Therapeutic exercises are movements meant for healing and restoration of health. Its dosage, repetition is considered in respect of the condition of the patient, age, sex, climate etc.
Type and form of exercise will depend on the quality and form of the muscle concerned. On this basis, intensity is increased or decreased.
There must be clear understanding between the therapist and the patient. Prescription should be flexible. And patient should never reach the stage of fatigue.
In the prescription to be noted: duration, number of repetitions, period, weight or resistance, time schedule (whether concentrated or scattered), varieties of exercise, speed of the exercise (although if is generally slow); mention must be made whether movements are active, assisted or passive, or resisted.
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The therapist demonstrates the exercise, if necessary helps the patient doing the exercise, and also adds resistance to movements for therapeutic reasons.
Classification of therapeutic movements:
Therapeutic movements are classified according to their nature as under:
(i) Passive – Here major role is played by the therapist.
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(a) Relaxed Passive
Only up to the possible range of relaxation or the existing range at the moment.
(b) Forced Passive
To extend the range further.
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(c) Assistive Passive
The patient also contributes a little.
(ii) Assistive
The patient can perform but still needs assistance. Assistance is provided by therapist or another person or through pulleys, elastic band etc. i.e., mechanical assistance.
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(iii) Active
When the patient himself can perform.
(iv) Resistive
Resistance is applied to build power. This can be done with the help of equipment, with the help of the therapist, and also with the help of some other body parts of the patient.
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It gives strength, power, endurance and range of movements. Pulleys are sometimes used for applying resistance. To avoid gravitational force, some times exercises are performed under water to utilize the effect of buoyancy.
Static exercises sometime produce more physiological effect.
Resistive exercises
When exercise is done against some resistance it is called resistive exercise. Resistance is given by an assistant or through weight. Contraction and relaxation of the muscles are done in progression when static exercises, assistive exercises and non-assistive exercises are given.
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Static exercises are done through contraction and relaxation of the muscles without joint movement, 5-20 repetitions per hour. This type of exercise is effective in cases of treatment of fractures or inflammation of joints and tissues, and also in chronic inflammation cases.
In resistive exercises, resistance can be provided manually (generally useful at the early stages), or mechanically (with barbells, dumbbells, springs, sand bags, iron bands, underwater exercises.)
There are two methods of providing resistance:
(i) Load resisting exercise (when load/weight is added in the natural way, to the minimum).
(ii) Load assisting exercise (weight arranged to counterbalance a desired amount of resistance).