Types Of Therapeutic Exercise And How They Are Used To Promote Healing

By Coleen Torres


When a person sustains an injury from playing sports, an accident or any other reason, he or she may need to undergo physical therapy to restore normal movement to the body. Part of this approach involves the use of therapeutic exercise to help the patient regain balance, strength, flexibility, and range of motion and alleviate pain.

The injured person will visit a physical therapist who will take a medical background from him or her and evaluate the ability to move in various ways. Based on this, the therapist will put together a customized therapy schedule of increasingly challenging exercises to help eliminate pain, and restore normal endurance, flexibility, and strength.

Physical therapy exercises are classified according to the nature of the movement involved and the impact it has on the muscles and joints. Passive exercises help restore normal movement in joints and require little to no work from the muscles as the force is applied to them, either manually or from a continuous passive motion unit or similar mechanical device. In contrast, active exercise calls for muscular involvement, with or without assistance, in a manner which improves joint movement and neuromuscular control.

There are other type of activities designed to build endurance and strength in damaged muscles. Once the patient has progressed to the point where he or she can safely carry out range-of-motion and flexibility exercises, it's time to begin strength and endurance training. Gradually increasing resistance is added steadily so the body can respond by naturally gaining strength in the tendon, ligaments, muscles, and bones.

Exercises for regaining strength are generally grouped as either static or dynamic. The former are those which do not involve joint movement, with the length of the muscle fibers remaining the same since the resistance and tension are equal, rather it is the angle they are performed at which makes the difference and helps the patient increase strength, so using varied angles in practice and holding each movement for several seconds is recommended.

Dynamic exercises differs in that it does involve movement of the joints and muscles, in particular concentric and eccentric movement, which refers to a repeated shortening and lengthening of the muscle fibers that produces force and develops strength. This type of exercise can be grouped into isotonic, isokinetic, variable-resistance, and manual movements.

An isotonic movement is one that applies an external force to the muscle which alters the angle of the joint, lengthening the muscular fibers. Some common examples of this are many weight machines, free weights, and ankle weights. Training equipment for variable-resistance movements are built to impose correct joint alignment and apply resistance relative to force, or the therapist may do this manually as well, deliberately placing the muscles in range-of-motion extremes that will limit the force produced.

An isokinetic exercise is performed at a fixed speed and the resistance is equal to the force exerted by the muscle. There are machines built to provide movement of this kind, which match the force to the user's degree of muscle resistance, and can be adjusted in terms of velocity, concentric and eccentric action.




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