0 ‫ِ ٰٱَله َّّلـ ّـٱَّلْحَرـ َٰم ِن ّـٱَّلِحَرـي ِم‬ ‫بــ ِم‬

‫ِ ْس‬
in the name of god,the Most Gracious,
the Most Merciful.

LECTURE NO 1
SUBJECT

kinesiology ii

Dr Syeda Abida Hussain Sherazi(PT)

MSAPT(DUHS)DPT(BMU)
MPPTA
Snr.Lecturer physical therapy UAJ&K
 Human movements

Classification of human movements

classified into two main kinds:
 Intentional movements(voluntary
movements)
&
 Non-intentional movements (involuntary
movements)
 Cont;
Non-intentional movements have many kinds of
movement:
 Normal non-intentional movements:
(associate movements, mirror movements or juggling
knees etc.), several reflexes (spinal reflex, cortical
reflexes and startle response)
 Pathological non-intentional movements:
which should be treated (so called “involuntary
movements” in clinical practice, medical term of
involuntary movement).
 Cont;
Voluntary movements:
The final motor commands for movements are
mediated by several descending motor
pathways.
These final pathways are modified, regulated by
two main loops (basal ganglia loop and
cerebellar loop).
 Cont;
Involuntary movements:
The involuntary movements are produced by a non-
intentional, pathological activation anywhere within
the final common pathways or the above two loops
It divided into four major groups.
1. Tremor:
Some oscillation mechanisms may produce
tremor: one site oscillation or loop oscillation.
A tremor 
https://www.youtube.com/watch?v=zgUJ6kU0J6M
&list=PL45C2C4C96A4421CD&index=28
 Cont;

2. Myoclonus:
• Sudden, brief, shock-like involuntary
movements arising from anywhere from the
cortex to the muscle.
• https://www.youtube.com/watch?v=VC6HJPZr
1VU&list=PL45C2C4C96A4421CD&index=11
 Cont;
3. Chorea/Ballism
Suddenly appearing, irregular, phasic
movements which are usually mimicked by
normal subjects.
Ballism:
https://www.youtube.com/watch?v=nM6f7LB
mvzk&list=PL2HG7XbKdGCxWdkRcjzLU4e4lw9
WUYS3J
Chorea:
https://www.youtube.com/watch?v=k5RgDh7
 Cont;
4. Dystonia/Athetosis
Sustained, long duration muscle contraction sometimes
associated with torsion components.
Dystonia
https://www.youtube.com/watch?v=b1yc6YnvrMs&lis
t=PL45C2C4C96A4421CD&index=14

:
https://www.youtube.com/watch?v=eKhOVaY-YNo&lis
t=PL45C2C4C96A4421CD&index=4
Athetosis:https
://www.youtube.com/watch?v=J_wIDm1_ax4&list=PL
Active & Passive movements
 Active Exercise

The movement or stability of joints which results from the

activity of skeletal muscles may be

Voluntary or Involuntary.

 Voluntary movement is directly under the control of the will

and is known as Active Exercise.

 Involuntary movement which is the result of the activity of

skeletal muscles is not directly under the control of the will.
The activity of involuntary muscle is never under the control of
the will.
Active movement
 PASSIVE MOVEMENT

Movements which are produced by an

external force during muscular inactivity.
 Reference :
• The principles of exercise therapy by: M. Dena
Gardiner, 4th Edition
• Clinical kinesiology and anatomy 5th Ed. by
Lynn S Lippert
• www.sciencedirect.com/science/article/pii/S0
168010219304341
 Thanks

any question
0 ‫ِ ٰٱَله َّّلـ ّـٱَّلْحَرـ َٰم ِن ّـٱَّلِحَرـي ِم‬ ‫بــ ِم‬
‫ِ ْس‬
in the name of god,the Most Gracious,
the Most Merciful.

LECTURE NO 2
SUBJECT
kinesiology ii
Active movement
 ACTIVE EXERCISE/VOLUNTARY MOVEMENT

Definition:
Movement performed or controlled by the voluntary action of muscles, working in
opposition to an external force.
Classification
Free Exercise
The working muscles are subject only to the forces of gravity acting upon the part
moved or stabilized.
Assisted Exercise
When muscle power or co-ordination is in adequate to overcome the resistance of
gravity or another external force, it can be augmented by the use of an external
force applied in the direction of the muscle pull to perform movement or to
stabilize a joint.
Resisted Exercise
The forces of resistance offered to the action of the working muscles are artificially
and systematically increased to develop the power and endurance of the
muscles.
 a. Free Exercise
• Free exercises are those which are performed
by the patient’s own muscular efforts
without
the assistance or resistance
of any
external force, other than that of gravity.
 Cont;
They vary widely in character and effect,
not only
because of the nature & extent of the movement
but according to
the manner in which they are performed.
 Cont;
Free exercise can be used
 to obtain any of the effects
 which are produced by exercise as a whole,
 if and when it is used with caution.
 Effects of free exercise
 A degree of relaxation is induced by exercises
which are rhythmical or pendular in character;
 muscle tone is maintained and power increased
according to the speed, leverage and duration of
the exercise, and the relationship of the part
moved to gravity ;
 co-ordination is trained or improved as the natural
pattern of group action is employed,
 confidence in the ability to perform and control
movement is established.
 Cont;
 Success in achieving the required effect
depends not only on the selection of a
suitable exercise and on the manner
in which it is performed, but also on
 the degree of co-operation obtained from the
patient and
 the skill of the instructor.
 Cont;
• The great advantage of free exercises lies in
the fact that
once the patient has mastered the technique
of their performance
 and is aware of their purpose,
they are his own,
 to practice when and where he pleases.
 Cont;
He has, in fact, been given the means to cure or
to help to cure himself and need no longer rely
on others for this purpose.
Whether or not he uses the exercise for home
practice to help himself largely depends on his
desire for rehabilitation and his confidence in
the efficacy of the exercises
 Classification of Free Exercises

Free exercises may be classified according to the extent

of the area involved;
they may be
a. Localised
b. General.
 Cont;
a. Localised exercises:
are designed primarily to produce some local and
specific effect
 for example, to mobilise a particular joint or to
strengthen a particular muscle group.

Movement is localised to one or more joints,

 either by the use of a suitable starting position,
 or by voluntary fixation of other areas by the
patient’s own muscular effort.
 Cont;
b. General exercises
• usually involve the use of many joints and
muscles all over the body and
the effect is widespread,
 for example, as in running.
 character of a particular exercise
It may be
a. Subjective
b. Objective
a) Subjective:
Exercises which are subjective are usually
 formal and consist of more or less anatomical movements
performed in full range.
The attention of the patient is purposely focused on the
 form and pattern of the exercise to ensure accuracy of
performance,
e.g. sitting ; Arm bending and stretching sideways and upward.
 Cont;
 As many of these exercises are artificial and
bear little relation to natural movement, these
are now used to a lesser degree than formerly.
 Some, however, are undoubtedly useful in
establishing a correct pattern of movement
and in avoiding the tendency to develop ‘trick’
movement,
which is often functionally effective
 but wasteful of energy in comparison with the
correct movement
 Cont;
b. Objective exercises :
are those during the performance of which the
 patient’s attention is concentrated
 on the achievement of a particular aim which
will result from his efforts,
e.g. standing; Arm stretching upwards, to touch a
mark on the wall, or to throw a ball.
 Cont;
The presence of a goal to be reached is
stimulating to effort,
like the proverbial carrot held in front of the
donkey’s nose, but care must be taken to see
that the accuracy of the movement is not
sacrificed to the achievement of the aim;
e.g. in walking across a room to get a cup of tea,
the quality of the walking must not be allowed
to deteriorate
 The Technique of Free Exercises

1. The starting position is

 selected and taught with care
 to ensure the maximum postural efficiency
as a basis for movement.
 Cont;

2. Instruction is given
 in a manner which will gain the interest and
co-operation of the patient and
 lead him to understand both the pattern and
the purpose of the exercise.
 Cont;
3. The speed at which the exercise is done depends
on the effect required.
 It is usually slow during the period of learning
and later the patient is either allowed
 to find his own natural rhythm, or the speed
required is dictated by the physiotherapist.
 It often helps the patient to maintain his natural
rhythm at home if,during practice under
supervision, he is encouraged to count aloud.
 Cont;
4. The duration of the exercise depends very
largely on the patient’s capacity.
 Usually three bouts of practice for each
exercise, with short rest periods, or a change
of activity, between, ensure sufficient practice
without undue fatigue.
 Muscle Power and Tone.

The power and endurance of the working muscles are

 maintained or increased in response to the tension
created in them.
This tension is greater when the exercise is performed at
any speed
 which is slower,
 or more rapid,
 than when the natural speed of movement is employed,
and it increases with the duration of the exercise.
 Cont;
A high degree of tension and consequent increase
in power
can be developed by free exercises
 when the muscles work for any time against the
resistance offered by the body weight,
or against the mechanical disadvantage of an
adverse leverage provided by a long and heavy
limb.
 Cont;
Normally, muscle power is maintained adequately
by
 a minimum of everyday activities,
 most of which are performed in the middle range.
Under abnormal conditions, however,
 for example during fixation of a joint, the power
can only be maintained or
 improved by repeated static contractions,
 which the patient must practice through out the
day.
 Neuromuscular Co-ordination.
Co-ordination is improved by the repetition of an
exercise.
 As the pattern of movement is established,
 it is simplified and becomes more efficient, and
the conduction of the necessary impulses along
the neuromuscular pathways is facilitated.
 Cont;
Exercises or activities,
 which at one time required concentration and
much effort,become with practice more or
less automatic in character, and skill is
developed,
as for example in walking or playing the piano.
 Confidence.
The achievement of co-ordinated and efficient
movement
 assures the patient of his ability to maintain
subjective control of his body, giving him
confidence to attempt other and new activities,
 together with a feeling of exhilaration and
satisfaction when they are accomplished,
for example, jumping a rope, or shooting a goal.
Objective exercises and activities are usually
used for this purpose.
Circulatory and Respiratory Co-operation.

 During vigorous or prolonged exercise it is

apparent that the speed and depth of
respiration is increased,
 that the heart beat is faster and more forceful,
and that heat is produced,
 whereas in light exercise these changes are so
slight that they are not noticed.
 Cont;
a. The Needs of the Active Tissues.
 The active tissues involved during muscular
exercise require a free supply of oxygenated
blood and the removal of metabolic products
to enable them to continue their activity.
 To meet these demands and to keep pace
with them, the co-operation of the Circulatory
and Respiratory Systems is enlisted.
 Cont;
b. Preparation for Activity .It is probable that
the cerebral cortex, which initiates the muscular
contraction, also prepares the body to supply the needs
of the tissues concerned,
by communicating with the Respiratory, Cardiac and Vaso-
motor centres which form part of the Autonomic Nervous
System.
Sympathetic fibres from these centres convey impulses to
the appropriate organs which,
with the help of adrenalin,
which is released into the blood stream, produce
widespread results.
 Cont;
 Adrenalin release :These results include
 increased respiration, increased frequency of the heart
beat,
 a rise in arterial blood pressure, and
 a re-distribution of blood,
 so that the volume of blood in the muscles is increased
 at the expense of that in the splanchnic area and the
skin.
 All these changes occur merely as the result of the
anticipation of exercise in competitive sports
 Cont;
c. Local Circulatory Changes in the Muscles:
 During active exercise the capillaries in the working
muscles dilate and their permeability is increased.
 Many capillaries that were closed when the muscle
was at rest become open and blood flows through
them.
 In this way the capacity of the muscles to contain
blood is markedly increased and
 the interchange of fuel and waste products between
the blood and the tissue fluids is facilitated.
 Cont;
d. Regulation of Circulatory and Respiratory Function
during Exercise:
 The venous return to the heart is increased during
exercise and results in an increase in cardiac output.
The increased venous return is caused
 partly by the pressure variations in the abdominal and
thoracic cavities resulting from increased respiratory
movements.which exert a pumping action upon the large
veins in the direction of the heart,
 and partly by the pressure of the contracting muscles on
the thin walls of the peripheral veins. Valves in these veins
prevent regurgitation during relaxation of the pressure.
 Cont;
 Muscular contraction increases both the
carbon dioxide content and the temperature of
the blood, and both these factors stimulate the
circulatory and respiratory systems to further
activity.
 The rise in temperature of the body is kept
within normal limits by dilatation of the skin
capillaries and stimulation of the sweat glands,
thus enabling heat to be lost from the surface.
 Cont;
 Active exercise can therefore be used to
increase Respiration, to increase both the local
and the general Circulation, and to provide
work for the Heart Muscle.
 The effect of active exercise as a whole is so
widespread and varies so much in intensity
according to the nature of the exercise.
 Reference :
• The principles of exercise therapy by: M. Dena
Gardiner, 4th Edition
 Thanks

any question