Muscle Strength Training

Clinical Application of Muscle Strength Training

Muscle strength training is divided into Level 0, level 1, level 2, level 3, level 4 and above.

Level 0

Level 0 muscle strength training includes passive training and electrotherapy

1. Passive training

Therapists touch the training muscle with hands to make patients focus on the training part.

Patients’ random movement can be induced through passive movement, so that they can feel muscle movement exactly.

Before training the dysfunction side, complete the same action on the healthy side, so that the patient can experience the way and action essentials of muscle contraction.

Passive movement can help maintain the physiological length of muscle, improve local blood circulation, stimulate proprioception to induce motor sensation, and conduct to CNS.

2. Electrotherapy

Neuromuscular electrical stimulation, NMES, also known as electro gymnastic therapy;

EMG Biofeedback: convert the myoelectric changes of muscle contraction and relaxation into auditory and visual signals, so that patients can “hear’ and “see” the slight contraction of muscles.

Level 1

Level 1 muscle strength training includes electrotherapy, active-assist movement, active movement (muscle isometric contraction).

Level 2

Level 2 muscle strength training includes active-assist movement (hand assisted active movement and suspension assisted active movement) and active movement (weight support training and aquatic therapy).

Level 3

Level 3 muscle strength training includes active movement and resistance movement against limb gravity.

Movements that resist limb gravity are as follows:

  Gluteus maximus: patients lying in prone position, therapists fix their pelvis to make them stretch their hips as much as possible.

  Gluteus medius: patients lying by one side with the dysfunction lower limb above the healthy side, therapist fixed their pelvis and make them abduct their hip joints as much as possible.

  Anterior deltoid muscle: patients in sitting position with their upper limbs naturally drooping and their palms face ground, complete shoulder flexion.

Level 4 and Above

Muscle strength training for level 4 and above includes the training of freehand resistance active training, equipment assisted resistance active training, and isokinetic training. Among them, the freehand resistance active training is generally applicable to patients with muscle strength level 4. Because patients’ muscle strength is weak, therapists can adjust the resistance at any time accordingly.

What Can Muscle Strength Training Do?

1) Prevent muscle disuse atrophy, especially after long-term immobilization of limbs.

2) Prevent the reflex inhibition of atrophy of spinal cord anterior horn cells caused by pain during limb trauma and inflammation. Promote the recovery of muscle strength after nervous system damage.

3) Help maintain the function of muscle relaxation and contraction in myopathy.

4) Strengthen the trunk muscles, adjust the balance of abdominal muscles and back muscles to improve the arrangement and stress of the spine, increase the stability of the spine, as a result, prevent cervical spondylosis and various lower back pain.

5) Enhance the muscle strength, improve the balance of antagonistic muscles, and strengthen the dynamic stability of the joint to prevent the degenerative changes of the load-bearing joint.

6) Strengthen the training of abdominal and pelvic floor muscles is of great significance in preventing and treating visceral sagging and improving respiratory and digestive functions.

Precautions for Muscle Strength Training

Choose the appropriate training method

  The effect of enhancing muscle strength is related to the training method. Evaluate joint range of motion and muscle strength before training, choose the appropriate training method according to the muscle strength level for the purpose of safety.

Control the amount of training

  It is better not to feel fatigue and pain the next day after training.

  According to the patient’s general condition (physical fitness and strength) and local condition (joint ROM and muscle strength) to choose the training method. Take training 1-2 times a day, 20-30 minutes each time, training in groups is a good option, and patients can rest 1 to 2 minutes during training. In addition, it is a wise idea to combine muscle strength training with other comprehensive treatment.

Resistance application and adjustment

The following principals should be noted when applying and adjusting resistance:

Resistance is usually added to the attachment site of the distal muscle that needs to be strengthened.

  When increasing the strength of the anterior deltoid muscle fiber, resistance should be added to the distal humerus.
   When the muscle strength is weak, resistance can also be added to the proximal end of the muscle attachment site.
   The direction of resistance is opposite to the direction of joint movement caused by muscle contraction.
   The resistance applied each time should be stable and should not change drastically.