Resistance Exercise For Impaired Muscle Performance
Advantages and Disadvantages of Free Weights and Simple Weight-Pulley Systems (Gravitational)
Pros (Advantages)
• Exercises can be set up in many positions, such as supine, side-lying, or prone in bed or on a cart, sitting in a chair or on a bench, or standing. Many muscle groups in the extremities and trunk can be strengthened by simply repositioning the patient.
• Free weights and simple weight-pulley systems typically are used for dynamic, non-weight-bearing exercises but also can be set up for isometric exercise and resisted weight-bearing activities.
• A variety of movement patterns is possible, incorporating single plane or multiplanar motions. An exercise can be highly specific to one muscle or generalized to several muscle groups. Movement patterns that replicate functional activities can be resisted.
• Free weights with interchangeable disks, such as a barbell, are versatile and can be used for patients with many different levels of strength, but they require patient or personnel time for proper assembly.
• Bilateral lifting exercises with barbell weights often require the assistance of a spotter to ensure patient safety, thus increasing personnel time.
Pros (Disadvantages)
• Stabilizing muscle groups are recruited; however, because there is no external source of stabilization and movements must be controlled entirely by the patient, it may take more time for the patient to learn correct alignment and movement patterns.
• Most exercises with free weights and weight-pulley systems must be performed slowly to minimize acceleration and momentum and prevent uncontrolled, end-range movements that could compromise patient safety.
• Free weights with interchangeable disks, such as a barbell, are versatile and can be used for patients with many different levels of strength, but they require patient or personnel time for proper assembly.
• Bilateral lifting exercises with barbell weights often require the assistance of a spotter to ensure patient safety, thus increasing personnel time.
Advantages and Disadvantages of Exercise with Elastic Resistance
Pros (Advantages)
• Elastic resistance products are portable and relatively inexpensive, making them an ideal choice for home exercise programs.
• Because elastic resistance is not significantly gravity dependent, elastic bands and tubing are extremely versatile, allowing exercises to be performed in many combinations of movement patterns in the extremities and trunk and in many positions.
• It is safe to exercise at moderate to fast velocities with elastic resistance because the patient does not have to overcome the inertia of a rapidly moving weight. As such, it is appropriate for plyometric training.
Cons (Disadvantages)
• One of the most significant drawbacks to the use of elastic resistance is the need to refer to a table of figures for quantitative information about the level of resistance for each color-coded grade of material. This makes it difficult to know which grade to select initially and to what extent changing the grade of the band or tubing changes the level of resistance.
• As with free weights, there is no source of stabilization or control of extraneous movements when an elastic band or tubing is used for resistance. The patient must use muscular stabilization to ensure that the correct movement pattern occurs.
• Although the effects of material fatigue are small with typical clinical use (up to 300% deformation in most exercises), elastic bands and tubing should be replaced on a routine basis to ensure patient safety.146,245 If many individuals use the same precut lengths of bands or tubing, it may be difficult to determine how much use has occurred.
• Some elastic products contain latex, thus eliminating use by individuals with an allergy to latex. However, there are latex-free products on the market at a relatively comparable cost.
Advantages and Disadvantages of Isokinetic Equipment
Advantages
• Isokinetic equipment can provide maximum resistance at all points in the ROM as a muscle contracts.
• Both high- and low-velocity training can be done safely and effectively.
• The equipment accommodates for a painful arc of motion.
• As a patient fatigues, exercise can still continue.
• Isolated strengthening of muscle groups is possible to correct strength deficits in specific muscle groups.
• External stabilization keeps the patient and moving segment well aligned.
• Concentric and eccentric contractions of the same muscle group can be performed repeatedly, or reciprocal exercise of opposite muscle groups can be performed, allowing one muscle group to rest while its antagonist contracts; the latter method minimizes muscle ischemia.
• Computer-based visual or auditory cues provide feedback to the patient so submaximal to maximal work can be carried out more consistently.
Disadvantages
• The equipment is large and expensive.
• Setup time and assistance from personnel are necessary if a patient is to exercise multiple muscle groups.
• The equipment cannot be incorporated into a home exercise program.
• Most units allow only open-chain (non-weight-bearing) movement patterns, which do not simulate most lower extremity functions and some upper extremity functions.
• Although functional movements typically occur in combined patterns and at many different velocities, most exercises are performed in a single plane and at a constant velocity.
• Although the range of concentric training velocities (up to 500 degree/sec) is comparable to some lower extremity limb speeds during functional activities, even the upper limits of this range cannot begin to approximate the rapid limb speeds that are necessary during many sports related motions, such as throwing. In addition, the eccentric velocities available, at best, only begin to approach medium-range speeds, far slower than the velocity of movement associated with quick changes of direction and deceleration. Both of these limitations in the range of training velocities compromise carryover to functional goals.
Ref: Therapeutic Exercise by Kisner & Colby (5th Edition)
Pros (Advantages)
• Exercises can be set up in many positions, such as supine, side-lying, or prone in bed or on a cart, sitting in a chair or on a bench, or standing. Many muscle groups in the extremities and trunk can be strengthened by simply repositioning the patient.
• Free weights and simple weight-pulley systems typically are used for dynamic, non-weight-bearing exercises but also can be set up for isometric exercise and resisted weight-bearing activities.
• A variety of movement patterns is possible, incorporating single plane or multiplanar motions. An exercise can be highly specific to one muscle or generalized to several muscle groups. Movement patterns that replicate functional activities can be resisted.
• Free weights with interchangeable disks, such as a barbell, are versatile and can be used for patients with many different levels of strength, but they require patient or personnel time for proper assembly.
• Bilateral lifting exercises with barbell weights often require the assistance of a spotter to ensure patient safety, thus increasing personnel time.
Pros (Disadvantages)
• Stabilizing muscle groups are recruited; however, because there is no external source of stabilization and movements must be controlled entirely by the patient, it may take more time for the patient to learn correct alignment and movement patterns.
• Most exercises with free weights and weight-pulley systems must be performed slowly to minimize acceleration and momentum and prevent uncontrolled, end-range movements that could compromise patient safety.
• Free weights with interchangeable disks, such as a barbell, are versatile and can be used for patients with many different levels of strength, but they require patient or personnel time for proper assembly.
• Bilateral lifting exercises with barbell weights often require the assistance of a spotter to ensure patient safety, thus increasing personnel time.
Advantages and Disadvantages of Exercise with Elastic Resistance
Pros (Advantages)
• Elastic resistance products are portable and relatively inexpensive, making them an ideal choice for home exercise programs.
• Because elastic resistance is not significantly gravity dependent, elastic bands and tubing are extremely versatile, allowing exercises to be performed in many combinations of movement patterns in the extremities and trunk and in many positions.
• It is safe to exercise at moderate to fast velocities with elastic resistance because the patient does not have to overcome the inertia of a rapidly moving weight. As such, it is appropriate for plyometric training.
Cons (Disadvantages)
• One of the most significant drawbacks to the use of elastic resistance is the need to refer to a table of figures for quantitative information about the level of resistance for each color-coded grade of material. This makes it difficult to know which grade to select initially and to what extent changing the grade of the band or tubing changes the level of resistance.
• As with free weights, there is no source of stabilization or control of extraneous movements when an elastic band or tubing is used for resistance. The patient must use muscular stabilization to ensure that the correct movement pattern occurs.
• Although the effects of material fatigue are small with typical clinical use (up to 300% deformation in most exercises), elastic bands and tubing should be replaced on a routine basis to ensure patient safety.146,245 If many individuals use the same precut lengths of bands or tubing, it may be difficult to determine how much use has occurred.
• Some elastic products contain latex, thus eliminating use by individuals with an allergy to latex. However, there are latex-free products on the market at a relatively comparable cost.
Advantages and Disadvantages of Isokinetic Equipment
Advantages
• Isokinetic equipment can provide maximum resistance at all points in the ROM as a muscle contracts.
• Both high- and low-velocity training can be done safely and effectively.
• The equipment accommodates for a painful arc of motion.
• As a patient fatigues, exercise can still continue.
• Isolated strengthening of muscle groups is possible to correct strength deficits in specific muscle groups.
• External stabilization keeps the patient and moving segment well aligned.
• Concentric and eccentric contractions of the same muscle group can be performed repeatedly, or reciprocal exercise of opposite muscle groups can be performed, allowing one muscle group to rest while its antagonist contracts; the latter method minimizes muscle ischemia.
• Computer-based visual or auditory cues provide feedback to the patient so submaximal to maximal work can be carried out more consistently.
Disadvantages
• The equipment is large and expensive.
• Setup time and assistance from personnel are necessary if a patient is to exercise multiple muscle groups.
• The equipment cannot be incorporated into a home exercise program.
• Most units allow only open-chain (non-weight-bearing) movement patterns, which do not simulate most lower extremity functions and some upper extremity functions.
• Although functional movements typically occur in combined patterns and at many different velocities, most exercises are performed in a single plane and at a constant velocity.
• Although the range of concentric training velocities (up to 500 degree/sec) is comparable to some lower extremity limb speeds during functional activities, even the upper limits of this range cannot begin to approximate the rapid limb speeds that are necessary during many sports related motions, such as throwing. In addition, the eccentric velocities available, at best, only begin to approach medium-range speeds, far slower than the velocity of movement associated with quick changes of direction and deceleration. Both of these limitations in the range of training velocities compromise carryover to functional goals.
Ref: Therapeutic Exercise by Kisner & Colby (5th Edition)
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