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Paper III – Exercise Therapy – II

Total hours:250
Total Hours/ Week:6 hours
Lecture:3 hours /week
Practicals:2 hours/ week
Seminars/ Tutorials:1 Hour/ week
Method of Assessment:Written, Oral, Practical

Course Description:
In this course, the students will learn the principles and effects of exercise as a therapeutic modality and will learn the techniques in the restoration of physical functions.


  • Introduction to Exercise Therapy [5 Hours]: The aims of Exercise Therapy, The techniques of Exercise Therapy, Approach to patient’s problems, Assessment of patient’s condition – Measurements of Vital parameters, Planning of Treatment.
  • Methods of Testing [15 Hours]
    • Functional tests
    • Tests for neuromuscular efficiency
      • Manual Muscle Testing: Introduction to MMT, Principles & Aims, Indications & Limitations, Techniques of MMT for group & individual muscles : Techniques of MMT for upper limb / Techniques of MMT for lower limb / Techniques of MMT for spine
      • Anthropometric Measurements: Muscle girth – biceps, triceps, forearm, quadriceps, calf
      • Static power Test
      • Dynamic power Test
      • Endurance test
      • Speed test
      • Measurement of Limb Length: true limb length, apparent limb length, segmental limb length
      • Measurement of the angle of Pelvic Inclination
    • Relaxation [4 Hours]: Definitions: Muscle Tone, Postural tone, Voluntary Movement, Degrees of relaxation, Pathological tension in muscle, Stress mechanics, types of stresses, Effects of stress on the body mechanism, Indications of relaxation, Methods & techniques of relaxation-Principles & uses: General, Local, Jacobson’s, Mitchell’s, additional methods.
    • Aerobic Exercise [7 Hours]: Definition and key terms; Physiological response to aerobic exercise, Examination and evaluation of aerobic capacity – Exercise Testing, Determinants of an Exercise Program, The Exercise Program, Normal and abnormal response to acute aerobic exercise, Physiological changes that occur with training, Application of Principles of an Aerobic conditioning program for patients – types and phases of aerobic training.
    • Balance [7 Hours]: Definition, Physiology of balance: contributions of sensory systems, processing sensory information, generating motor output Components of balance (sensory, musculoskeletal and biomechanical) Causes of impaired balance, Examination & evaluation of impaired balance, Activities for treating impaired balance: mode, posture, movement, Precautions & contraindications, Types Balance retraining
    • Co-ordination Exercise [6 Hours]: Anatomy & Physiology of cerebellum with its pathways Definitions: Co-ordination, Inco-ordination, Causes for Inco-ordination, And Test for co-ordination: equilibrium test, non equilibrium test Principles of co-ordination exercise Frenkel’s Exercise: uses of Frenkel’s exercise, technique of Frenkel’s exercise, progression, home exercise.
    • Proprioceptive Neuromuscular Facilitation [10 Hours]: Definitions & goals Basic neurophysiologic principles of PNF: Muscular activity, Diagonals patterns of movement: upper limb, lower limb, Procedure: components of PNF, Techniques of facilitation, Mobility: Contract relax, Hold relax, Rhythmic initiation, Strengthening: Slow reversals, repeated contractions, timing for emphasis, Stability: Alternating isometric, rhythmic stabilization , Skill: timing for emphasis, resisted progression, Endurance: slow reversals, agonist reversal.
    • Functional Re-education [7 hours]: Lying to sitting: Activities on the Mat/Bed, Movement and stability at floor level; Sitting activities and gait; Lower limb and Upper limb activities.

    • Passive Movements [ 4 Hours]: Causes of immobility, Classification of Passive movements, Specific definitions related to passive movements, Principles of giving passive movements, Indications, contraindications, effects of uses , Techniques of giving passive movements.
    • Manual Therapy: Spinal & Peripheral Joint Mobilization [15 Hours]: Schools of Manual Therapy, Principles, Grades, Indications and Contraindications, Effects and Uses – Maitland, Kaltenborn, Mulligan, Biomechanical basis for mobilization, Effects of joint mobilsation, Indications and contraindications, Grades of mobilization, Principles of mobilization, Techniques of mobilization for upper limb, lower limb, Precautions.
    • Resisted Movements [9 hours]: Definition of strength, power & work, endurance, muscle actions. Physiology of muscle performance: structure of skeletal muscle, chemical & mechanical events during contraction &relaxation, muscle fiber type, motor unit, force gradation. Causes of decreased muscle performance. Physiologic adaptation to training: Strength & Power, Endurance. Types of resisted exercises: Manual and Mechanical resistance exercise, Isometric exercise, Dynamic exercise: Concentric and Eccentric, Dynamic exercise: Constant versus variable resistance, Isokinetic exercise, Open-Chain and Closed-Chain exercise. Specific exercise regimens, Isotonic: de Lorme’s, Oxford, Mac Queen, Circuit weight training, Isometric: BRIME (Brief Resisted Isometric Exercise), Multiple Angle Isometrics Isokinetic regimens, Plyometrics.
    • Stretching [6 Hours]: Definition of terms related to stretching; Tissue response towards immobilization and elongation, Determinants of stretching exercise, Effects of stretching, Inhibition and relaxation procedures, Precautions and contraindications of stretching, Techniques of stretching.
    • Posture [5 Hours]: Definition, Active and Inactive Postures, Postural Mechanism, Patterns of Posture, Principles of re-education: corrective methods and techniques, Patient education.
    PRACTICAL [150 Hours]
    The students of exercise therapy are to be trained in Practical Laboratory work for all the topics discussed in theory. The student must be able to evaluate and apply judiciously the different methods of exercise therapy techniques on the patients. They must be able to:

    • Demonstrate muscle strength using the principles and technique of MMT
    • Demonstrate the techniques for muscle strengthening based on MMT grading
    • Demonstrate the PNF techniques
    • Demonstrate exercises for training co-ordination – Frenkel’s exercise
    • Demonstrate techniques for functional re-education
    • Demonstrate mobilization of individual joint regions
    • Demonstrate the techniques for muscle stretching
    • Assess and evaluate posture and gait
    • Demonstrate to apply the technique of passive movements
    • Demonstrate various techniques of Active movements
    • Demonstrate techniques of strengthening muscles using resisted exercises
    • Demonstrate techniques for measuring limb length and body circumference.
    Practical Exam Format
    PRACTICAL-80 marks + INT. ASSESSMENT-20 marks: TOTAL-100 MARKS
    • Long case-based on techniques of application of MMT/ Mobilization/ Stretching/ PNF/ Posture & Gait [35 marks]
      • Principles, Indications, Contra-indications, Documentation of findings etc [20 marks]
      • Psychomotor & affective-skills [15 marks]
    • Short Case – Any one of the following [20 marks]
      • Passive movements /Strengthening/ Relaxation / Functional Reeducation/ Mat Exercises/ General Fitness / Group Exercises / Balance/ Coordination etc.
      • Spots-Based on Therapeutic Gymnasium [Four] [5×4= 20 marks]
      • Journal [5 marks]
    Recommended Textbooks:
    • Therapeutic Exercise: Foundations and Techniques : Carolyn Kisner, Lynn Allen Colby
    • Principles of exercise therapy: M. Dena Gardiner
    • Practical Exercise therapy by Hollis Margaret
    • PNF in Practice: An Illustrated Guide: Susan S. Adler , Dominiek Beckers, Math Buck
    Reference Books:
    • Principles of muscle testing by Hislop.
    • Proprioceptive Neuromuscular Facilitation: Patterns and Techniques Voss , Ionta & Myers
    • Facilitated Stretching -Robert McAtee , Jeff Charland
    • Relaxation Techniques: A Practical Handbook for the Health Care Professional , Marie Donaghy , Rosemary A. Payne & Keith Bellamy
    • Water Exercise : 78 Safe and Effective Exercises for Fitness and Therapy Martha White
    • Yoga as Therapeutic Exercise: A Practical Guide for Manual Therapists Luise Worle , Erik Pfeiff
    • Proven Therapeutic Exercise Techniques: Best Practices for Therapists and Trainers – R. Eric Oestmann
    • Therapeutic Exercise in Developmental Disabilities Barbara H. Connolly, Patricia Montgomery
    • Therapeutic Exercise: Moving Toward Function – Lori Thein Brody, Carrie M. Hall
    • Therapeutic Exercises Using the Swiss Ball: Caroline Corning Creager , Caryl Riedel , Mike Berry
    • Ultimate Core Ball Workout: Strengthening and Sculpting Exercises Jeanine Detz
    • Therapeutic Exercises Using Foam Rollers[Paperback] Caroline Corning Creager
    • Therapeutic Exercises Using Resistive Bands[Paperback] Caroline Corning Creager
    • Therapeutic Exercise: Techniques for Intervention : William D. Bandy, Barbara Sanders
    • Advanced Fitness Assessment and Exercise Prescription : Vivian H. Heyward
    • Progressive Exercise Therapy in Rehabilitation and Physical Education: John H. Colson
    • New Directions in Progressive Relaxation Training: A Guidebook for Helping Professionals: Douglas A. Bernstein , Thomas D. Borkovec
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South Gujarat Medical Education & Research Center
SPB (BPT & MPT) Physiotherapy College,
Ugat-Bhesan Road, Mora Bhagal,
Rander Road,

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Phone: +91 95373 69696