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Resisted exercises
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Resisted Exercises

What is Resisted exercise?

• It is any form of active exercises in which dynamic or

static muscle contraction is resisted by an outside
force applied manually or mechanical.
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Resisted Exercises

Principles of resistance
 External force:
• It may be applied to the body levers
• To oppose the force of muscular contractions.
 Tension:
• It is increased within a muscles by the opposing
force (or resistance)
• Muscle respond by ↑ in
i. Power
ii. Hypertrophy
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Resisted Exercises

Amount of resistance

• Sufficient to increase the intramuscular tension

• Co-ordinated movement
Isotonic
contraction

• Maximum increase in the intramuscular

tension
• Resistance= muscles ability to maintain the
Isometric
hold
contraction
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Resisted Exercises

Overload principle: muscle must be challenged to

perform at a level greater than that to which it is
accustomed.

SAID(Specific Adaptation to Imposed Demand)

principle: parameters of exercise should be selected
to create specific training effect.
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Resisted Exercises

Factors contribute to the development of muscular

efficiency
1. Power
2. Endurance
3. Volume
4. Speed of contraction
5. Co-ordination

• Power, endurance and volume are inter-related and

imp factors.
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Resisted Exercises

POWER
• It develops in response to,

Application of the maximum resistance

Consistence with the ability of the muscle to
overcome it

• Essential factor for power development is,

Magnitude/great size, of the resistance
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Resisted Exercises

• The method used to promote is,

PROGRESSIVE RESISTANCE- LOW

REPETATION EXERCISES

• The number of times the movement being relatively

few to allow the resistance to be as great as possible.
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Resisted Exercises

Endurance
• That develops in response to repetitive contraction….
• So the method used is

LOW RESISTANCE- HIGH REPETITIONS

EXERCISE
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Resisted Exercises

VOLUME

It can be,

• Observed or measured as an indications of

hypertrophy
• Usually it is in proportion to POWER.
• It indicates progression of the patient.
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Resisted Exercises

Variability of the power

• The power of the muscles will not be equal at all the
parts of their range.

• Variations in the power will always be there in

different parts of their range.
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Resisted Exercises

• Capable of exerting max

Physiologicall
y strength in the outer range
• Force diminishes as they
shortened

• Like angle of pull of tendon

Mechanical insertion
factors • Effect will be greatest, angle
of pull approaches right angle
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Resisted Exercises

• It is different in diff muscle groups.

• Mostly each group found to be most powerful in the

part of range where it is habitually used.
• Eg. Shoulder flexors in outer range,
Hip extensors in inner range.

• So when we are giving resistance we should adjust

accordingly.
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Resisted Exercises

Technique of Resisted Exercises

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Resisted Exercises

Starting position
• Comfort and stability of the whole body is imp

• So patients whole attention concentrated,

1. On the pattern of movement
2. Efforts require to overcome the resistance.
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Resisted Exercises

The pattern of movement

i. Well known by patient

ii. Taught as passive or free exercise
iii. One which allows the contractions in full range
iv. Based on natural pattern
v. Purposeful movement
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Resisted Exercises

Stabilization
• It improves muscles efficiency

• It is rarely static when natural pattern of movement is

used

• If there is a tendency for the movement to be

transferred to the neighboring joints, then means of
fixation such as manual pressure or a strap must be
used to ensure movement at the required joints.
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Resisted Exercises

Traction
• Traction maintained through out the range facilitates,

i. Joint movement
ii. Maintained tension in the muscles
iii. Elicits the stretch reflex provides powerful
stimulus to contraction
iv. It augments the effect of resisting force
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Resisted Exercises

Resisting force
• Various means used to provide the force used to resist
the contraction,

1. Manual pressure
2. Mechanical resistance
i. Weights
ii. springs
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Resisted Exercises

Mechanical
Manual resistance
resistance
• It can be adjusted • Usually measurable
accurately in every • So useful for
part of the range measuring progress
• Disadvantage is
that it not easily
measurable
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Resisted Exercises

• The amount of resistance varies according to the

purpose.

• Maximal resistance used to develop,

Power
Hypertrophy

• Resistance given to develop muscular endurance is

less than the maximal resistance.
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Resisted Exercises

Character of the movement

• It should be smooth and controlled through out

• Speed of the movement should be according to the group

of muscle to be resisted and the amount of resistance
used.

• The ROM should be full whenever possible

• Resistance can be applied in any part of the range which

is convenient or desirable
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Resisted Exercises

Repetitions
• It is the number of times the muscles are thrown into
action against a resistance.

• Varies acc to the condition and individual patient

• No rule of thumb
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Resisted Exercises

• LOW RESISTANCE HIGH REPETITIONS

exercises suitable for weak or elderly patients.

• It is proved to be effective in such conditions like

Osteoarthritis.
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Resisted Exercises

• HIGH RESITANCE-LOW REPETATIONS exercises

build up power and hypertrophy

• So it is useful for muscles suffering from disuse as a

result of traumatic injury or orthopaedic surgery eg.
menisectomy
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Resisted Exercises

• In case of RA, when there is effusion or joint

changes,

Static resisted contractions , high repetitions are

useful for retaining the muscular efficiency in any
part of the range.

• The number of repetitions depends on the specific

conditions.
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Resistances
Resisted Exercises
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Resisted Exercises

• The two main resistive forces are gravity and

friction, other than that are,
1. The physiotherapist
2. The patient
3. Weights
4. Weight and pulley circuits
5. Springs and other elastic structures
6. Substances which are malleable
7. Water
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Resisted Exercises

Resistance by the physiotherapist(PT)

• Physiotherapist’s hand placed on the surface of the
skin

• Applied manually in line with the movement

• PT stance must be in line of the movement

 to prevent waste of effort
To ensure smooth controlled pressure
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Resisted Exercises

• Traction or approximation may be maintained

throughout the movement

• Resistance varied according to the variations in

power in diff parts of the muscle’s range.
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Resisted Exercises

Resistance by the patient

• Can be done by,
Sound limb
Own body weight(free exercises)
• Eg. Moving of a trunk over limb
• Here the quantity of resistance is more
• Unreliable as it can’t be measured or felt by the PT
• And it requires careful instruction, co-operation and
understanding of the pt.
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Resisted Exercises

Resistance by the weight

• Direct application of,
Sand bags
Metal weight
Medicine ball

• Applied by,
Held in the hand
Attachment to the shoes or any other part
Suitable straps
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Resisted Exercises

• It is essential that the means of resistance should be

comfortable and efficient

• Resistance must be given in the direction of gravity

• Its effects increases progressively if the weight is moved

away from the central axis of the body.

• Suitable and convenient for home practice after suitable

instruction
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Resisted Exercises

Progressive resistance exercises(PRE)

• System of dynamic resistance training
• Constant external load applied to the contracting
muscles
• By mechanical means
• Incrementally increased
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Resisted Exercises

• The use of PRE was first described by Delorme in

1945.

• The repetitions maximum(RM) is used as the basis

for determining and progressing the resistance.

• 10 RM- It is the maximum weight which can be

lifted 10 times at a natural speed without rest between
the lifts.
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Resisted Exercises

• Two frequently used regimens are:

1. Delorme regimen
2. Oxford regimen
Method:
• Metal weights applied to the part of the body
• By means of bar-bell held in the hand or by
delorme metal boot
• The poundage is determined by testing the RM for
given number of repetitions
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Resisted Exercises

• 3 sets of 10 repetitions are used in both the methods.

• Delorme – progressive loading

• Oxford – regressive loading

• In both,
 Rest interval between the sets
Increase the resistance incrementally over time to
apply progressive overload
Result in training induced strength gains.
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Resisted Exercises

Comparison of two PRE regimens

Delorme Regimen Oxford Regimen

Determination of a 10 RM Determination of a 10 RM

10 reps @ 50 % of the 10 RM 10 reps @ 100 % of the 10 RM

10 reps @ 75 % of the 10 RM 10 reps @ 75 % of the 10 RM

10 reps @ 100 % of the 10 RM 10 reps @ 50 % of the 10 RM

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Resisted Exercises

DAPRE(Daily Adjustable Progressive Resisted

Exercise)
• When and how much to increase the resistance in a
PRE program to overload the muscle is imprecise
and arbitrary.

• DAPRE is more systematic

• The system is based on 6 RM of the Working

weight.
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Resisted Exercises

Adjustable Working Weight:

 It is based on the maximum number of repetitions

possible using the working weight in set #3 of the
regimen, determines the working weight for the next
exercise session
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Resisted Exercises

DAPRE Technique

Sets Repetitions Amount of Resistance

1 10 50% 6-RM

2 6 75% 6-RM

3 Maximum Possible 100% 6-RM

4 Maximum Possible 100% adjustable working

weight
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Resisted Exercises

Calculation of the Adjustable working weight for the DAPRE

Regimen
Adjustment of the working weight

Repetitions in set 3 Set 4 Next exercise session 3

0-2 ↓ 5-10 lb ↓ 5-10 lb

3-4 ↓ 0-5 lb Same weight

5-6 Keep same weight ↑5-10 lb

7-10 ↑5-10 lb ↑5-15 lb

11 or more ↑10-15 lb ↑10-20 lb

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Resisted Exercises
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Resisted Exercises

Resistance by weight and pulley circuits

• The use of rope and pulley allows,
 the force exerted by a weight to act in any direction
therefore the muscles need not be required to work
against the resistance of both the gravity and the
weight.

• Provides a useful method of arranging resistance for

weak muscles when the limb is heavy
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Resisted Exercises

• The angle of pull of the rope by which it is applied

must vary during the course of a movement.

• Eg if perticular muscle group is more powerful in the

mid range , the resistance should be applied at a right
angle.

• Pt must be able to see the weight moving as a result

of his work
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Resisted Exercises

Resistance by spring and other elastic substances

• The resistance of spring increases as it is stretched or
compressed according to the type of the spring used

• Speed of movement must be carefully controlled as

accumulated energy in the extended spring makes its
natural speed of recoil very great
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Resisted Exercises

• Other substances like,

 rubber elastic of various widths and thickness
Rubber sponges
Rubber balls

Mostly useful for gripping muscles of the hands

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Resisted Exercises

Resistance by the substances which are malleable

• Various substances like,
Putty
Clay
Some kind of wax
Plasticine
Wet sand
• Used both for strengthening and mobilizing the hands
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Resisted Exercises

Resistance by Water
• It increases with speed and the surface area of the
part moved

• When the movement is vertical, buoyancy adds to the

resistance on the way down and cancel out much of
the resistance on the way up
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Resisted Exercises

Progression
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Resisted Exercises

• As the power increases the resistance must

increased.
• Four ways,
1. ↑ weight
2. ↑ leverage of the resisting force
3. Alteration in the speed of movement
4. ↑ in the duration of exercise.
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Effect and uses of resisted

exercises
Resisted Exercises
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Resisted Exercises

1. Increase the power and endurance

2. Increase the blood flow to the working muscles
3. A general increase of blood pressure
4. Heat produced causes vasodilatation