Functional Progression Sport/Activity Specific Training

 Distinguish between Functional Exercise and Functional Evaluation  Distinguish between Basic Functional activities and Advanced Functional activities  Design Advanced Functional Exercise progression adjusting each of the five components of progression  Describe Precautions to Functional activities  Develop a functional exercise progression program for the elderly patient population

 Functional Exercise: Exercise that mimics functional activities, but is performed in a controlled manner or environment  Progression is the movement from low level to high level functions Progressive Resistance Exercises Example- Isometric  Isotonic  Isokinetic  Plyometrics

 Progression of Functional Exercise Multifaceted Muscle Activity Multiplanar Motion/Muscle Group Stabilization and Acceleration Changes Proprioceptive Stimulation Agility and Power Development

 Should be included in the final phases of a rehabilitation program  Necessary for skill development  Necessary for confidence building

 Prerequisites Flexibility Strength and endurance Coordination and agility Stabilization and acceleration ability  Start with easy activities  Progress in difficulty and complexity as ability and confidence build

 Functional: Usually incorporates triplanar motions of muscles used in normal activities Used to prepare patient to advance to activity- specific exercises  Activity-Specific: Includes specific activities and requirements of normal performance Utilizes tools and equipment used in normal activity In sport, these may be similar to practice drills

 Mimic performance demands that the patient will require for return to sport, recreation, or work  Include specific tasks and execution needs  Determined by the patient’s sport or work demands

 Determined by the patient’s specific responsibilities within that sport or activity  Developing the activities may require assistance from a coach  Drills progress from simple to difficult  May be used to test patient’s readiness to return to activity

 Design is based on patient’s job or sport and position  Needs of job or sport and position dictate emphasis  Stresses of job or sport = stresses of functional exercises  Exercises mimic job or sport activities  Skill exercises progress in demands to mimic real or competitive situations

 Force and intensity  Speed  Distance  Complexity

 Rolling side-to-side  Supine to sit/sit to lying down  Sit to stand/stand to sit  Getting into and out of car  Walking  What activity progressions might be appropriate after walking?

 Weight-Bearing Exercise Core stabilization exercises in hooklying Wall push-ups with Trunk Stabilization Wall Slides Partial Lunges and Partial Squats Walking against Resistance  Transitional Stabilization Exercises Quadruped weight shifting Squat and Reach Weight shift and Turning

 Increase ambulation challenges Uneven surfaces, turns, walking backwards, up/down ramps Climbing stairs  Repetitive squats and lunges  Lift and carry  Push and pull various loads  Agility drills  Plyometric drills  Maximize eccentric loading

 Progress endurance by increasing number of repetitions or time element at each resistance level Leg press, Total Gym, isokinetic dynamometer, treadmill, stationary bike, stair-stepper  Emphasis on balance, coordination, timing and skill acquisition  Plyometrics  Drills  Work-related activities- Repetitive lifting

Pyramiding Box Jumps

 Lifting, pushing and pulling  Squatting and Lunging  Climbing and descending steps or ladders while carrying weights  Plyometric drills Push-offs on total gym Box-jumps  Agility and skill- obstacle course, skipping

BOSU

 Maximize resistance both concentrically and eccentrically  High intensity exercise to develop endurance  Pulleys in standing, diagonal patterns  Plyometrics  Functional & Activity Specific Exercises: Loading dishwasher, washing windows Bat and golf club swinging

 Generally involve the entire upper extremity  Combined pulling motions Bilateral pull-ups, chin-ups, bilateral or unilateral rows  Combined pushing motions Table push-ups, UBE  Practice swings on the wall pulley Backhand, forehand, and serving