MUSCULOSKELETAL FITNESS ASSESSMENT AND RESISTANCE TRAINING PROGRAM Types

MUSCULOSKELETAL FITNESS ASSESSMENT AND RESISTANCE TRAINING PROGRAM

Types of Muscle Contraction � Isometric �(static) � Dynamic �Concentric (muscle shortens) �Eccentric (muscle lengthens)

Types of Muscle Contraction � Isokinetic �“same” “motion” �Action at constant velocity (ex. 120°/sec) �Velocity and ROM controlled mechanically �Person generates force and device matches the force produced

Types of Muscle Contraction � � Dynamic constant external resistance (DCER) �Constant external force (e. g. free weight) �Force varies across range of motion due to varying joint mechanics and muscle lengths �Velocity varies and is controlled by the subject Accommodating Resistance

Adaptations to Resistance Training � Morphological Factors �Increase in size and strength of ligaments and tendons �Increase in bone density and bone strength �Increase in muscle capillary density � Neural Factors �Increase in motor unit activation and recruitment �Increase in discharge frequency of motor neurons. �Decrease in neural inhibition

Muscular Strength � Strength: ability of muscle groups to develop force: �Maximal contractile force �Single contraction �Specified velocity � Force �Dependent on velocity of movement �Force Velocity Relationship

The Force Velocity Relationship http: //www. pt. ntu. edu. tw/hmchai/bm 03/bmmaterial/Muscle. htm

Force Velocity Power Relationship http: //en. wikipedia. org/wiki/File: Muscle_For ce_Velocity_relationship. png http: //en. wikipedia. org/wiki/File: Muscle_Force_Velocity_relationship. png

Length Tension Relationship http: //www. pt. ntu. edu. tw/hmchai/bm 03/bmmaterial/Muscle. htm

FACTORS AFFECTING MUSCLE STRENGTH

Body Temperature � Muscle function is most efficient at 38. 5°C (101°F). � elevated muscle temperature shift in force velocity curve � Increased maximum isometric tension � Nerve conduction velocity Increased muscle force � Increased Enzyme activity efficiency of muscle contraction elasticity of collagen extensibility of muscle force http: //www. pt. ntu. edu. tw/hmchai/bm 03/bmmaterial/Muscle. htm

Muscular Hypertrophy and Atrophy Hypertrophy �Increase in sectional area of muscle fibers �number of muscle fibers �change in proportion of muscle fiber types Atrophy � Decreased Cross sectional area of fibers � Decreased Number of muscle fibers � Decreased aerobic capacity http: //www. unm. edu/~lkravitz/Article%20 folder/hypertrophy. html

Adaptations to Resistance Training � Morphological Factors �Muscle hypertrophy due to increase in contractile proteins, number and size of myofibrils, connective tissues, and size of type II muscle fibers � No change in relative amounts of type I and II muscle fibers � Little or no change in the number of muscle fibers (<5%)

Adaptations to Resistance Training � Biochemical Factors �Minor increase in ATP and CP stores �Minor increase in CPK, myosin ATPase, and myokinase activity �Decrease in mitochondrial volume density �Increase in testosterone, growth hormone, IGF, and catecholamines during resistance training exercises � Additional Factors �Little or no change in body mass �Increase in fat free mass �Decrease in fat mass and relative body fat �Improved bone health

Muscular Endurance � Submaximal force �Multiple repetitions �Number reps/min �Decline in force over time

Assessment of Muscular Strength � Isometric � Free weights, weight stacks, Smith machines � Isokinetic testing � Dynamometers � Field Tests �sit ups, pull ups, push ups, etc.

Isometric Strength Testing � Uses a dynamometer or tensiometer � 3 MVC/s � 1 to 3 minutes rest between contractions � Important to standardize body position � Important to limit other limb movements � Norms in book

Table 6. 2

Isometric Strength Testing � Hand grip dynamometry for strength: �Adjust hand grip to accommodate client’s hand. �Set dial to zero. �Stand upright and grasp dynamometer. �Arm position varies between protocol selected. �Client squeezes hand grip quickly and as tightly as possible and then releases the pressure. �Extraneous body motion is kept to a minimum. �Do 3 trials for each hand; 1 minute rest between trials. �Select best trial for each hand.

Free-Motion Machines � � � Eliminate many challenges of free weights and constant resistance machines Allow movement in multiple planes Can allow both constant and variable resistance exercise Have many adjustable compartments Must simulate starting and ending body position of validated muscular tests in order to use those normative values Note settings during baseline assessment testing; use them for follow up assessment settings.

Dynamic Strength Testing � � � One repetition maximum (1 RM): maximum weight that can be lifted for one complete repetition of the movement Involves trial and error in setting weights Has been applied to all age groups, but use standardized technique to keep all clients safe. Spotting for your client is a must. 1 RM bench press and leg press are good for assessing upper body and lower body strength. Compute relative strength (maximal lift/body mass) and use normative values.

1 -RM Testing � Warm up: 5 to 10 reps (40 to 60% est. 1 RM) � Rest 1 min � 3 to 5 reps at (60 to 80% est. 1 RM) � Attempt 1 RM � Rest 3 to 5 min if necessary � Attempt 1 RM � Usually attained within 3 to 5 trials � Can be time consuming

Submaximal 1 RM Testing � Determine number of reps (2 10) to fatigue � 1 RM = weight lifted (lbs) / (1. 0278 – (reps to fatigue x 0. 0278)) or use Table 6. 11 � Example: Client completes 7 reps of bench press with 100 lbs. � 1 RM = 100/(1. 0278 – (7 x 0. 0278)) � 1 RM = 120 lbs � Submax often used with children and elderly

Dynamic Strength Tests � Leg Press �Lower body strength � Bench Press �Upper body strength � Norms in Tables in Book

Whole Body Strength Assessment � Whole Body 1 RM testing (Table 6. 5) � 6 exercises �bench press, arm curl, lat pull down, leg press, leg extension, leg curl � Express 1 RM as % body wt (1 RM/body weight) �Be consistent if using lbs or kgs

Whole Body Strength Assessment � Add points in right column to get strength fitness score (Table 6. 6) � Exercises are described in Appendix C 3

Dynamic Endurance Testing: YMCA bench press test: gender specific resistance at set cadence � Need metronome � Set @ 30 beatmin. = 30 repetitionsmin � � � Male: 80 lb (36. 4 kg) Female: 35 lb (15. 9 kg) Lift as many reps as possible until client can not longer maintain cadence. � Norms Table 6. 7 �

Dynamic Endurance Testing: Other �Seven item multiple repetition battery: maximum of 15 reps at set % of client’s body mass; add the number of reps completed over the seven items; use sum for overall categorization of dynamic muscular endurance score (Table 6. 8) � Arm Curl . 33. 25 � Bench press. 66. 50 � Lat Pull Down. 66. 50 � Tri Extension. 33 � Leg Extension. 50 � Leg Curl. 33 � Bent Knee sit up (no body weight adjustment)

Field Test Assessments � Dynamic strength tests: Add additional weight to client and have them perform the desired movement as a 1 RM. � Can be difficult. � Dynamic endurance tests: maximum number of reps performed for select calisthenic exercises �Pull ups �Push ups �Trunk curls

Dynamic Endurance Testing: Field Tests � ACSM push up and modified push up �Male push ups, � straight backed �Female push ups, � kneeling �Maximum number performed without rest � Sit ups, Curl ups �Number of sit ups in 1 minutes �Can modify to curl ups �www. exrx. net for specifics and norms

RESISTANCE TRAINING PROGRAMMING

Types of Resistance Exercise Training � Static or isometric �gains of 5% per wk, 66% MVC for 6 sec, 6/wk �gains specific to joint angle � To improve static strength �Intensity, 100% MVC �duration, 5 sec/contraction, 5 10 reps �frequency, 5 days/wk � To improve static endurance � 60% MVC or less �hold until fatigued, 1/session � 5 days/wk

DYNAMIC EXERCISE PROGRAM GUIDELINES

First: Establish Training Goal: � Strength � Hypertrophy � Power � Endurance � Motor performance

Training Program Design � Goals of individual Need to be considered �Goals should be testable: �Need to be able to objectively determine if gains are being made � Fitness assessment and workout logs �Muscle strength, endurance, power �Physiological changes: body mass, body comp. , blood pressure, metabolic rate, anthropometric � Health: prevention of osteoporosis, posture, reduction of low back pain

Guidelines for Resistance Training for General Health

General Guidelines � Strength � � high velocity and strength training � low volume, high intensity � Hypertrophy � high volume, moderate intensity � Endurance � high volume, low intensity Power � Motor Performance � specific to sport

Training for Power � Train for both strength and power �Include explosive movements � Total body exercises with rapid force production � 3 6 sets with light to moderate loading (30 60%1 RM) � This type of training only for the advanced!

Plyometrics � Power training involving eccentric and concentric contractions �Makes use of the stretch receptor response �stretch, contract �good for developing power �good for athletes requiring powerful motions �baseball pitcher �basketball

ACSM Guidelines � Maintain normal breathing � adhere to technique � full range of motion � control concentric and eccentric

Guidelines For Program � Order of Exercises �At least 1 exercise per major muscle group �Multi joint exercises first �Alternate muscle groups �Exercise front and back �Do dynamic (Power) exercises prior to slower exercises �Some prefer large to small and other small to large

Number of Sets � Volume (reps x sets) � Single set: may be preferable for initial and general fitness programs �Single sets might be as effective if they work to exhaustion � Multiple sets �More time consuming �Tolerance, progression, � Increased risk for overtraining �Possibly greater potential for improvement �The recent elderly research has used three sets for each exercise

Rest Between Sets � Strength/Power: � 1 2 minutes for small muscle groups, trained � 2 3 minutes for large muscle groups, untrained � Endurance/Hypertrophy: �shorter resting periods �fatigue is required for endurance training

Progression of Program � Muscles must be forced to do progressively harder work �Important Note: This is not a linear process! �Make sure the increases are comfortable but challenging � Progressions of 5% or less are very tolerable

Time Course of Adaptations � First few weeks: neural pathways improve �Increased neural drive to muscle �Increased number of motor units firing (referred to as intramuscular coordination) �Increased synchronization of motor units �Increased activation of synergistic muscles (intermuscular coordination) �Increased activation of contractile apparatus

Time Course of Adaptations � Velocity specific �Increases occur at or near training speed �Sport application vs. general fitness � Long term changes: attributable to hypertrophy

The Elderly � Recent studies support using Resistance exercise to prevent the 15% per decade decline in strength � Maintaining leg power = predictor of functional capacity � even 80 and 90 yr olds response to both endurance and strength training � guidelines (not maximal, machines) � 60 75% 1 RM, for 10 15 reps, at least 1 set, twice a week � 8 10 multi joint exercises

ADL Assessments for Elderly � 1 RM or 1 RM estimates can be safely conducted �Subject lifts 45% of their weight in kg use equation for estimation.

ADL Assessments for Elderly � Arm curl test �Sit on chair with dumbbell �Women: 5 lbs (2. 3 kg) �Men: 8 lbs (3. 6 kg) �Hold weight in a handshake grip with arm fully extended to side of chair

ADL Assessments for Elderly �Curl weight by flexing elbow while turning palm of hand toward shoulder �Lower until elbow is straight �Repeat curling until 30 seconds expires � Functional Test of Elbow Flexors

ADL Assessments for Elderly � 30 sec Chair Stand Test �Sit on chair with feet shoulder width close to chair �Maintain arms across chest �Stand up without pushing off with arms �Repeat until 30 seconds expires

ADL Assessments for Elderly � Correlates well with stair climbing ability, walking speed, and risk of falling. � Reliable and valid indicator of lower body strength � Safe and sensitive method in detecting (1) age related declines in strength and (2) the effects of physical training in older adults.

Training for Children � Children may be more prone to overuse injury or damage to epiphyseal plates � Guidelines (submaximal, no power training) � 70 80% 1 RM or 8 12 reps � 1 or 2 sets of 8 10 multi joint exercises �not more than twice a week �supervised for breathing and form

The Core

Assessment of the Core � Bunkie Test �http: //www. nsca lift. org/Perform/articles/080306. pdf

The Core- Basic Exercises � A good website for Core Exercises and modifications. http: //www. mayoclinic. com/health/core strength/SM 00047