - Muscle pain develops during or directly after strenuous exercise due to lack of adequate blood flow & oxygen and accumulation of lactic acid and potassium in the exercised muscle.- it is transient and subside quickly when adequate blood flow & oxygen are restored to the muscle.- Delayed-onset Muscle soreness: Muscle tenderness and temporary stiffness develop 12-24 hours after exercise. This may be due to microtrauma to muscle fibers and/or connective tissues that result in tissues degeneration.

6- Substitute motions: it occur if too much resistance is applied during exercise. An appropriate amount of resistance and correct stabilization should be applied to avoid substitute motions.7- Osteoporosis: A reduction of mineralized bone mass associated with an imbalance between bone resorption and bone formation. Resistance exercise must be applied and progressed vary cautiously to avoid pathological fracture.Contraindications include:1- Inflammation: the use of dynamic resisted exercise can lead to increase swelling and more damage to muscle. In this case it can be replaced by low-intensity isometric exercise.2- Pain: sever joint or muscle pain during exercise or 24 hours after it, should be carefully evaluated.

Active Resisted Exercise-part 2

Manual Resistance ExerciseManual Resistance ExerciseA form of active resistance exercise in which the resistance force is applied by the therapist to either a dynamic or a static muscular contractionPreparation for Manual resistance exercise:1- Select the form of exercise and the appropriate resistance.2- Choose between manual or mechanical resistance.3- Review the goals and functional outcome.4- Explain the plan and procedures of exercise for the patient.5- Place the patient in comfortable position.6- warm up before the starting of exercise.7- Instruct the patient to perform the exercise with his maximum effort.8- Ask the patient not to hold his breathing during exercise.

Application during Manual resistance exercise :1- Resistance is usually applied to the distal end of the movement.2- Resistance is usually applied opposite to the direction of motion during concentric exercise and in the same direction during eccentric exercise.3- Provide stabilization to avoid substitution.4- Adjust the intensity of resistance to be equal to the abilities of the muscle.5- In general, for most adult, use 8-12 repetitions of specific motion against a moderate exercise load. Additional repetitions may be carries out after adequate period of rest.

Technique of Manual resistance exercise

• When applying resistance, 4 basic rules should be4 basic rules should be observed:

1- The resistance must be given smoothly from the beginning to the end of range.

2- The direction of resistance force must be opposite to the direction of the movement.

3- It should be diminish gradually from the beginning to the end of movement, as to apply the physiological principle that muscles are capable to exert their greatest force when they are fully extended, and just they shorten their force diminishes.

4- don’t forget to give enough period of relaxation to avoid fatigue.

Mechanical Resistance ExerciseMechanical Resistance ExerciseDefinition: is any form of exercise in which resistance is applied by the use of mechanical equipments. They include progressive resistive exercise, active resistive training and overload trainingAdvantages: 1- Considered as baseline measurement for muscular performance prior to exercise..2- Appropriate during the advanced phase of Rehabilitation program.3- Practical and Useful for improving muscle strength, endurance and power.4- Appropriate for independent exercise in a home program.5- Effective source for patient motivation. 6- Objective measurement for patient progress.

Equipment used with Resistance ExerciseMany types of mechanical equipments can be used for resistance exercise programs, which include:1- Free weights: as Dumbbells, sandbags, weight boots2- Elastic resistance devices: as Thera-band, Cuff weight3- Pulley system4- Isotonic torque arm units5- Exercise bicycle

Variables of Mechanical Resistance ExerciseVariables of Mechanical Resistance ExerciseMany variable could be used during Mechanical Resistance Exercise to improve muscle performance1- Intensity of exercise and number of repetitions: - Exercise should be performed with suitable intensity which is directly related to the goals of the exercise program.- The number of repetitions at which exercise is performed against resistance should be gradually increased in order to improve muscle endurance.2- Bouts and frequency of exercise: - Exercise bouts: are the number of sets performed during each exercise session. To gain strength combination of sets and repetitions are used, three bouts of 6 RM, two bouts of 12 RM and six bouts of 3 RM have been used. The fewer the number of repetitions performed per set, the greater the number of sets in exercise session.

-Exercise frequency: is the number of time is done within a day or a week. Generally exercise performed every other day or four times a week.3- Exercise Duration: Is the total number of exercise program, to increase strength a program must be at least 6 weeks in duration.4- Speed of contraction: the speed of muscle contraction affects the produced muscle tension( force-velocity relationship). As the velocity of muscle shortening increases, the generated muscle force decreases.

usually in isotonic training exercise is done at slow speeds.usually in isotonic training exercise is done at slow speeds. 5- Mode of exercise: is the type of muscle contraction, static or dynamic(concentric or eccentric). Isometric exercise can be used in the early stage of REHAB and in case of immobilization or when active movement can’t be tolerated. Eccentric exercise can be used when joint motion must be carefully controlled or the tension is very poor. 6- Range of Motion: Resistance exercise can be done through the entire or a limited ROM.

Progressive resisted exercise (PREProgressive resisted exercise (PRE) One way to progressively increase muscle performance (strength,

power and endurance) is to increase the amount of resistance used in an exercise program. In PRE the contracting muscles are overloaded by a constant mechanical external load that is incrementally progressed. The basis for determining and

resistance progression is the repetition maximum (RM).repetition maximum (RM).

RMRM is the greatest amount of weight a muscle can move through is the greatest amount of weight a muscle can move through the ROM a specific amount of time. the ROM a specific amount of time.

• There are many ways to achieve progressive resistance:1-Increase the weight you’re lifting. Do the same number of

repetitions and sets each week, but increase your weight.2-Increase the number of repetitions, use the same weight

for each workout but increase the repetitions each week.3-Increase the number of sets each time you workout. 4-Shorten the rest time between the sets.5-Lengthen the time under tension- or how long your muscle

fibers are under stress. Use the same weight and repetitions, but slow down the exercise.

Specific Exercise RegimensMany types of resistance training can be utilized as effective and efficient methods to increase muscle performance.Isotonic Regimens1- Delorme techniqueDescribe a system approach by progressively increasing the resistance (weight lifted). a-Determine the 10 RMb- The patient then carries out:1- 10 repetitions at 50% of the 10 RM 2- 10 repetitions at 75% of the 10 RM3- 10 RM at 100% of the 10 RM.c- The patient performs all three bouts at each exercise session with a brief rest between bouts.d- The approach builds in a warm-up period as the patient initially lifts only one-half and three-forth of the 10RM.e- The amount of weight is increased weekly as strength increase.

Delorm Technique

set Amount of weight

Repetitions

1 50% of 10 RM 10

2 75% of 10 RM 10

3 100% of 10 RM 10

30 lifts 4 times weekly progress 10 RM once weekly.

2- Oxford Technique 1- This technique was designed to be used in beginning of

rehabilitation, and to diminish resistance as muscle fatigue develop (it is the reverse of Delorm).

2- a-Determine the 10 RMb- The patient then carries out:1- 10 repetitions at full of the 10 RM 2- 10 repetitions at 75% of the 10 RM3- 10 RM at 50 % of the 10 RM.

3- This technique works to decrease the effect of fatigue.4- Prior to beginning the bouts of resisted exercise, nonspecific

warm-up period of active exercise is needed.

Oxford Technique

Set Amount of weight Repetitions 1 100% of 10 RM 102 75% of 10 RM 10

3 50% of 10 RM 10

30 lifts 4 times weekly progress 10 RM once weekly.

72

Resistance Training Techniques Used in Rehabilitation

• DeLorme’s method– Based on repetition

maximum of 10– Designed for early rehab– Designed for beginning

rehab– Introduced PRE –

“progressive loading”– Builds in warm-up period– 50%, 75% and 100% of 10

RM

• Oxford method– Used during early,

intermediate & advanced levels of rehabilitation

– Percentages of 10 RM– Diminishes resistance as

muscle fatigues – “regressive load”

– 100%, 75%, 50% of 10 RM

Definitions of Some Terminology

• Repetition: number of times you repeat specific movement.• Repetition Maximum (RM): maximum number of repetitions

at a given weight.• Intensity: the amount of weight or resistance lifted.• Recovery Period: the rest interval between repetitions.

• One Rep Max, or 1RM: is a measure of how much you can lift for one repetition of an exercise. When you determine your 1RM, you can use a percentage of this to figure out how much weight to use for different exercises. Since it's hard to lift enough weight to only do 1 rep without hurting yourself (if you're a beginner), it's best to guess how much weight you

need and adjust it throughout the workout.