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At the completion of this chapter, the reader will be able to:

  1. Outline the various roles of human skeletal muscle.

  2. List the various roles of muscle in the human body.

  3. Differentiate among muscle strength, endurance, and power.

  4. Understand the importance of manual muscle testing.

  5. Perform a gross muscle screening of a patient’s strength.

  6. Perform specific manual muscle tests to the various muscles of the body.

  7. Define delayed onset muscle soreness (DOMS) and explain why it occurs.

  8. Describe the concept of specificity of training.

  9. Describe strategies to increase muscle strength, endurance, and power.

  10. List the different types of resistance that can be used to improve muscle performance.

  11. Outline the various types of exercise progression and the components of each.

  12. Explain the basic principles behind plyometrics.



Movement of the body or any of its parts involves considerable activity from those muscles directly responsible. Muscle is the only biological tissue capable of actively generating tension. This characteristic enables the human skeletal muscle to perform the important functions of maintaining upright body posture, moving body parts, and absorbing shock. For functional body motions to take place, the muscles producing movement must have a stable base from which to work from. If a functional limitation is highlighted during the physical examination of the patient, the clinician must determine the cause of the functional and/or participation restrictions. If the cause is found to be poor muscle performance, a progression of exercises to enhance muscle performance must be initiated. One of the most common ways of improving muscle performance is through the use of graded resistance exercises, which can be applied globally or locally. The clinician must remember that there are a number of factors that influence a patient’s ability to exercise. These factors can include fear of pain or reinjury, poor motivation, low compliance, depression, the side effects of medication, and impaired attention or memory.

Muscle Performance

The ability of a muscle to carry out its various roles is a measure of muscle performance. The three main types of muscle contractions are isometric, concentric (Fig. 12-1A and B), and eccentric (Fig. 12-2A and B) (see Chapter 1). Muscle performance can be assessed by measuring a number of parameters. These include strength, endurance, and power.

  • Strength. The improvement of muscle strength is an integral component of most rehabilitation programs. Strength may be defined as the amount of force that may be exerted by an individual in a single maximum muscular contraction against a ...

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