Select exercises
Previous TopicPrinciples of muscle strengthening
Muscle strength can be improved by doing muscle strengthening exercises.
When providing exercises to a person, it is important to provide the person:
- A description of the exercise
- Number of repetitions they should perform
- Number of sets they should perform
- Exercise frequency (how often they should perform the exercise)
When doing muscle strengthening exercises, resistance will usually be provided by gravity or an object.
An object can be anything that can be easily held or moved and applies resistance against a movement, Examples include; a dumbbell, an elastic band, a brick or a bottle filled with water.
Question
Which of the following objects could be used to provide resistance for muscle strengthening exercises ?
- a. Drink bottle filled with water
- b. Bag of rice
- c. Bed sheet
- d. Gym equipment
- e. All of the above
If you selected e, you are correct.
All of these options are examples of objects that could be used at home as resistance for muscle strengthening exercises.
Question
Remember Farah?
Farah is a university student who fractured her wrist after falling down some stairs walking between class at university.
Farah visits you for an appointment. She has recently returned home and shows you an exercise plan that the university doctor gave her.
The following is written on the exercise plan:
Shoulder abduction 3 x 10
Shoulder external rotation 3 x 10
Bicep curl 3 x 10
Wrist extension with weight 3 x 10
Finger and thumb movements in rice 3 x 30 seconds
Wrist flexion with weight 3 x 10
Grip strength with towel 3 x 30 second holds
How many exercises are in this exercise plan ?
- a. 5
- b. 7
- c. 6
If you selected b, you are correct.
For the exercise; bicep curl, how many repetitions per set has Farah been instructed to do?
- a. 10
- b. 3
- c. 15
If you selected a, you are correct.
Things to consider when planning a muscle strengthening exercise program
It is important to select exercises that are appropriate for the person.
Appropriate exercises should:
- Be of moderate intensity (using BORG RPE scale)
- Be able to be performed without significant discomfort or pain
- Relate to the everyday activities that the person is having difficulty with
- Improve muscle strength
- Be able to be performed safely with the appropriate level of support
Recommended number of repetitions and sets
Generally:
- To improve muscle strength, person should be able to complete 10 repetitions at a moderate intensity level
- A person should aim to complete 3 sets of 10 repetitions in order to increase muscle strength
Planning appropriate exercise duration
The information gathered throughout the assessment and during the first session should be used to guide the appropriate duration of exercise.
Generally:
- If the person is less active, initial exercise duration should be reduced
- Aim for 5-10 mins of exercise total for each muscle group. Duration may be shorter or longer depending on fitness, level of fatigue, pain levels
- It is important to allow for recovery between sessions
Question
Remember Gabriella?
Gabriella runs a small flower stall at her local market. Gabriella used to enjoy walking with her friends but due to her shortness of breath, she has stopped exercising completely over the past few months.
If you knew this information about Gabriella, should you make exercise duration shorter or longer ?
- a. Shorter duration
- b. Longer duration
If you selected a, you are correct.
As Gabriella has not exercised at all recently, it would be appropriate to have a shorter exercise duration while Gabriella regains her fitness. It would also be important to monitor Gabriella’s shortness of breath and exertion level during the initial session(s).
Planning appropriate exercise frequency
The frequency of muscle strengthening exercise will depend on the type of movement being performed.
In general, if performing:
- Passive movements: Exercises can be performed twice a day
- Active-assisted movements: Exercises can be performed twice a day
- Active movements with no resistance added: Exercises can be performed once a day
- Active movements with resistance added: Exercises can be performed once every two days.
Please note that these are general guidelines only and that it is important to ask the person about their levels of muscle soreness before completing muscle strengthening exercises.
Question
Remember Sachin?
Sachin works at his son’s fruit and vegetable store.
You have provided him with muscle strengthening exercises to help manage his COPD so he is able to work more at the fruit and vegetable store.
You have provided him with some exercises against gravity and resistance and some against gravity only.
What would be an appropriate exercise frequency for Sachin?
- a. Once every two days for the ‘against gravity only’ exercises and daily for the ‘against gravity and resistance’ exercises
- b. Once every two days for the ‘against gravity and resistance’ exercises and daily for the ‘against gravity only’ exercises
- c. Daily for all exercises
- d. Once every two days for all exercises
If you selected b, you are correct.
Exercises ‘against gravity only’ can be performed daily. Exercises ‘against gravity and resistance’ require more recovery time for muscles and should be performed once every two days. As always, It is important to monitor Sachin’s exertion and symptoms when performing exercises and remind Sachin to do the same when performing exercises at home.
Question
Remember Lionel?
Lionel works for his local council, he has been experiencing low back pain for many years.
Lionel used to enjoy riding his bike and doing woodwork at home, however, his low back pain prevents him from doing these activities as much as he would like.
You have prescribed a
muscle strengthening exercise program for Lionel to work towards being able to
ride his bike and do woodwork more, without aggravating his low back pain.
Lionel has been seeing you for an appointment once every two weeks. Lionel comes in for his fourth visit and reports that he has been getting more muscle soreness and is not getting the improvements in strength that he was previously getting.
Which of the following might be the reason Lionel is experiencing soreness and is not getting improvements in muscle strength ?
- a. He is not doing his exercises enough
- b. He is not trying hard enough when exercising
- c. He is not getting enough recovery time in between exercise sessions
If you selected c, you are correct.
In this situation, if Lionel was experiencing increasing soreness, it would be likely that he is not getting enough recovery time in between exercise sessions. It would be appropriate to ask Lionel about his exercise frequency and adjust as needed in this situation.
Selecting exercises based on grade of strength assessed
Selecting the appropriate muscle strengthening exercises and exercise dosage will depend on the grade of strength assessed.
However, whenever planning a muscle strengthening exercise program, it is important to remember that grade of muscle strength assessed is only one part of the assessment and that you should consider other assessment findings also.
Use the muscle strengthening exercise plan to help you decide the appropriate muscle strengthening exercises and exercise dosage to plan for the person.
Planning strengthening exercises for muscles with 0/5 strength
Type of exercise: Passive
Recommended exercise duration: 5-10 minutes for each muscle group
Recommended exercise frequency: Twice daily
Progression: Progress to active-assisted exercises when strength re-assessed as 1/5
Remember Nguyen?
In the first 1-2 days after experiencing a stroke, Nguyen was unable to move her left arm but had full passive range of motion.
At this stage of Nguyen’s rehabilitation, to stimulate neural pathways in Nguyen’s left arm, it would be appropriate to plan passive range of motion exercises that will help to stimulate neural pathways, regain motor control and maintain Nguyen’s range of motion.
Planning strengthening exercises for muscles with 1-2/5 strength
Type of exercises: Active-assisted or active with gravity eliminated
Recommended exercise duration: 5-10 minutes for each muscle group
Recommended exercise frequency: Twice daily
Progression: If starting with active assisted exercises, progress to active exercises with gravity eliminated, then progress to active against gravity as strength improves to 3/5 on re-assessment
Remember Farah?
After falling and fracturing her wrist, Farah was experiencing weakness in her wrist and hand. She was able to contract her wrist extensors and wrist flexors and is able to generate small amounts of movement, however cannot move her wrist through its full range of motion without assistance.
To help Farah regain the strength in her wrist, you should plan some active-assisted exercises with her.
Planning strengthening exercises for muscles with 3/5 strength
Type of exercise: Active against gravity
Recommended exercise duration: 5-10 minutes for each muscle group
Recommended exercise frequency: Once every day
Progression: Add resistance as strength improves on re-assessment
Planning strengthening exercises for muscles with 4/5 strength
Type of exercise: Active against gravity and some resistance
Recommended exercise duration: 5-10 minutes for each muscle group
Recommended exercise frequency: Once every 2 days
Progression: Increase resistance gradually as strength improves on re-assessment
Question
Remember Lionel?
Lionel has suffered from low back pain for the past 18 months. He is able to perform most movements for a short amount of time, but quickly fatigues and develops poor technique when having to do any movements that involve bending or lifting, aggravating his low back pain.
After assessing Lionel’s gluteal and trunk strength, you find that he has 4/5 trunk strength, 4/5 hip abduction and hip extension strength on the right side and 3/5 hip abduction and hip extension strength on the left side.
In this situation, what type of exercises would you want to prescribe for Lionel ?
- a. Against gravity for left hip abduction and extension strength and against gravity and resistance for trunk, right hip abduction and hip extension strength
- b. Against gravity for right hip abduction and extension strength and against gravity and resistance for trunk, left hip abduction and extension strength
- c. Against gravity for trunk strength and left hip abduction and extension strength and against gravity and resistance for right hip abduction and extension strength
- d. Against gravity and resistance for trunk, right and left hip abduction and hip extension strength
If you selected a, you are correct.
Planning strengthening exercises for muscles with 5/5 strength
Type of exercises: Active against gravity and resistance
Recommended exercise duration: Total of 45 minutes (or 5-10 minutes for each muscle group)
Recommended exercise frequency: Once every 2 days
Progression: Progress to exercises targeting function
Question
Remember Farah?
Farah has been doing muscle strengthening exercises for a number of weeks to help her fractured wrist recover.
Farah’s wrist is now feeling good and she is able to do all of the activities that she wants to do, including writing for university studies. She likes the strength she has gained by doing muscle strengthening exercises and wants to continue doing muscle strengthening exercises in the future.
On assessment, Farah is measured as having 5/5 strength for all movements assessed.
Question text What type of exercises are appropriate for Farah?
- a. Against gravity
- b. Against gravity and resistance
- c. Gravity eliminated
- d. Passive
If you selected b, you are correct.
As Farah has 5/5 muscle strength for all movements assessed, an exercise program consisting of muscle strengthening exercises against gravity and resistance would be suitable.
The exercise plan summarizes all of the information in this topic, helping you to select exercise type, duration, frequency and progress exercises based on grade of muscle strength assessed.
