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Linking kinesiology to exercise prescription, Potentially an insight into…
Linking kinesiology to exercise prescription
Components of Fitness
Health Related
Cardiovascular endurance
Run, cycle, row, walk etc. for distance or time (e.g. Coopers 12 min field run)
VO2 Max (lab based test)
Muscular endurance
Repetitions to failure at a specific intensity
Time to failure at a specific movement/intensity
Muscular strength
One repetition maximum Handheld dynamometry - (10 Rep max?)
Flexibility
‘Bod pod’
Body composition scales
Body calipers
Role as a component questioned by research
Body composition
Sit and reach
Muscle length tests
General ROM tests
Can Overlap
Skill-Related
Speed
Timed sprint
Time to perform a certain task
GPS units to measure speed (more in PTY 1014) - Gym aware to measure velocity (more in PTY 1014)
Power
Velocity of a movement x load (gym aware)
Jump for distance (e.g., Broad jump)
Impact forces e.g., boxing punch
Agility
T- agility tests
Figure of 8 test
Shuttle runs etc.
Balance
Tandem, single leg (static)
Y-balance test (dynamic)
Covered in 1015
Coordination
Throw and catch test
Finger nose test
Reaction Time
Ruler drop test
Sprinters reaction time from blocks
Physical activity and Exercise
Bodily movement via skeletal muscles
Results in energy expenditure
Energy expenditure (kilocalories) varies continuously from low to high
Positively correlated with physical fitness
Exercise difference with physical activity
Planned
structured and repetitive movement
An objective is to
improve or maintain (physical) fitness components
Principles of exercise training
Progressive overload
The body will
adapt
to loads applied to it
Continual and gradual increase
in training workloads or stimulus are required as the individual adapts
Increases in workloads can be achieved by increasing the
length of training, adding weight or new stimulus
Kinesiology knowledge of
MRC/Oxford score
can act as a theoretical framework for this (but note its limitations)
We need to combine this principle in line with
acute programme variables
Specificity
SAID principle
(Specific Adaptations to Imposed Demands)
Adaptations will occur that are
specific to the training
e.g. In general a runner will train by running, not rowing a boat
When developing a rehabilitation/training program, it should consider:
Energy source specific
Muscle action specific
Muscle group specific
Velocity specific
Variety
Use multiple training types and methods - Complete and full development of fitness
The need to have variety in the program to avoid boredom and over training eg. rugby player uses aerobic, strength, flexibility, resistance and anaerobic training
Clinically there is a fine line between specificity of exercises vs variety due to compliance issues
Kinesiology knowledge of movement analysis may help you identify and select different exercises to provide variation
Reversibility and recovery
Adaptations lost at a similar rate to which they are gained
4-6 weeks after training stops
This can be avoided by maintaining
2 x training sessions per week
Equally need to ensure that you
do not overload an individual
Linked to progressive overload and is a
fine line
too much vs too little
Individualisation
Need to
balance
the prior factors while considering the individuals’ current condition, trainability, sports specific and personal goals
Taking into account the need for
recovery
Additionally, the
resources and time
available to the patient
Acute Programme Variables – FITT
Frequency – 2 times per day?
Intensity – 8/10 RPE
Time – 10 reps x 3
Type – double leg squat
Additional variables
Sets
Reps
Load/intensity
Speed of movement (Velocity/ Tempo)
Arc of motion/type of contraction
Type and position of resistance (if applicable)
General exercise descriptors
Rest period between sets
Rest days Frequency per day/week
Exercise order
Volume = Set x Reps
Performs 3x10 sets of a squat
3x10 = 30 repetitions total
Absolute resistance
squats at 60kgs
Volume load =
Sets X Reps X Load/Weight
Performs 3x10 sets of 60kg of a squat
(3x10) x 60(kgs) = 1,800 kgs moved during session
Relative strength =
Load moved ÷ Body weight
80kg patient
Load moved/body weight = 60/80 = 0.75
Time Under Tension (TUT or tempo) =
Volume x total time exercising (secs) =
eccentric: isometric: concentric
Tempo of 3:2:1
6 secs per rep x 30 (total reps)= 180secs total time under tension
Arc of Motion
Full range squats (vs half squats)
Type of resistance
Pulley (vs free weights)
Physio Roles
Conduct an assessment of the needs of their clients
Formulate a diagnosis and plan appropriate goals and treatment Implement physical therapy intervention
Evaluate the intervention with appropriate outcome measures
Kinesio Knowledge
Assessment
Goals
Intervention (Treatment/Mamangement)
Evaluation
Assessments
The ability to
gain/identify
clinical markers/outcome measures is essential to all physiotherapy assessments
Be aware that we also
measure other factors
related to mental well-being, pain, participation restrictions etc – at present we are biasing kinesiology/physical movement based scenario’s only
Including (but not limited to) the following based upon A&P and Kinesiology knowledge
Obs/postural assessment
Ascertain imbalances or abnormalities
Palpation
Ascertain pain sensitivity, identify swelling etc
ROM
Ascertain impairments in movement
Strength
Ascertain impairments of muscle
Functional movements/assessments
Identify activity limitations e.g. gait, squats
Goals
Once you have your baseline assessment data you can start to
plan your goals
(in conjunction with your patient)
As Physiotherapists we can easily become very focused on ‘impairments’ - ROM, strength etc.
However what usually matters to patients most is
participation restrictions and activity limitations
It's important to have a
good mix
of each category of the ICF for your goals…
SMART Principle
Specific (simple, sensible and significant)
Measurable (meaningful and motivating)
Achievable (agreed and attainable)
Relevant (reasonable, realistic, resourced, results- based)
Time-bound
Example on slide 20
Intervention
Conceptualize treatment planning using a toolbox approach. E.g.
Hot/cold packs
Education
Mob aids
Hydroptherapy
Manual therapies
EPA
EXERCISES
Potentially an insight into the component of strength that the individuals are targeting
