2. Active Movement (b) kinesiology slide.pptx

2. Active Movement (b) kinesiology slide.pptx

1. Active Movement Dr. Tooba Asif , PT Lecturer DPT (RIU), MS-OMPT (RIU) Certified Kinesio Taping Practitioner (CKTP, USA) Certified Dry Needling Practitioner (CDNP, UK)

2. DEFINITION: Exercises performed by a person with the help of an external force are called as assisted exercises. This external assistance may be manual or mechanical. ASSISSTED EXERCISES

3. When muscular action is insufficient. The external force must be applied in direction of muscle action. Magnitude of this external force must be to augment only not act as its substitution. As power of muscle increases, assistance given should be decreased proportionally. PRINCIPLES OF ASSISTANCE

4. Make ensure that inefficient muscles exert their maximum effort. Starting Position: Ensure that patient’s whole attention is concentrated on pattern of movement. Pattern Of Movement: Known to patient Fixation: Fixation of bone; prime movers origin Should be achieved actively to reinforce the weak muscles TECHNIQUE

5. Controlled or ‘held back’ so that movement is pivoted at required joint. Support: Reduce excessive weight on weak muscles by : Physio hand Suspension sling Re-education board Buoyancy of water Ball bearing skates TECHNIQUE

6. The Antagonist Muscles: Reduce tension in antagonist muscles Assisted dorsiflexion when knees are flexed. Traction: Stretching of weak muscles to elicit myotatic stretch reflex. The Assisting Force: In direction of movement ROM is as full as possible. TECHNIQUE

7. Different assistance at different level; possible only by manual mean not mechanical. The Character Of Movement: Smooth Speed of movement depends on muscles involved ; fusiform contract rapidly while multi pennate slowly. TECHNIQUE

8. Repetitions: Depends on the condition The Cooperation Of Patient: Very essential Target is controlled active movement without assistance. TECHNIQUE

9. Used in the early stages of neuromuscular re-education. Memory of the pattern Confidence in the ability ROM is increased. Effects & Uses

10. Combination of assistance & resistance during a single movement. ASSISTED-RESISTED EXERCISE

11. External resistance is applied which produces Tension in muscles Power Hypertrophy So application of max. resistance cause maximum development Amount Of Resistance: must be good enough to raise intra muscular tension. RESISTED EXERCISE Principles Of Resistance:

12. Five factors contribute in the development of muscle efficiency. Power: Develops in response of maximum resistance. Progressive resistant-low repetition exercises. Factors

13. Endurance: develops in response to repetitive contractions method used is low resistant-high repetition exercise. Volume: measured as an indication of hypertrophy although it is not a reliable method. Speed Of Contraction: depends on muscles 5. Coordination: Important for fine movement. Factors

14. VARIATION OF THE POWER OF MUSCLE IN DIFFERENT PARTS OF THEIR RANGE: Physiologically muscles exerts their greatest force in their outer range. Mechanically in the mid range when angle of pull is at right angle. In rough estimation it is max. in outer part of middle range. Broadly speaking each group is found to be most powerful in the part of range in which it is habitually used.

15. Starting Position: Comfort & stability Ensure that patient’s whole attention is concentrated on pattern of movement. Pattern Of Movement: Known to patient Taught as passively or free exercise Stabilization: Stabilization of bone of origin of muscles Controlled or localized so that movement is pivoted at required joint. Technique

16. Traction: Stretching of weak muscles to elicit myotatic stretch reflex. The Resisting Force: Variety of ways can be used like; manual pressure weights springs pulleys In the direction of movement ROM is as full as possible Magnitude of resistance depends on muscle Technique

17. Max. resistance elicits max. power & hypertrophy Manual pressure is of great advantage as it can be varied in circumference of range. The Character Of Movement: Smooth Speed of movement is consistent Full ROM Technique

18. Repetitions: Depends on the condition Low Resistance-High Repetition for weak or elderly patients i.e osteo-arthiritis . High Resistance-Low Repetition to build up power after surgery or disuse i.e menisectomy . Static resisted contraction in effusion & rheumatoid conditions. Technique

19. 8. The Cooperation Of Patient: Patient’s interest is very essential Movements should be precise Regular measurements & recording of progress. Verbal encouragement. Technique

20. Other than friction & gravity can be provided by Physiotherapist Patient Weights Weight & Pulley circuits Springs Substances which are malleable Water RESISTANCES

21. Applied manually in the line of movement. Physiotherapist's stance must be in the line of movement Maintain traction & approximation throughout the movement Resistance can be varied in range according to the muscle power. 1. Resistance By The Physiotherapist:

22. With the sound limb e.g. knee extension in high sitting Free movement i.e. by own body weight e.g. press ups. 2. Resistance By The Patient

23. Weights used in the form of: sand bags metal weights medicine balls This can be used in progressive resistance exercises. 3. Resistance By Weights