Kine II Assisted Exercises Lec # 2

ASSISTED EXERCISES
Physical Therapist
Dr. Amber Shabbir
DPT (SMC)MS-OMPT (RIU)
Hcpc (UK)
Lecture Outline
 Definition
 Principles of assisted exercises
 Techniques
 Effects and uses
Definition
 When muscle strength or co-
ordination is inadequate to
perform a movement an
external force is applied to
compensate for the deficiency
are called assistance
exercises.
 OR
 Type of Exercise in which

assistance is provided manually
or mechanically by an outside
force because the prime mover
muscles need assistance to
complete the motion.
THE PRINCIPLES OF
ASSISTANCE
1-When the voluntary contraction of the muscle
is insufficient to produce movement,
2- An external force may be added to complete
range.
3- This external force must be applied in the
direction of the muscle action.
4-The magnitude of this assisting force must be
sufficient only to improve muscular action and
must not be allowed to act as a passive
movements.
5-As the muscle power increases, the
assistance given must be decreases
proportionally.
THE PRINCIPLES OF
ASSISTANCE
TECHNIQUES
 Assisting force is applied only to augment
the maximum effort and not to act as a
substitute force.
1. Starting position
2. Pattern of movement
3. Fixation
4. Support
5. The Antagonist Muscles
6. Traction
7. The assisting force
8. The character of the movement
9. Repetitions
10. The co-operation of the patient
1. STARTING POSITION
 Stability of the body is important to
ensures that the patient’s attention is
concentrated on the pattern of
movement and the effort required to
perform it.
2.PATTERN OF MOVEMENT
 This can be explained to the patient by
performing it passively or actively on the
sound limb.
3.FIXATION
 Fixation of the proximal part of the
prime movers improves their
efficiency.
 Avoid trick movements to occur by
proper fixation.
 When there is a tendency for

movements to be transferred to
neighboring joints to compensate for
the inefficiency of weak muscles,
 Movement in these joints must be

controlled or ‘’held back’’ by
manual pressure or other means of
fixation, so that the movement is
pivoted at the required joint.
4.SUPPORT
 Moved part should be
supported to reduce the load
on the muscle.
 Manual support is more

effective.
 This support may be

provided by the
physiotherapist’s hands,
suspension slings, a polished
horizontal surface such as
a re-education board, the
buoyancy of water or ball-
bearing skates.
5.THE ANTAGONISTIC
MUSCLES
 Every effort must be made
to reduce tension in the
muscles which are
antagonistic to the
movement.
 Proper starting position

selected to reduce the
tension in the antagonistic
muscles,
E.g.
a position in which the
knee flexed is suitable
for assisted dorsiflexion
6.TRACTION
 Preliminary
stretching of the
weak muscle provides
a powerful stimulus
to contraction
because it stimulate
the muscle spindle
( Myotatic reflex) which
helps in the initiation of
movement.
7.THE ASSISTING
FORCE
 Force used in assisting
the action of the muscle
must be applied in the
direction of the
movement by PT hands.
 In general, most
assistance is required
to overcome initial
inertia at the
beginning of movement
 at the end to complete
the range.
8.THE CHARACTER OF THE
MOVEMENT
 Smooth movement is characteristics of
efficient voluntary movement.
 Smoothly performed movement efficiency

depends on the speed of contraction .
 Speed of movement depends on the

muscles.
 Each muscle has own optimum rate of

contraction which varies according to its
structure and the load.
 Fusiform muscles contract rapidly and

Multipennate ones take longer.
 Very weak muscles cannot be expected

to produce a sustained contraction
and therefore assistance is given in
9.REPETITIONS
 No of times the movement is repeated depends
on whether it is considered advisable or injurious to
fatigue the muscles.
 Repetition of the movement depends on the

condition.
 Condition which has caused the weakness must be

known and understood.
10.CO-OPERTION OF PATIENT
 Co-operation of the patient
is essential during this type of
exercise,
 Concentrated effort is
needed to encourage the
muscles to do all they can to
help the movement.
 Patient should be encouraged

to exert maximum effort.
 The ability to see the results

and to feel what is
happening is a great help to
the patient so he can be
encouraged to palpate his
muscles as they contract.
Effects and uses of assisted
exercise
 When a patient has weak musculature and is unable to move a
joint through the desired range (usually against gravity).
 Maintain physiologic elasticity and contractility of the

muscles.
 If a segment immobilized for a period of time it is used on the

regions above and below the immobilized segment to maintain
the areas in as normal condition,
 Provide sensory feedback from the contracting muscle to be

used in early stages of neuromuscular re-education.
9
 A-AROM is used to provide enough
assistance to the muscles in a carefully
controlled manner so the muscle can function
at its maximum level and strengthened.
 Confidence of the patient in his ability to move

and helping to co-operate.
 Provide stimulus for bone integrity, so the

range of effective joint movement may be
increased.
 When movement must be maintained inspite of

pain in joints these exercises are very useful
e.g. in Rheumatoid Arthritis.
Contra-indications of Assisted
exercise
1-Acute tears and fracture.
2-Greater swelling, fever and
redness.
3-Immediatlly followed myocardial
infarction.
4-If active assisted exercises
induced pain during movement.
END OF LECTURE 02

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ASSISTED EXERCISES

 Type of Exercise in which

 When there is a tendency for

 Movement in these joints must be

 Manual support is more

 This support may be

 Proper starting position

 Smoothly performed movement efficiency

 Speed of movement depends on the

 Each muscle has own optimum rate of

 Fusiform muscles contract rapidly and

 Very weak muscles cannot be expected

 Repetition of the movement depends on the

 Condition which has caused the weakness must be

 Patient should be encouraged

 The ability to see the results

 Maintain physiologic elasticity and contractility of the

 If a segment immobilized for a period of time it is used on the

 Provide sensory feedback from the contracting muscle to be

 Confidence of the patient in his ability to move

 Provide stimulus for bone integrity, so the

 When movement must be maintained inspite of

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