Flashcards in Evidence Based Practice - Strengthening Deck (14)
What three factors affect muscle strength?
Structural - decreased cross-sectional area and reduced density of fibres
Biomechanical - inefficient leverage across the joints
Functional - inefficient recruitment of number, type and frequency of motor units
What are the secondary complications of weakness?
secondary atrophy, reduced muscle volume, decreased cross-sectional area
What are the primary benefits of strength training?
increase strength and functional performance
What are the secondary benefits of strength training?
Decreased muscle stiffness, decreased co-contraction, decreased hyperreflexia
How can task specific exercise decrease stiffness?
improve neural control and maintian muscle extensibility, reduce co-contraction
How can task specific exercises improve strength?
improves firing and synchronisation of the motor units increase muscle length, increase muscle mechanics
What types of exercises should be included in a strengthening programme?
weight-bearing and non-weight-bearing exercises
Concentric and eccentric exercises
What are the principles of exercises for grades 0 and 1?
initally eccentric with outer and middle ranges
progress to concentric and eccentric
What are the principles of strengthening grades 2 and 3?
Specific training - functionally to increase force generation and intersegmental control of the muscles
Start impairment based then practice in function
What are the principles of exercises for grades 4 and 5?
Start progressive resistance training and high intesity for 70-80% of 1RM
How to achieve full movements?
Modification of exercises to achieve graded practice and stop the patient getting too used to one exercise
How many reps should be applied?
continuous repetitions to mild fatigue - then short rest and repeat same number of repetitions up into the 100s
What should the speed of movement be?
Start quickly as easier, then slow down to increase force through muscle (newton's 2nd law), then speed up again for explosive force