Section7:
MuscularStrength,
EnduranceandFlexibility
ACSMGuidelines:Chapter4(pp.94107)
ACSMManual:Chapter5,6
HPHE4450
Dr. Cheatham
Outline
Importanceofmuscularstrengthandendurance
Typesofmuscularcontractions
GeneralTestingGuidelines
Musclestrength
HandGripDynamometry,1RM
MuscularEndurance
PushUpTest,CurlUpTest,YMCABenchPressTest
Importanceofflexibility
SitandReachTests
LumbarFlexionandExtension
SpecificROMTests
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ImportanceofMuscularSandE
Healthrelatedfitness
componentthatmay
maintainorimprovethe
following:
Bonemass(relatedto
osteoporosis)
Glucosetolerance(relatedto
Type2diabetes)
Musculotendinous integrity
(relatedtolowerriskofinjury,
lowbackpain)
CarryoutADLs
FatfreemassandRMR
(relatedtoweight
management)
Performanceapplications
TypesofContractions
Static(Isometric)
Musclegeneratesforcewithoutmovement(i.e.
muscledoesnotchangelength)
Dynamic
Musclegeneratesforcewhilelengtheningor
shortening
Concentric:Muscleshortens
Eccentric:Musclelengthens
Isotonic:Fixedresistance
Isokinetic:Fixedmovementspeed
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GeneralTestingGuidelines
Useafamiliarization/practicesession
Adheretospecificprotocol
Predeterminedrepetitiondurationandrangeof
motion
Thestandardizedprotocolshouldinclude:
Strictposture
Consistentmovementspeed
FullROM
Useofspotters(ifnecessary)
Equipmentfamiliarization
Properwarmup
MuscularStrength
Definition:Maximalforcethatcanbegenerated
byaspecificmuscleormusclegroup
Specificto:
Musclegroup
Typeofcontraction
Speedofcontraction
Jointangletested
Resultsfromatestarespecifictotheprocedures
used
Nosingletestexistsforevaluatingtotalbody
muscularenduranceormuscularstrength
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MuscularStrength
Purposeofmeasurement:
Assessmuscularfitness
Identifyweaknesses
Monitorprogressinrehabilitation
Measuretheeffectivenessoftraining
AssessingMuscularStrength
Commonassessments
Handgriptest
1repetitionmaximum(RM)benchpress
Isokinetic testing
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AssessingMS HandGrip
AssessingMS HandGrip
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AssessingMS HandGrip
Numbersareinpounds(lbs).
AssessingMS 1RM
OneRepetitionMaximum(1RM)
Maximalforcethatcanbegeneratedbyaspecific
muscleormusclegroup
Theheaviestweightthatcanbeliftedonlyonce
usinggoodform
DynamicStrength
GoldStandard
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AssessingMS 1RM
AssessingMS 1RM
6or10RMTest
Canbeusefulespeciallyfordeterminingweightsfor
exerciseprescription
Adapt1RMprocedurestodetermine6or10RM
value.
Optional:
Convert10RMvaluetoa1RMestimationbydividing
10RMweightby0.75
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AssessingMS 1RM
InterpretationofData:
ACSMprovidesnormchartsforUpperBody
Strength(BenchPress)andLowerBodyStrength
(LegPress)
ValuesareoftenexpressedasStrengthtoweight
ratio
StrengthtoWeightRatio=WeightLifted/BodyWeight
Bothweightsmustbeinthesameunits
AssessingMS 1RM
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AssessingMS 1RM
AssessingMS 1RM
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AssessingMS 1RM
MuscularEndurance
Definition:Theabilityofamusclegroupto
executerepeatedcontractionsoveratime
periodsufficienttocausemuscularfatigueorto
maintainaspecificpercentageofmaximum
voluntarycontractionforaprolongedtime
Sameideawithrespecttospecificityandmuscle
strength
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AssessingMuscularEndurance
Commonassessments
Pushuptest
Partialcurluptest
YMCAbenchpresstest
AssessingME PushUpTest
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AssessingME PushUpTest
AssessingME PushUpTest
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AssessingME CurlUpTest
AssessingME CurlUpTest
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AssessingME CurlUpTest
AssessingME YMCABenchPressTest
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AssessingME YMCABenchPressTest
Flexibility
Definition:Functionalcapacityofthejointsto
movethroughthefullrangeofmotion(ROM)
Jointspecific
Dependson:
Jointcapsuledistensibility
Adequatewarmup
Muscleviscosity
Complianceoftheligamentsandtendons
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Flexibility
Whyisflexibilityimportant?
PerformanceofADLs
Relationshiptolowerbackpain
Athleticperformance
AssessingFlexibility
Commonassessments:
SitandReachBoxTest(trunkflexion)
YMCASitandReachTest
LumbarFlexionandExtension
SpecificRangeofMotionTests
GeneralTestingGuidelines
Stretching,lightaerobicexercise(510min)
Practicesessiontoassesspain,discomfort
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AssessingFlexibility SitandReachTests
AssessingFlexibility SitandReachTests
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AssessingFlexibility SitandReachTests
AssessingFlexibility SitandReachTests
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AssessingFlexibility SitandReachTests
MakingaSitandReachBox
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AssessingFlexibility LumbarFlexion
Seatedwithpelvisstabilized
Tapeispositionedwithzero
atthespinous processC7
Measuredownthesuperior
iliac
Lumbarflexionperformed
untilfirstsignofresistance
Averagehealthyrange:4
inchincrease
AssessingFlexibility LumbarFlexion
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AssessingFlexibility LumbarExtension
Samebodyandtapepositionasforflexion
assessment
Lumbarextensionisperformeduntilfirst
signofresistance
Averagehealthyrange:2inchincrease
AssessingFlexibility LumbarExtension
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AssessingFlexibility ROMTests
UseofGoniometers:
Fulcrumcenteredto
identifiedanatomic
landmark
Stabilizationarm
remainsfixed
(establishesthestart
position)
Movementarmmoves
inrelationtoclients
movement(establishes
theendingposition)
AssessingFlexibility ROMTests
GeneralProcedures:
Beforebeginning:
Providetheclientwithademonstrationofan
ROMtest
Positionthegoniometer
Locatethefulcrumatthejointaxisorhingepoint
Wheretheaxisofrotationoccursforthetwobody
segments
Placethestabilizationandmovementarms
Centeredalongeachbodysegment
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AssessingFlexibility ROMTests
Goniometryisanaccuratemeasureif:
Allanatomiclandmarksareidentified
Jointaxispointhasbeenclearlydefined
Bodyisstabilizedinproperalignment
Clientisinstructedtomoveslowlythroughthe
properROMandthegoniometer isproperlyaligned
TestadministratorisfamiliarwithnormalROMfor
eachjoint
ObservationofwhetherROMassessmentispain
freeoccurs
AssessingFlexibility ROMTests
Foreachassessment,locationsofthegoniometer
forthefollowingthreepointsarespecified:
1. Fulcrum
2. Stabilizationarm
3. Movementarm
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Stabilization
Clientisingoodposturewithastabilizedscapula
(retracted),thoracic,andlumbar
Stabilizescapulatopreventtilting,rotation,or
elevation
AverageROM:0180
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Stabilization
Clientisingoodposturewithastabilizedscapula
(retracted),thoracic,andlumbar
Stabilizescapulatopreventtilting,rotation,orelevation
Placetowelunderhumerus tostabilizeandalignwith
acromion process
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Stabilization
Clientisingoodposturewithastabilizedscapula(retracted),
thoracic,andlumbar
Stabilizescapulatopreventtilting,rotation,orelevation
Placetowelunderhumerus tostabilizeandalignwith
acromion process
AverageROM:070
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Stabilization
Clientisingoodposturewithastabilizedscapula,
thoracic,lumbarspine,andpelvicarea
Pelvisshouldnotriseofftable
Oppositelegnotbeingassessedshouldhaveknee
flexedandfootflatontableforaddedstabilityand
protectionfortheback
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Clientissupineontable
withhipin0degreesof
flexion,extension,
abduction,adduction,
androtation
Testingleghasknee
fullyextended
Clientperformship
flexionuntilthefirst
signofresistanceor
untilthepelvisrotates
orkneebreaks
extension
AverageROM:090
Starting/endingbodyposition
Clientissupineontable
withkneeflexedat90
degreesandhipflexedat90
degrees;hipisin0degrees
ofabduction,adduction,
androtation
Kneeisflexedtoreduce
contractionofhamstrings
Clientperformshipflexion
untilthefirstsignof
resistanceoruntilthepelvis
rotates
AverageROM:0120
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Starting/endingbody
position
Clientisproneontable
withhipin0degreesof
flexion,extension,
abduction,adduction,
androtation
Testingleghasknee
fullyextended
Clientperformship
extensionuntilthefirst
signofresistanceor
untilthepelvisrotates
AverageROM:030
Goniometer position
1. Fulcrum:LocateattheASIS(anteriorsuperioriliac
spine)
2. Stabilizationarm:Imaginaryhorizontalline
connectingaxispointASIStotheotherASIS
3. Movementarm:Anteriormidlineofthefemur,
usingthemidlineofthepatellaasareference
Stabilization
Clientisingoodposturewithastabilizedscapula,
thoracic,lumbarspine,andpelvicarea
Stabilizeforlateraltrunkflexiononbothsides
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Goniometer position
1. Fulcrum:LocateattheASIS(anteriorsuperioriliac
spine)
2. Stabilizationarm:Imaginaryhorizontalline
connectingaxispointASIStotheotherASIS
3. Movementarm:Anteriormidlineofthefemur,
usingthemidlineofthepatellaasareference
Stabilization
Clientisingoodposturewithastabilizedscapula,
thoracic,lumbarspine,andpelvicarea
Oppositelegnotbeingtestedshouldbeabducted
fullytoallowfortestinghiptobeassessed
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Starting/endingbodyposition
Clientissupineontablewithhipin0
degreesofflexion,extension,androtation
Testingleghaskneefullyextended
Clientperformshipadductionuntilthe
firstsignofresistanceorlateraltrunk
flexionorpelvicrotationoccurs
AverageROM:030
AssessingFlexibility ROMTests
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AssessingFlexibility ROMTests
Itisimportanttorecognizethatalearningeffectis
likelywithflexibilitymeasurements.
Thus,thefollowingstatementfromACSM's
ResourceManualforGuidelinesforExercise
TestingandPrescriptionisofimportance:
ArecommendationfromtheAmericanMedical
AssociationsuggeststhatROMshouldbemeasured
usingthreeconsecutivetrialsandaveragedasthetrue
value.IftheaverageROMis50degrees,threeofthe
measurementsmustfallwithin5degreesofthemean.
Iftheaverageisgreaterthan50degrees,three
measurementsmustfallwithin10degreesofaverage.
Suchmeasuresmaybetakenuptosixtimesuntilthey
meetthecriteria;otherwise,theyareconsidered
invalid.
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