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 patient's movement abilities will be assessed and his or her medical history will be taken by the physical therapist. Based on this information, a personalized training plan of specific exercises will be devised to present the patient with increasing physical challenges that will promote healing. The first step is to overcome pain, and then continuing on to regain bodily 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.

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.

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 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.

With isokinetic exercises, the resistance and muscle force are equal, and they are performed with a fixed speed. Specially designed fitness machines provide a level of force commensurate with the user's muscle resistance, and the balance of concentric/eccentric action and velocity can normally be adjusted as well.




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