Creating a Strengthening Program

Question 1

Things to consider when determining appropriate exercise and dosage…

Answer 1

• What muscles are you targeting?
• What functional activity is the person wanting to get back to doing?
• Current stage of healing if there was injury to the muscle?
• Current acuity and irritability of symptoms?
• Any medical precautions or restrictions to consider?
• Working on activation, strength, endurance, or power?
• What will patient agree to and what resources do they have to follow through? Must come to a common consensus of what patient will do at home!

Question 2

Variables of resistance training
Consideration for Exercise DOSAGE

Answer 2

• Targeted muscle groups and patient position
• External stabilization/assistance provided
• Types of resistance (ex: equipment)
• Volume (sets and reps)
• Amount of resistance (intensity)
• Training frequency
• Velocity (speed)
• Range of motion
• Type of mm contraction (Concentric, Eccentric, Both)

Question 3

Targeted muscle groups and patient position

Answer 3

• Is chosen exercises or movement appropriate to isolate muscle you are intending to strengthen? (Using biomechanics and anatomy)
• How does the patient position affect gravity?
  – Resistance (against gavity)
  – Asssistance (Gravity assisted)
  – Position can negate effects of gravity (gravity neutral or gravity eliminated)
  – Where throughout ROM are effects of gravity greatest/least?

Question 4

External Stability?

Answer 4

Use of weight machines provide external stability
OR
Use of other devices to provide stability of proximal segments
OR
No external stability

Ex: Squats
1: Squat Machine (External resistance to neck back and shoulders)
2: Holding onto table for proximal support
3: Squat no stability provided

Question 5

Types of resistance to be used

Answer 5

• Body weight/gravity
• Manual resistance
• Free weights
• Machines
• Others (ex: kettle bells, resistance bands, theraband, etc.)

Question 6

Volume

Answer 6

• Number of repetitions you are prescribing
• Goal of muscle hypertrophy: Relatively high load, low reps (8-10 reps); 2-3 sets
• Goal of gradual increase of load to injured tissue: Light to moderate load; multiple sets, high reps (10-20 reps)

Question 7

Frequency

Answer 7

• How often we do exercise
• Goal of muscle hypertrophy: Traditionally: 2-3 x/ week
• Goal of motor control and retraining: FREQUENTLY THROUGHOUT DAY OR WEEK

Question 8

Velocity - MC vs Functional Training

Answer 8

• Goal of motor control training: slow and controlled
• Goal of functional training: fast and controlled
• May differ based on phase of the movement (concentric/eccentric)

Question 9

ROM options

Answer 9

• Limited arc of motion (Range in which they can generate the most force)
• Full arc of motion
• Functional range of motion

Question 10

Type of mm contraction

Answer 10

• Isometric vs. Isotonics
• Submaximal to maximal
• Eccentric only, concentric only, or both
• Single plane vs. multiple planes of motion

Question 11

Precautions for strength training

Answer 11

• Ensure client is breathing
  – Esp. those with CV conditions
• Watch for substitutions
  – May be due to …?
• Too rapid of progression
• Muscle soreness (DOMS) - 24-48 hours after
• Osteoporosis: caution with loading joint or spine