1. Muscle Strength, Endurance and Proprioception: Early Stages Therapy & Exercise 6/23/2016 1

2. Objectives 1. Understand terminology relevant to the rehabilitation process 2. Explain and demonstrate early strengthening, endurance and proprioceptive exercises for a rehabilitation program 6/23/2016 Property of AZ CTE Curriculum Consortium2

3. Bellwork Isometric Exercise Isotonic ExerciseIsokinetic Exercise Definition: Definition: When is it used? Examples: Examples: 6/23/2016 Property of AZ CTE Curriculum Consortium3

4. Terminology O Muscle strength- the ability to generate force. Measured with a 1 repetition maximum (1RM). O Muscle endurance – the ability to repeatedly contract a muscle without fatigue. Measured with a sit-up test – number of sit-ups in 1 minute. O Proprioception - The ability to sense stimuli arising within the body regarding position, motion, and equilibrium. In other words, the ability of the body to sense positioning of trunk, limbs, etc. 6/23/2016 Property of CTE Joint Venture4

5. Terminology O PRE (progressive resistive exercise)- exercises that become increasingly more difficult O RROM (resistive range of motion)- some form of resistance is applied to the movement O Manual resistance- clinician physically resists range of motion 6/23/2016 Property of AZ CTE Curriculum Consortium5

6. Terminology O Isometric – constant length. Contracting the muscle without any joint movement 6/23/2016 Property of CTE Joint Venture6

7. Terminology O Isotonic – constant weight. Contracting the muscle and lifting a weight 6/23/2016 Property of CTE Joint Venture7

8. Terminology O Isokinetic – constant speed. Contracting the muscle while moving the resistance arm of a machine 6/23/2016 Property of CTE Joint Venture8

9. Terminology O SLR (straight leg raise)- ROM performed at hip if there is a lower extremity injury that prevents knee ROM O Open kinetic chain exercises- when the foot or hand is mobile or off the ground O Closed kinetic chain exercises- when the foot or hand is fixed or on the ground O Neuromuscular control- ability for muscles to respond to environmental changes 6/23/2016 Property of CTE Joint Venture9

10. Considerations 6/23/2016 Property of AZ CTE Curriculum Consortium10 O Protect healing tissue, but must provide some stress for proper healing (Wolff’s law) O PRE O Safe ROMs and planes of movement O Exercise choice O Maintain rest of body fitness to prevent atrophy

11. Strengthening O Isometric vs. isotonic vs. isokinetic O Easy progression: O Isometric O Gravity resistance O Light weight or manual resistance http://www.youtube.com/watch?v=Hhcz0qJvEeI O Tubing/bands http://www.youtube.com/watch?v=z1zInVH6X28 6/23/2016 Property of CTE Joint Venture11

12. Using tubing or bands for strengthening is an isotonic exercise? True/False ? 12

13. Endurance O Pain-free ROM O No undue stress to healing site O Examples: O Bike O UBE- upper body ergometer O Rowing O Swimming O Elliptical O Treadmill 6/23/2016 Property of CTE Joint Venture13 http://www.abqjournalfit.com/414/blog/2010/09/11/try-your- hand-on-a-ube/

14. Is the UBE an open-kinetic chain endurance exercise? True/False ? 14

15. Proprioception O Static balance exercises- tandem stance or one leg O Flat hard surface O Foam or mat surface O Add weights or movements to each O Static upper extremity exercises O Mirror movements between limbs O Closed kinetic chain stability on hand- tandem and single arm 6/23/2016 Property of CTE Joint Venture15 http://www.reflexportland.com/exercise/at -home-knee-strengthening-exercises/

16. Is this an open-kinetic chain proprioceptive exercise for the shoulder? True/False ? 16 http://sdchiropracticcare.com/tag/plank-exercises

17. Closure 6/23/2016 Property of AZ CTE Curriculum Consortium17 Summarize today’s lesson on your Exit Ticket. What did you learn about progression? What is an example of a strengthening exercise? A proprioceptive exercise?