Therapeutic Exercise Goals and Principles

Goals of Therapeutic Exercise

• Strength: Ability of contractile tissue to generate force against resistance.
• Muscle Endurance: Ability of a muscle to repeatedly contract, generate tension, and resist fatigue over time.
• Power: Ability to produce maximum force in the shortest time (rate of performing work). Work is calculated as force multiplied by distance per unit of time.
• Balance: Maintaining the body in equilibrium.
• Reaction Time: Time to respond to a stimulus.
• Coordination: Integration of the nervous system for smooth, harmonious body movement.
• Agility: Ability to quickly and efficiently change body position and direction.
• Cardiovascular Endurance: Capacity to sustain cardiovascular activity.
• Neuromuscular Reactivity: Response of the neuromuscular system.

Principles of Therapeutic Exercise

• Overload Principle: To improve muscle performance, apply a load exceeding the muscle's metabolic capacity.
• Specificity Principle: Exercises should mimic anticipated function in the training program.
• Length-Tension Relationship: Muscle generates greatest force at midrange or slightly beyond.
• Reversibility Principle: (Specificity - correction in the intro) Gains from exercise are lost if the exercise is stopped.

Muscle Contraction Types

• Eccentric Contraction: Muscle lengthens while contracting; crucial for shock absorption and deceleration. Eccentric contractions tend to generate greater tension than isometric or concentric contractions.
• Concentric Contraction: Muscle shortens while contracting.
• Isometric Contraction: Static muscle contraction with no joint movement.

Open Kinetic Chain (OKC) vs. Closed Kinetic Chain (CKC)

• OKC: Distal segment moves freely in space. Movement occurs only distal to the joint. Typically non-weight-bearing. Isolated muscle action of the prime mover.
• CKC: Distal segment is fixed. Often in weight-bearing positions. Joint approximation (which are mechanoreceptors) and muscle facilitation occur. Multiple muscle groups co-contract for stability. CKC exercises increase challenge with OTIS and ITIS.

Exercise Dosing

• Power: 1-8 repetitions maximum (RM) with 2-3 sets (80-100% of 1RM).
• Strength: 6-12 RM, 2-3 sets (70-80% of 1RM).
• Endurance: More than 12 repetitions with low weight, 3-5 sets (<70% of 1RM).

Repetition Maximum (RM)

• RM: Greatest weight (load) a muscle can move through the full ROM a specific number of times.
• Power exercises use 80-100% of 1RM.
• Strength exercises use 70-80% of 1RM.
• Endurance exercises use <70% of 1RM.

Phases of Rehabilitation

• Maximum Protection (Acute): Inflammatory phase; maximal protection; passive range of motion (PROM) and muscle setting exercises.
• Controlled Motion (Sub-Acute): Repair and healing; controlled movement; open and closed kinetic chain exercises; emphasis on muscle endurance.
• Return to Function: Remodeling; increase strength and endurance. Functional exercise; agility drills; plyometrics.

Response to Exercise

• Monitoring heart rate, blood pressure, respiratory rate, and glucose levels is important during and following exercise.

This quiz explores the fundamental goals and principles of therapeutic exercise including strength, endurance, power, and agility. It focuses on how to achieve optimal physical performance and recovery through various techniques and concepts. Test your knowledge on these key elements of physical therapy and exercise science.