CHAPTER 18 Therapeutic Exercise

HE 18-5 The molecular basis of muscle contraction. A, Each myosin cross-bridge in the thick filament moves into a resting position after an ATP binds and jwfers its energy. B. Calcium Ions released from the sarcoplasmic reticulum bind to troponin in the thin filament, allowing tropomyosin to shift from Its position ,ocking the active sites of actin molecules. C, Each myosin cross-bridge then binds to an active site on a thin filament, displacing the remnants of ATP hydrolysis: r,&DP >nd inorganic phosphate. D, The release of stored energy from step A provides the force needed for each cross-bridge to move back to its original position, fluiling actin along with it. Each cross-bridge will remain bound to actin until another ATP binds to It and pulls it back to lis resting position (A). (Redrawn from Kjbodeau G A Patton KT: Anorony and physiology. S t Louis. 1999. Mosby. with permission.)

Active sites

Kling length hcloic contraction, resting tension develops, lion laid ,i( ii \ e t e n s i n i i
( t h e increase in tension during contni nCS jln.) d e i l e a s e s

Efficiency (percentage of energy that is converted into work instead of heat) occurs at a velocity of contraction of about 30% of maximum.-'1-'1
F-actin Troponin complex

Torque-Velocity Relationship
The greatest amount of force is generated by a muscle during fast eccentric (lengthening) contractions.'1-'1 The least amount of force is produced during fast concentric (short ening) contractions. Ihe amount of force developed in Unorder of most force to least force can be summarized as follows: fast eccentric, isometric, slow concentric, and fast concentric.(figure 18-7).

Tropomysin SURE 18-6 Tropomyosin molecules The actin filament, composed of two /helical strands of F-actin and tropomyosin molecules that fit loosely in the grooves "between the actin strands Attached to one end of each tropomyosin molecule troponin complex that initiates contraction. (Redrawn fiom Guyton A ^^QOOk of medKOl physiotogy Philadelphia. 1996 Saunders, with permission )

Effects of Exercise Training The SAID principle (specific adaptations to imposed demands) states that a muscle will adapt to a specific demand imposed on it. making it better able to handle the greater load.

h. producing limb motion Concentric contractions wncn the muscle shortens Eccentric contractions r when the muscle lengthens More fast-twitch fibers are recruited during Observed strength gains within the first few weeks of a weightlifting program are eccentric contractions. Isokinetic confections occur when muscle contraction is performed mostly because of neuromuscular adaptations, the nervous system ret mils largei at a instant velocity. 1 his can be done only with the assistance preset rate-limiting device motor units with higher frequencies of stimulation to provide the force ncicssarv to This type of exercise does | exist in nature. KmtraM.<oc<v&uJn--ic 4 / Kefcic*, &*\ mM/ec<deK overcome the imposed resistant e I arly strength gains and in< leased muscle tension production from training therefore result from a more efficient neural recruitment pro cess. Ibis means that most of the improvement in strength related tors Affecting Muscle Strength ^c^s r'i^^cu^c^^| and Performance Determinants of Strength Amuse les ability to produce force is directly proportional to its uoss sec tional aiea. lor parallel muscles, this corresponds to the c ross-scction at the bulkiest pan of the muscle. I'm pennate muscles, multiple cross-sections are taken IIIright angles to each of the muscle fibers. Pennate muscles life particularly adapted to force production because many Imore muscle libers are contained in pennate muscles and I these libers are shorter.7"
*e*=o-c^ oM

Neural Adaptations

functional activities gained on inpatient rehabilitation units arc due to neural recruitment rather than muscle hyper trophy, due to the relatively short length of stays.1"

Muscle Hypertrophy
Muscle hypertrophy represents enlargement of total muscle mass and cross-sectional area. Muscle hypertrophy is mine common in fast-twitch than in slow-twitch muscles. Type 2A fibers exhibit the greatest growth, more so than type 2It and type I fibers. Muscle hypertrophy is typically experienced after 6 to 7 weeks of resistance training.nM Conversely, muscle atrophy resulting from disuse occurs primarily In type 2 fibers Virtually all muscle hypertrophy occurs from hypertro phv ol the individual muscle libers During muscle hypertrophy the rate ol muscle contractile protein synthesis is

n%ion Relationship
[Maximum force of contraction occurs when a muscle is |1ils normal resting muscle length, lor the muscles, this Iponds to about midrangc of joint motion or slightly iger, and is the length at which tension just begins to hcecd zero If a muscle is stretched to much greater than , no