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The Caregivers' Role in
Most rehabilitation programs are geared
towards progression. In regards to resistance training
and strength improvement, one of the most commonly used
programs is the Daily Adjustable Progressive Resistance
Exercise (DAPRE) system. This is a four set exercise
program (the first two sets are progressive warm-ups)
that take in to consideration the daily variations of a
patient's strength levels. Resistance can be applied
through weights, machines, latex bands, or manually by
the caregiver or therapist.
Another common exercise prescription for strength
improvement is isometric exercises. An isometric
contraction is when the muscle is neither shortened or
lengthened, merely contracted and tensed. Tension is
generated, and energy is released in the form of heat,
not mechanical work. Pushing against an immovable object
such as a wall is an example of isometric exercise.
These are especially valuable to a patient who needs to
exercise an immobilized limb or when joint motion is
hindered by inflammation. Instead of using repetitions
to measure work, "seconds of contraction" are the units
in isometric programming.
Flexibility drills, active-assisted exercise and limited
ROM exercises are also frequently employed by the
therapist and introduced to the caregiver.
Below is an example of a few of the major muscle groups
that are targeted by rehabilitation programs. You can
see how conditioning each area can improve one's quality
of life. The person in this example is wheelchair bound
Muscles Strengthened Functional Benefits
Shoulders, deltoids (anterior,
Self-care, loading/unloading wheelchair, posterior),
trapezius. lifting objects, wheelchair sports.
Biceps Transfer activities such as
Rotar Cuff (supraspinatus,
Transfers, pressure relief, counteract
subscapularis, infraspinatus, tight internal rotors
from wheelchair teres m.). propulsion.
Triceps Transfers, wheelchair
Chest (pectoralis major). Wheelchair
propulsion, driving and braking.
Back (latissimus dorsi, rhomboids,
posterior deltoid) Pressure relief, transfers,
Sean Kenny, C.P.T, a certified
trainer, author, and guest speaker is a consultant with
Mercy Hospital and Pacific Health Education Center in
Bakersfield, Ca., reviews exercise protocols for the
senior, disabled and diabetic populations. Visit Sean's
Fitness Web Site: http://anythingfitness.com, or call