Terapi Latihan Dasar dan Latihan Fungsi (3)

(1)

TERAPI LATIHAN DASAR

DAN LATIHAN FUNGSI (3)

Lenny Agustaria Banjarnahor, SSt, M. Fis

(2)

KEPUSTAKAAN

Wajib



Kisner, Carolyn & Allen Colby, Lynn Therapeutic

Exercise (Foundations & Techniques)

Penunjang



Basmajian, John V, Therapeutic Exercise (Third

edition)



Hollis Margaret, Practical Exercise Therapy



Licth, Sidney, Therapeutic Exercise

(3)

AD.1 KEKUATAN (STRENGTH)

 Kemampuan otot/grup memproduksi tegangan utk

menghasilkan tenaga dgn upaya maksimal scr statis & dinamis

 Faktor-faktor pengaruh :

1. Ukuran cross-sectional otot

2. Hubungan length-tension otot saat kontraksi

(4)

TONE PRODUCED THROUGH

THE ACTIVATION OF MOTOR UNITS

TONE PRODUCED THROUGH

THE ACTIVATION OF MOTOR UNITS

MOTOR UNIT

THE MOTOR NEURON

ALL THE MUSCLE FIBERS

IT INNERVATES

(5)

(6)

FG

Fast-twitch Glycolytic

(involved in phasic movement)

FOG

Fast-twitch Oxidative Glycolytic

SO

Slow-twitch Oxidative

(involved in tonic movement)

WHITE

B. HWANG 1999

PINK

(7)

Muscle Number of Motor Unit

Innervation Ratio

Extensor Rectus 2970 9

1st Lumbricals 96 108

Brachioradialis 333 410

Tibialis Anterior 445 562

Gastrocnemius 579 1934

NUMBER OF MOTOR UNIT &

INNERVATION RATIO

(8)

(9)

 4. Tipe kontraksi

- Isometrik - Isotonik

- Eksentrik - Konsentrik - Isokinetik

5. Distribusi fiber type

6. Cadangan energi & suplai darah 7. Kecepatan kontraksi

(10)

Relationship between fiber type, motor unit type and histochemical profiles of muscle fibers

Fiber type I II IIB

Histochemical profiles

Myofib. ATPase Low High High

NADH dehydro. High Medium-High Low

SDH High Medium-High Low

Glycogen Low High High

Phosphorylase Low High High Capillary supply Rich Rich Sparse Fiber diameter Small Medium-Small Large

(11)

 Perubahan sistem neuromuskular yg mengarah kpd

peningkatan kekuatan 1. Hipertropi

2. Rekruitmen

(12)

AD.2 ENDURANCE &

CARDIOVASCULAR FITNESS

 Tipe endurance

1. Muscular endurance

2. General (total) body endurance

 Perubahan sistem muscular, cardiovascular &

pulmonal

AD. 3 MOBILITAS & FLEKSIBILITAS

 Soft tissue mobility/flexibility

 Joint mobility

(13)

AD. 4 STABILITAS

 Koordinasi sinergis pd sistem neuromuscular utk

dasar stabilisasi thd gerakan-gerakan fungsional & aktifitas

 Mengarah kpd struktur-struktur proksimal

AD. 5 RELAKSASI

 Usaha utk menurunkan ketegangan otot

 Penempatan pd posisi nyaman (comfortable

(14)

AD. 6 KOORDINASI, KESEIMBANGAN &

FUNCTIONAL SKILLS

 Koordinasi

Otot yg tepat pd waktu yg tepat dgn sekuensis & intensitas tepat

 Keseimbangan

Mempertahankan COG



Functional skills

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reserved 3-15

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reserved 3-16

BIOMECHANICS

 Biomechanics - study of the mechanics as it

relates to the functional and anatomical

analysis of biological systems and especially humans

 Necessary to study the body’s mechanical

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reserved 3-17

BIOMECHANICS



Mechanics - study of physical

actions of forces



Mechanics is divided into



Statics

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reserved 3-18

BIOMECHANICS

 Statics - study of systems that are in a

constant state of motion, whether at rest with no motion or moving at a constant velocity without acceleration

 Statics involves all forces acting on the body

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reserved 3-19

BIOMECHANICS

 Dynamics - study of systems in motion with

acceleration

 A system in acceleration is unbalanced due to

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reserved 3-20

BIOMECHANICS

 Kinematics & kinetics

 Kinematics - description of motion and includes

consideration of time, displacement, velocity, acceleration, and space factors of a system‘s motion

 Kinetics - study of forces associated with the

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reserved 3-21

TYPES OF MACHINES FOUND IN THE

BODY



Mechanical advantage

 Load/effort or load divided by effort

 Ideally using a relatively small force, or effort to move a much greater resistance



Musculoskeletal system may be thought of

as a series of simple machines

 Machines - used to increase mechanical advantage

 Consider mechanical aspect of each component in analysis with respect to components’

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reserved 3-22

TYPES OF MACHINES FOUND IN THE

BODY

 Machines function in four ways

 balance multiple forces

 enhance force in an attempt to reduce total force needed to overcome a resistance

 enhance range of motion & speed of movement so that resistance may be moved further or

faster than applied force

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reserved 3-23

TYPES OF MACHINES FOUND IN THE

BODY

 Musculoskeletel system arrangement

provides for 3 types of machines in producing movement

 Levers (most common)

 Wheel-axles

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reserved 3-24

LEVERS

 Humans moves through a system of levers

 Levers cannot be changed, but they can be

utilized more efficiently

 lever - a rigid bar that turns about an axis of rotation or a fulcrum

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reserved 3-25

LEVERS

 Levers rotate about an axis as a result of

force (effort, E) being applied to cause its

movement against a resistance or weight

 In the body

 bones represent the bars

 joints are the axes

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reserved 3-26

LEVERS

 Resistance can vary from maximal to minimal

 May be only the bones or weight of body segment

 All lever systems have each of these three

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reserved 3-27

LEVERS

 Three points determine type of lever & for

which kind of motion it is best suited

 Axis (A)- fulcrum - the point of rotation

 Point (F) of force application (usually muscle insertion)

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reserved 3-28

LEVERS

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reserved 3-29

(30)

reserved 3-30

LEVERS



The mechanical advantage of levers may be

determined using the following equations:

Mechanical advantage =

Resistance

Force

or

Mechanical advantage =

Length of force arm

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reserved 3-31

FIRST-CLASS LEVERS

 Produce balanced movements when axis

is midway between force & resistance (e.g., seesaw)

 Produce speed & range of motion when

axis is close to force, (triceps in elbow extension)

 Produce force motion when axis is close

to resistance (crowbar)

Modified from Hall SJ:

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reserved 3-32

FIRST-CLASS LEVERS

 Head balanced on neck in

flexing/extending

 Agonist & antagonist muscle groups are

contracting simultaneously on either side of a joint axis

 agonist produces force while antagonist supplies resistance

Modified from Booher JM, Thibodeau GA:

Athletic injury

(33)

reserved 3-33

FIRST-CLASS LEVERS

 Elbow extension in triceps applying force to

olecranon (F) in extending the non-supported

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reserved 3-34

FIRST-CLASS LEVERS

 Force is applied where muscle inserts in

bone, not in belly of muscle

 Ex. in elbow extension with shoulder fully flexed & arm beside the ear, the triceps applies force to the olecranon of ulna behind the axis of elbow joint

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reserved 3-35

FIRST CLASS LEVER



A lever in which the

muscular force and

resistance force act

on

opposite sides

of

the fulcrum

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reserved 3-36

SECOND-CLASS LEVERS

 Produces force movements, since a

large resistance can be moved by a relatively small force

 Wheelbarrow

 Nutcracker

 Loosening a lug nut

 Raising the body up on the toes

Modified from Hall SJ:

(37)

reserved 3-37

SECOND CLASS LEVER



A lever in which the

muscular force and

resistance force act

on the

same side

of

the fulcrum, but the

(38)

reserved 3-38

SECOND-CLASS LEVERS

 Plantar flexion of foot to raise the body up on the toes where ball (A) of the foot

serves as the axis as ankle plantar flexors apply force to the calcaneus (F) to lift the resistance of the body at the tibial

articulation (R) with the foot

 Relatively few 2nd class levers in body

Athletic injury

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reserved 3-39

THIRD-CLASS LEVERS

 Biceps brachii in elbow flexion

Using the elbow joint (A) as the axis, the biceps brachii applies force at its insertion on radial tuberosity (F) to rotate forearm up, with its center of gravity (R) serving as the point of resistance application

Athletic injury

(40)

reserved 3-40

THIRD-CLASS LEVERS



Brachialis - true 3

rd

class leverage

 pulls on ulna just below elbow

 pull is direct & true since ulna cannot rotate



Biceps brachii supinates forearm as it flexes so

its 3

rd

class leverage applies to flexion only



Other examples

 hamstrings contracting to flex leg at knee while in a standing position

(41)

reserved 3-41

THIRD CLASS LEVER



A lever in which the

muscular force and

resistance force act

on the

same side

of

the fulcrum, but the

(42)

reserved 3-42

FACTORS IN USE OF

ANATOMICAL LEVERS

 Anatomical leverage system can be used to

gain a mechanical advantage

 Improve simple or complex physical

movements

 Some habitually use human levers properly

 Some develop habits of improperly using

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