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Progressive Resisted Exercises • There are many ways to achieve progressive resistance: 1-Increase the weight you’re lifting. Do the same number of repetitions and sets each week, but increase your weight. 2-Increase the number of repetitions, use the same weight for each workout but increase the repetitions each week. 3-Increase the number of sets each time you workout. 4-Shorten the rest time between the sets. 5-Use the same weight and repetitions, but slow down the exercise. Precautions and contra-indication • Precautions: 1 - Cardiovascular problems must be controled during exercises. 2- Avoid reaching to fatigue point. 3- Adequate time for recovery from fatigue. 4- Avoid over work to avoid excessive protein breakdown. 5- Osteoporosis: to avoid pathological fracture. 6- Muscle soreness: due to lack of blood flow and oxygen. Precautions and contra-indication • contra-indication: 1 – Inflammation which is leading to swelling. 2- Pain during the resistance exercises. Types of resistance exercises • Isotonic resistance exercise 1- Manually: in which the resistance force is applied by the therapist. 2- Mechanically: in which the resistance force is applied by equipment. Isometric resistance exercises • is referred to as resistive strength training (RST) because resistance is applied to the contracting muscle, preventing it from shortening. Isokinetic resistance exercises • Term means "constant force" and typically is used to describe dynamic exercise performed through range of motion of joint at constant velocity; - Equipment used in isokinetic exercises accommodates the exerted force to maintain the specified velocity throughout the arc of motion; - because velocity does not change, the kinetic energy remains constant; Delorm Technique • Describe a system approach by progressively increasing the resistance (weight lifted). The protocol underwent a number of modifications but settled upon the following approach: a-Once a week the 10 RM was determined for each muscle or muscle group to be strengthened. b-For each daily session 10 repetitions at 50% of the 10 RM, 10 repetitions at 75% and 10 RM at 100% of the 10 RM. Oxford Technique • This technique was designed to be used in beginning, intermediate, and advanced levels of rehabilitation (it is the reverse of Delorm). Endurance Definition: Is the ability to work for prolonged periods of time and the ability to resist fatigue. Types of endurance: 1-Local( muscular) endurance: is the ability of a muscle to general tension and sustain that tension over a prolonged of time 2-General( total) endurance: is the ability of an individual to sustain low-intensity exercise as walking, over an extended period of time. Endurance test 1- To test local muscular endurance: high repetitions of a movement without resistance are repeated until the muscles fatigue. The number of repetitions is counted. 2- To test general (cardiovascular )endurance: the patient perform a controlled repetitive total body activity for long period of time and to check the heart rate will decrease. Procedure - Warm up gradually for 5- 10 minutes, including stretching and repetitive motion at slow speeds with gradually increasing the effort. - Increasing the activity so that the exercise can be maintained for 20- 30 minutes. - Cool down for 5-10 minutes with slow, total body repetitive motions and stretching activities. - Exercises can be repeated 3-5 times/week. - To avoid insupport.juries, use appropriate equipment and proper biomechanical Physiological changes to endurance exercise 1- Cardiovascular changes - Increase myocardial contractility, HR and a reduction in pulse rate changes - Increase in the1- Cardiovascular cardiac output - Increase the extraction of oxygen by the working muscle - Decrease rate of depletion of muscle 2- Respiratory changes - Larger lung volumes - Larger diffusion capacities - Increase ventilatory efficiency 3- Metabolic changes - Increase fat mobilizing and metabolising enzymes - Decrease rate of depletion of muscle glycogen - Increase capability to oxidize carbohydrate 4-Other system changes -Decrease in body fat -Decrease in blood cholesterol and triglyceride levels -Increase in the strength of bones, ligaments and tendons