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

By Coleen Torres


Injuries to the muscles and other soft tissues of the body often require a course of physical therapy in order for the patient to regain normal body movement. Therapeutic exercise is an important component in most physical therapy regimens and it can effectively aid in not only easing pain, but also restoring range of motion, balance, strength, and flexibility.

The physical therapist will evaluate the patient's condition by conducting an assessment of his or her ability to move, and taking a medical history. This information will be used to formulate a specific course of exercises which become progressively more challenging as the patient improves. Once the pain is overcome, the focus will be on restoring the body's strength, endurance, and flexibility.

Exercises in a physical therapy program are classified by the type of movement and its effect on the body. Passive exercise applies an external force to the affected muscles, often by way of a mechanical device such as a continuous passive motion unit or manually by the therapist, these help to restore normal motions to the joints. Active exercises are those which require the patient to the work the muscles at least somewhat, possibly with assistance at first, and help improve neuromuscular control and joint movement.

After the patient has demonstrated that he or she is capable of safely completing flexibility and range of motion activities, it is time to move on to strength and endurance training. Resistance is gradually increased, which has the effect of strengthening muscle and connective tissues which have damaged, naturally improving strength.

Strength exercises are classified as static or dynamic. A static activity does not require movement of the joint, the tension and resistance are equal, and the muscle fibers remain the same length throughout the movement. The angle is the key aspect which makes the difference in this case, so patients are advised to vary the angle of each set, making sure they hold it for several seconds each time, as this is what builds strength.

Dynamic exercises require muscle and joint involvement and can be sub-grouped as isotonic, isokinetic, variable-resistance, and manual movements. What each of these has is common is that it results in concentric and eccentric muscle action, which is the lengthening and shortening of fibers, generating force. This repetitive stretching of muscle-tendon bundles eventually boosts tensile strength.

Isotonic movements are those which lengthen the muscle by means of an externally applied force that imposes a change on the angle of the joint. Examples include the use of free weights, ankle weights, and weight machines. Variable-resistance exercises involve limited force production by the muscles when the joints are in extreme positions of range-of-motion. There are machines to apply resistance relative to force with proper joint alignment. Manual resistance is similar except that it is performed with the therapist's assistance rather than a machine.

Isokinetic exercises are carried out with a fixed speed and equal muscle force and resistance. Machines to generate this type of movement deliver force to match the user's level of muscle resistance and often have adjustable settings in terms of concentric and eccentric actions with varying velocities.




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