Chapter 30

Biomechanical principles of the exercise

design
Elif Turgut1 and Gul Baltaci2
1
Faculty of Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey, 2Department of Physiotherapy and Rehabilitation, Ankara
Guven Hospital, Ankara, Turkey

Introduction Individuality: Optimal benefits occur when exercise

meet the individuals needs and capacities of the
From the perspective of the evidence-based medicine, the patient or client. The exercise prescription should be
exercise therapy is the best available active treatment based on individual needs that will change by person
method for several neuro-musculo-skeletal disorders to person.
(Smidt et al., 2005; White et al., 2011; Swart et al., 2016; Trainability: It is another principle that explains each
Bartholdy et al., 2017; da Silva Rosa et al., 2017; New person responds differently to the same training
et al., 2017; Sandler et al., 2017). The human body is tend stimulus.
to get better at what it performing regularly (Eisner, 2017). Specificity: The training stimulus must be specific to
So that when the human body is stressed under some form the patient or clients desired outcomes. Therefore,
of loading, that will lead adaptations; thus, it will allow the exercise design must be specific to individuals’ goals.
human body to get a better state that the specific form of Overload: It is important to consider that for adapta-
biological stress in the future. Therefore, the exercise tion to occur the volume of exercise must overload the
design is important for everyone and for individuals with body in some way in line with the capacity of the indi-
the specific demands and the applying the biomechanical vidual to cope with that overload.
principles simply changes stress in any particular exercise. Progressive Overload: For continual adaptation over-
The wide variety of exercise movements carried out by the load must be progressive, that is the dose of loading or
human musculoskeletal system are all performed by the stress must increase.
same elements: muscles, bones, joints, and the nervous Variability: It should be kept in mind that for
system including receptors (Brewer, 2017). Biomechanics optimal adaptation and to avoid stagnation, overuse,
can be defined as the application of the physics to the and injury the exercise stimulus must be varied.
movement, and can be accepted as an one of the important Therefore, variety allows recovery and can reduce
field for studying body movement and performance (van injury risk.
Keeken et al., 2016). From this point of view, the exercise Rest: Optimal adaptation requires sufficient rest peri-
movements can be assessed through biomechanical princi- ods to be interspersed with training sessions that the
ples. This chapter includes, application of the biomechani- adaptations caused by the exercise dose can take
cal principles combined with neuromuscular efficiency, place.
neural adaptation, proprioceptive demands and optimal Reversibility: All beneficial effects of exercise training
neuromuscular control for exercise design. are reversible if exercise ceases.
Overall, each of the exercise components has an ideal
Basic principles of exercise training frequency, intensity, time and type of exercise
Through its basic principles, exercise movement can be (FITT) to be used. The FITT principle is largely a practi-
progressed easily to adapt to the patient’s condition and cal integration of all the other exercise principles
to create targeted physiological effects.

Comparative Kinesiology of the Human Body. DOI: https://doi.org/10.1016/B978-0-12-812162-7.00030-8

© 2020 Elsevier Inc. All rights reserved. 527
528 PART | 8 Locomotion

Mechanical basis of exercise design Matveev, 1964; Komi and Tesch, 1979) also confirmed
the relationship between velocity and exerted force during
Basic concepts of biomechanics in exercise the complex sportive activities. The force velocity curve
design presents that the velocity of muscular contraction is
inversely proportional to the loading indicating that larger
Biomechanics is a scientific discipline including the
forces cannot be exerted in very rapid movements and the
mechanical principles and equations to understand how
greatest velocities are attained under conditions of low
the human body functions in a wide spectrum of move-
loading. In Fig. 30.1, the area under the curve represents
ments and exercise activities (Winter, 2009). However,
power which equals to force 3 velocity. Increase in
this approach has often been criticized since like any
strength changes curve profile, which means power is
other scientific discipline, the biomechanical principles of
increased at all points on the curve. Previously, the
the exercise design have limitations of the paradigms,
effect of heavy strength training has been shown to
which regard the human body as a physical machine
shift the curve upwards (Perrine and Edgerton, 1977;
(Raikova, 1999; Siff, 2000; Dudley, 2002; van Keeken
Caiozzo et al., 1981; Lamb, 1984), Velocity is important
et al., 2016). Biomechanics should be applied to exercise
when considering ballistic exercises such as plyometrics.
training and sports within an integrated framework com-
It has been shown that light, high-velocity training
prising all possible fields which relate to the structure and
shifts the maximum of the velocity curve to the right
function of the human body.
(Zatsiorsky, 1995).
Force
Work
When force applied to an object, the object starts to
move, stop, speed up, slow down, or change direction of Work is the product of force and the amount of displace-
the movement. That is explained in 1st. rule of Newton. ment (Harman, 1993). The Joule is the unit of work equal
Since the force is a vectoral quantity, it needs specifica- to the work done by a force of one newton when its point
tion of direction, velocity, acceleration, force and of application moves one meter in the direction of action
moment. During resistive exercise training, if applied of the force, equivalent to one 3600th of a watt-hour.
force is changed in amount, the intensity of the exercise
alters. The direction of the force affects the activated Movement planes
muscle groups. The universal method for defining movements is based on
the plane and the axes system (Fig. 30.2). A plane is a
Velocity flat, two-dimensional virtual surface. There are three car-
The velocity V is the rate of change in position of a mov- dinal planes that intersecting at the center of gravity of
ing object with respect to time (m s21). Hill described the the human body (Fig. 30.3). Anatomical point of view, a
dependence of force on velocity of movement for isolated movement may be parallel to one of these planes, moving
muscle with very best known hyperbolic curve in 1953 segment rotates around an axis which perpendicular to the
(Fig. 30.1; Gülch, 1994). Later studies (Zatsiorsky and plane.

FIGURE 30.1 The Force velocity relationship of

muscle.
 Biomechanical principles of the exercise design Chapter | 30 529

The exercise movements can be described based on (Fig. 30.5). During this exercise hip abduction is per-
the corresponding motion planes. For example, sit ups formed in closed kinetic chain movement form with using
exercise is one of the exercise that targets anterior myo- ropes and slings. The successful exercise is performed
fascial chains with focus on rectus abdominis muscle, while maintaining upright body position. The optimal
which contains movement on the sagittal plane (Fig. 30.4) position to observe frontal plane movements is from ante-
(Whiting et al., 1999). The sagittal plane movements are rior or posterior side of the human body.
best viewed from the lateral side of the body. The forearm supination-pronation exercise is an exam-
Sling based hip abduction exercise can be given as an ple of an exercise in the transvers plane, a simple ana-
example of exercise movement in the frontal plane tomic motion on the transvers plane. (Fig. 30.6).
In the kinetic chain approach, exercise movements
may occur include on multiple planes in the different
joints. During the lawnmower exercise, for example, the
lower extremity appears to move on the sagittal plane as
the knees and the hips moving into flexion-extension
(Fig. 30.7) while the torso rotates on the transvers plane.

Degree of freedom in exercise

The degree of freedom (DF) term may be used to
describe any exercise movement in a corresponding
plane. However, these terms are widely used to define
the amount of motion structurally allowed by the joints.
If a joint with 1 DF, the joint allows the segment
to move on one motion plane. For example, the elbow
FIGURE 30.2 The plane and the axis. joint moves only flexion-extension in the sagittal plane.

FIGURE 30.3 Planes and axes of the human body.

 FIGURE 30.4 The sit-ups exercise.

FIGURE 30.5 Side lying hip abduction exercise.

FIGURE 30.6 Forearm supination-pronation exercise.

 Biomechanical principles of the exercise design Chapter | 30 531

FIGURE 30.7 The lawnmower exercise.

Also, gliding and/or roll motions may occur across the

joint surfaces (Norkin and White, 2016). These motions
may be interpreted as adding to more degrees of freedom
to joints., A kinematic chain that is derived from combi-
nation of degrees of freedom at various joints produces
exercise movements. The chain is summation of the DF
in related joints that shows the total DF available or nec-
essary for a targeted exercise movement. For instance,
FIGURE 30.8 A lever system.
overhead throwing might involve a 12-DF system relative
to the trunk. This would include perhaps 3 DF at the
shoulder, 2 DF at the elbow, 2 DF at the wrist, 3 DF in
the carpal bones, and 2 DF in the fingers (Hamill and classified into as first class lever, second-class lever, and
Knutzen, 2006). third class lever. In the human body, the bones represent
the lever arm and joints represent the fulcrum. There are
three forces in a lever system:
Fundamental concepts of mechanics in exercise Effort Force: The effort force tends to create the
design desired movement. For the human body, the muscle
activity exerted the effort force. The distance from the
Mechanics is a quantitative science provides the descrip- axis to the effort force is called effort arm.
tion of the human movement in a quantitative manner Resistive Force: The resistive force tends to oppose
(Winter, 2009). All movement of the human body can the desired movement. For the human body the weight
be explained by the lever systems. Therefore, for any of a body segment or an external weight is the resis-
exercise setup, created moments by lever systems may tive force. The resistance arm is defined as a distance
guide to unload or load to change intensity of the from the motion axis to the resistive force.
exercise.
A lever is a rigid bar that moves on a fulcrum, when a The force on axis (fulcrum): The force that equalize the
force is applied to it (Fig. 30.8). The levers can be resultant torque created by effort force and resistive force.
532 PART | 8 Locomotion

Torque is defined as the rotational effect of force distributed or balanced, and through which the force of
explained as force (N) x moment arm (m) and repre- gravity acts. The CoG is a useful concept for analysis of
sented as Nm. Throughout exercise movements, the tor- human movement because it is the point at which the
que differs in joints. In any lever system, mechanical entire mass or weight of the body may be considered to
advantage could either be in a favor of the effort force or be concentrated. Therefore, the force of gravity acts
the resistive force. This depends on the ratio of effort downward through this point to the surface. For human
arm to resistance arm (Garcı́a-Morales et al., 2003). If body, standing in the anatomical position, CoG lies
this ratio . 1, the effort force is greater than the resis- approximately slightly anterior to the second sacral verte-
tive force. On the other hand, if the ratio ,1, the effort bral body (Palmer, 1944). This point always changes
force is less than the resistive force. When considering since the human body moves and does not remain fixed
the types of muscular contraction, a concentric muscular in the anatomical position during daily life and exercising.
action occurs when the produced muscular force is The location of the CoG changes constantly with every
greater than the resistance, therefore as in the biceps curl unique position of the body and limbs. The exercise spe-
exercise, the biceps brachii shortens. On the other hand, cifications may change when the distance between seg-
an eccentric action occurs when the force generated by mental CoG and the common CoG is changed. For
the muscle is less than the resistance, so the muscle example, during sit-ups exercise, abdominal muscles may
actively lengthens. work harder in arm flexed position than in arm extended
Because of their fundamental importance, implications by side because the location of CoG move proximally and
of the exercise mechanics may be explained by Newton’s increase resistance to the abdominal muscles. The anthro-
Laws of Motion. For example, according to Newton’s pometric characteristics of the individuals also affect the
third law (Law of Reaction), when force applied to a sta- location of the CoG in nature (Hasan et al., 1996). Another
bile object creates an equal and opposite reaction force. terms such as stability often used while explaining balance
This means that when two objects exert a force on each or capability of body that returning to previous position
other and if objects are not in the move the forces are after a perturbation. Apparently, the stability of a human
equal in magnitude and opposite in direction. During wall body is affected by the factors such as the height of the
press exercise performed with balance disc, there is an CoG, the size of the base of support, and the weight of the
equal and opposite reaction force occurs between upper body. The base of support is the area within the boundaries
extremity and the wall through disc (Fig. 30.9). connecting each points of support. Different exercise set
Balance is an important variable for assessing human ups can be used for creating various base of support area;
neuromuscular function. From the mechanical perspec- thus, increase the level of challenge for the neuromuscular
tive, an object is in static equilibrium when the resultant system. Fig. 30.10 shows examples of various exercise
force or moment is equal to zero. If the forces and positions with different bases of support area.
moments do not add up to zero, the object would not be Movement is described as a change in place, position,
in static equilibrium and it would move considering or posture occurring over time or relative to any point in
Newton’s second law, the object would accelerate as well. the space. There are two types of motion are presented.
Center of gravity (CoG) is the virtual point in a body Firstly, The motion may be linear, in which all points on
or an object around which it’s mass or weight is evenly a body or an object move the same distance and direction
in the same amount of time. The pathway either can be
straight (rectilinear) or curved (curvilinear) such as trajec-
tory of a thrown ball. The common idea behind the activ-
ity with linear motion is that activity occurs on a
particular direction, follows a path. The linear motion can
be easily analyzed by the observing the motion of the cen-
ter of mass of an object. For human body, it is also possi-
ble to analyze the center of mass or any selected point of
a body segment for linear motion analysis. All linear
motion during daily life activities and sports performance
occur as a result of angular contributions of the body seg-
ments through joints. At the joint, angular motion of the
relevant body segment occurs around an imaginary line
called the axis of the motion. During angular motion, the
body segment do not move through the same distance and
direction in a specific time duration. For example, swing-
FIGURE 30.9 Wall press exercise. ing of a gymnast on the bar is an angular motion.
 Biomechanical principles of the exercise design Chapter | 30 533

FIGURE 30.10 Base of support area in different exercise set-ups.

Identifying the type of motion in a particular exercise equilibrium against external forces can be measured by
helps to mechanically analyze the exercise. specific instruments such as forceplates, accelerometers
The biomechanical analysis of any exercise movement and EMG. The external and internal forces acting on the
can be performed using kinematics and kinetics. The human body and by human body (internal forces) can be
kinematics is concerned with the spatial and temporal calculated according to its segmental position in a given
characteristics of exercise movement without reference to time and obtained kinematic data of that pre-defined
the forces causing the motion. Kinematic analysis can motion. This inverse dynamic procedure widely used
provide information about position, velocity, and acceler- for movement analysis. Therefore, a kinetic analysis
ation such as speed of body segment during jumping or can provide information about movement quality, har-
degree of scapular rotation during shoulder elevation mony within the involved muscles in specific duration
exercise. Fig. 30.11 represents three-dimensional scapular which the movement required. This would also provide
kinematics during humero-thoracic elevation. The move- base information for exercise design in training and
ment occurs on the clavicle, scapula, and humerus. The rehabilitation.
coupled rotations in the sternoclavicular and acromiocla-
vicular joints are result in scapular movements and it
depends on factors such as thoracic posture, amount Internal biomechanics
and direction of resultant force exerted by muscles, condi- The any exercise movements are determined by the exter-
tion of acromioclavicular and sternoclavicular joints nal forces acting on the body segments. These forces
(Ludewig and Reynolds, 2009). always create internal forces for moving the body part
Kinetics examines the forces acting on the human against the external force or equalize the external force to
body. A force that creates movement or provide keep body segment still. Forces on the body segments
534 PART | 8 Locomotion

FIGURE 30.11 Scapular kinematics during

resisted shoulder elevation exercise.

eventually affect the internal structures such as cartilage, force (internal load) including stretching of the other sur-
tendons, ligaments, bones, and muscles. During single leg rounded soft tissues to neutralize external load. If amount
squat exercise on the knee joint, femur is pulled to flexion of the external force and its fulcrum is known, the internal
by gravity force (external load) and muscle exerts the forces could be calculated. In Additionally, the force
 Biomechanical principles of the exercise design Chapter | 30 535

contributions of ligaments and fasciae and other surround- Based on a specific aim, the exercise training can be
ing soft tissues can also be considered. Although research- designed by using an appropriate approach and technique,
ers have described the load bearing capacity of the fasciae considering the type of muscle contraction involved, the
(Bogduk and Macintosh, 1984; Stecco et al., 2007), the speed of movement and acceleration over different phases
research on the forces exerted by fasciae are still limited of movement, which are the exercise intensity, the rest inter-
(McGill and Norman, 1988). vals, the involved agonists and antagonists, and stabilizers
If we consider all kinetic chain segments together, the and movers. Therefore, the exercise design is important for
forces between body segments are produced by a combi- individuals with specific demands, and the biomechanical
nation of the reaction forces at each joint surface and the principles simply change stress in any particular exercise.
actions of the muscles crossing each joint.

Open kinetic chain exercises

Exercise training Open kinetic chain exercises do not require fixing of the
terminal segment and allow the terminal segment to move
In the era of evidence-based medicine, exercise therapy is
freely (Gowitzke and Milner, 1988; Lephart and Henry,
the best available active treatment method for several
neuro-musculo-skeletal disorders (Van den Ende et al., 1996; Camci et al., 2013). Open kinetic chain exercises
usually aims for strengthening. Resistive exercises often
1998; van der Lee et al., 2001; Taylor, Brown et al.,
used for strength training with using various equipment
2004; Hayden et al., 2005; Valkenet Port et al., 2011).
such as dumbbells, medicine balls, elastic bands, and
The effective and safe prescription of the exercise training
weight machines. While applying external resistance to
begins with single exercise design. The Specific
the relative limb, the clinicians should consider some
Adaptation to Imposed Demand (SAID) principle can be
principles that will change the loading.
accepted as one of the most important basic concepts in
As an example, consider the weighted biceps curl exer-
the exercise therapy. SAID means that when the body is
placed under some form of stress, it starts to make adapta- cise. During this exercise, biceps brachii and brachioradia-
lis muscles generate forces F1 and F2. Perpendicular
tions that will allow the body to get better at withstanding
distances between the lines of action of the forces and the
that specific form of stress in the future (Fox and
center of rotation at the elbow joint are (d1) and (d2)
Mathews, 1981). There could be various objectives of any
respectively. F3 represents the loading force and the d3
exercise design including the parameters below but not
represents the perpendicular distance between the lines of
limited to:
action of the forces and the center of rotation (Fig. 30.12).
G to increase strength and endurance; The moment generated can be calculated as M 5 F1 x
G to increase explosive power; d1 1 F2 x d2 F3 x d3. The greater distance between the
G to facilitate the muscles to sustain forces for a pro- action line of the force and the center of rotation of the
longed time; joint (the greater the lever arm) result with the greater
G to increase or maintain muscular hypertrophy; and, moment of the force (Fig. 30.12A). If the same amount of
G to improve neuro-musculo-skeletal function. weight applied on the wrist with bag instead of holding

FIGURE 30.12 Weighted biceps curl exercise, (A) using hand dumbbell, (B) weight bag at the wrist.
536 PART | 8 Locomotion

hand dumbbell, to flex the elbow joint, force generated by advantages of applying closed kinetic chain exercises
the muscles decreases as the d3 decreases (Fig. 30.12B). (Lutz et al., 1993; Yack et al., 1993; Wilk et al., 1996;
The range of motion on elbow joint during this exercise Beynnon et al., 1997; Escamilla et al., 1998; Turgut et al.,
also affects the mechanical loading. If the biceps curl per- 2016). It is recommended especially for early knee reha-
forms starting from 0 of elbow extension to elbow flexion, bilitation (e.g. anterior cruciate ligament reconstruction)
the length of the effort arm is continuously be increased. and (Wright et al., 2008). Closed kinetic chain exercises often
mechanical advantage is going to be greatest at 85 100 involve multi-joint movements and body weight bearing
of elbow flexion. While the longer effort arm provides the conditions which affect biomechanical and neuromuscular
mechanical advantage, as the muscle will be shorter and needs of the individuals (Tucker et al., 2010). There is
overlapped myofilaments in full range of elbow flexion agonist-antagonist muscular co-contraction around joints
reduces force capacity as it was first described by Gordon (Pincivero et al., 2000; Stensdotter et al., 2003), and artic-
et al. (1966), defining the force-length relationship and its ular compressive forces increase (Lutz et al., 1993) during
direct relation to the myofilament overlap. Therefore, if the closed kinetic chain exercise.
full range of elbow flexion is chosen during the biceps curl The squat exercise is commonly used exercise by phy-
exercise, the biceps muscle loses the force capacity. siotherapists and trainers, since there is scientific findings
The type of external load can alter the biomechanical showing its effectiveness for improving muscle endur-
demand of the exercise. Likewise, the elastic bands also ance, strength, and power (Fisher et al., 2011). The squat
provide some form of resistance, allow free range of is a multi-joint exercise, designed to aim to improve mus-
motion, variable speed of movement, and progressive cular performance of the lower body. There is some mod-
resistance. Based on their ease of use, low cost, and porta- ification of the squat exercises, such as the bodyweight
bility, elastic bands are frequently used in clinical practice squat, back-squat, front-squat, sumo-squat, split-squat,
to provide resistance in fitness and rehabilitation box-squat, or single-leg squat. However, commonly, the
(Patterson et al., 2001). Elastic bands provide variable posture and mobility towards hip and knee flexion and
resistance based on physical properties such as the elon- ankle dorsiflexion are the important components. In this
gation of the elastic material (Hughes et al., 1999). exercise, as a starting position, an individual is asked to
However, earlier studies have shown that muscle activity keep standing position with feet shoulder-width apart,
and peak load during elastic-resistance exercise is similar toes pointing straight ahead, and knees aligned over sec-
to free-weight resistance exercise (Treiber et al., 1998; ond and third toes. As much as 5 8 of external foot
Hughes et al., 1999; Patterson et al., 2001; McMaster rotation is allowed in the starting position (Schoenfeld,
et al., 2009). On the other hand, recent studies have inves- 2010). Then, individual is asked to perform squat without
tigated electromyographic signals to compare muscle acti- any movement compensations such as increased knee val-
vation in resistance exercises using both elastic and gus, lumbar lordosis, forward lean of the torso, and prona-
conventional resistance showed that conventional resis- tion of the foot. From biomechanical perspective, these
tance was found to be the favorable modality (Sundstrup compensations result in lower 1RM and unsafe loads.
et al., 2014; Vinstrup et al., 2017). In general, induced
muscle activity while using conventional exercise equip-
ments is greater than elastic resistance in the early concen-
Exercise training across lifespan
tric phase of the movement. However, when the elastic To promote and maintain health, American College of
band is maximally elongated the induced muscle activities Sports Medicine (ACSM) provides an evidence-based rec-
in both conditions are found similar. Biomechanically, ommendation for physical activity and exercise training
unlike free weights, elastic bands do not provide resistance for individuals across lifespan.
relying on gravity. Free weights only provide resistance in According to ACSM guidelines, adults need moderate
a vertical plane. With elastic bands, the resistance can also aerobic activity for a minimum of 150 minutes weekly or
applied on horizontal plane as in shoulder PNF exercise vigorous aerobic activity for a minimum of 60 minutes
which is accepted more functional, naturally by changing weekly. As an example; individuals can perform moderate
the direction of pull of the elastic bands (Page et al., 1993). aerobics 30 minutes daily, 5 days weekly; or, individuals
can perform vigorously intense cardio 20 minutes daily,
3 days weekly. Additionally, individuals should perform
Closed kinetic chain exercises
8 10 different strengthening exercises, for 8 12 repeti-
There is variety of description of closed kinetic chain tions of each exercise twice weekly.
exercises. It is widely accepted that closed kinetic chain On the other hand, it is essential to promote youth pop-
exercise requires weight-bearing position of the extremity ulation to participate more in physical activity. Of course,
by fixing the distal segment to a mobile or immobile that prescribed physical activity should be appropriate
object. Biomechanical studies support the rationale for for their age and enjoyable. Children and adolescents
 Biomechanical principles of the exercise design Chapter | 30 537

(ages between 6 through 17 years) should perform mini- Gowitzke, B.A., Milner, M., 1988. Scientific Bases of Human
mum of 60 minutes moderate to vigorous activity daily at Movement. Williams & Wilkins.
least 3 days a week. The daily physical activity for children Gülch, R., 1994. Force-velocity relations in human skeletal muscle. Int.
and adolescents should include muscle-strengthening and J. Sports Med. 15 (S 1), S2 S10.
Hamill, J., Knutzen, K.M., 2006. Biomechanical Basis of Human
bone-strengthening exercises on at least 3 days a week.
Movement. Lippincott Williams & Wilkins.
However, same exercise program does not suitable for
Harman, E., 1993. EXERCISE PHYSIOLOGY: strength and power: a
everyone, but it may help to see a sample exercise sched- definition of terms. Strength Cond. J. 15 (6), 18 21.
ule that allow a person to start. This may include all the Hasan, S.S., Robin, D.W., Szurkus, D.C., Ashmead, D.H., Peterson, S.
exercise program a person needs, from beginners to more W., Shiavi, R.G., 1996. Simultaneous measurement of body center
advanced level of exercise. of pressure and center of gravity during upright stance. Part I:
Methods. Gait Posture 4 (1), 1 10.
Hayden, J.A., Van Tulder, M.W., Tomlinson, G., 2005. Systematic
References review: strategies for using exercise therapy to improve outcomes in
chronic low back pain. Ann. Intern. Med. 142 (9), 776 785.
Bartholdy, C., Juhl, C., Christensen, R., Lund, H., Zhang, W., Henriksen, Hughes, C.J., Hurd, K., Jones, A., Sprigle, S., 1999. Resistance proper-
M., 2017. The role of muscle strengthening in exercise therapy for ties of Thera-Bands tubing during shoulder abduction exercise. J.
knee osteoarthritis: a systematic review and meta-regression analysis Orthopaedic Sports Phys. Ther. 29 (7), 413 420.
of randomized trials. Semin. Arthritis Rheum. Elsevier. Komi, P.V., Tesch, P., 1979. EMG frequency spectrum, muscle struc-
Beynnon, B.D., Johnson, R.J., Fleming, B.C., Stankewich, C.J., ture, and fatigue during dynamic contractions in man. Eur. J. Appl.
Renström, P.A., Nichols, C.E., 1997. The strain behavior of the ante- Physiol. Occup. Physiol. 42 (1), 41 50.
rior cruciate ligament during squatting and active flexion-extension Lamb, D.R., 1984. Physiology of Exercise: Responses and Adaptations.
a comparison of an open and a closed kinetic chain exercise. Am. J. Macmillan.
Sports Med. 25 (6), 823 829. Lephart, S.M., Henry, T.J., 1996. The physiological basis for open and
Bogduk, N., Macintosh, J.E., 1984. The applied anatomy of the thoraco- closed kinetic chain rehabilitation for the upper extremity. J. Sport.
lumbar fascia. Spine 9 (2), 164 170. Rehabil. 5, 71 87.
Brewer, C., 2017. Athletic Movement Skills: Training for Sports Ludewig, P.M., Reynolds, J.F., 2009. The association of scapular kine-
Performance. Human Kinetics. matics and glenohumeral joint pathologies. J. Orthop. Sports Phys.
Caiozzo, V.J., Perrine, J.J., Edgerton, V.R., 1981. Training-induced Ther. 39 (2), 90 104.
alterations of the in vivo force-velocity relationship of human mus- Lutz, G.E., Palmitier, R., An, K.-N., Chao, E., 1993. Comparison of
cle. J. Appl. Physiol. 51 (3), 750 754. tibiofemoral joint forces during open-kinetic-chain and closed-
Camci, E., Duzgun, I., Hayran, M., Baltaci, G., Karaduman, A., 2013. kinetic-chain exercises. J. Bone Jt. Surg. 75 (5), 732 739.
Scapular kinematics during shoulder elevation performed with and McGill, S., Norman, R., 1988. Potential of lumbodorsal fascia forces to
without elastic resistance in men without shoulder pathologies. J. generate back extension moments during squat lifts. J. Biomed. Eng.
Orthop. Sports Phys. Ther. 43 (10), 735 743. 10 (4), 312 318.
da Silva Rosa, K.P., Martinez, F.G., Peyré-Tartaruga, L.A., 2017. Benefits McMaster, D.T., Cronin, J., McGuigan, M., 2009. Forms of variable
of aquatic exercise therapy on locomotion in low back pain subjects: a resistance training. Strength Cond. J. 31 (1), 50 64.
narrative literature review. Mov. Sports Sciences-Science Motricité . New, C.C., Dannaway, J., New, H., New, C.H., 2017. Motor control
Dudley, R., 2002. The biomechanics of insect flight: form, function. exercise for chronic non-specific low-back pain (PEDro synthesis).
Evolution. Princeton University Press. Br. J. Sports Med. bjsports-2016-097266.
Eisner, E.W., 2017. The Enlightened Eye: Qualitative Inquiry and the Norkin, C.C., White, D.J., 2016. Measurement of Joint Motion: A Guide
Enhancement of Educational Practice. Teachers College Press. to Goniometry. FA Davis.
Escamilla, R.F., Fleisig, G.S., Zheng, N., Barrentine, S.W., Wilk, K.E., Page, P.A., Lamberth, J., Abadie, B., Boling, R., Collins, R., Linton, R.,
Andrews, J.R., 1998. Biomechanics of the knee during closed kinetic 1993. Posterior rotator cuff strengthening using Therabands in a
chain and open kinetic chain exercises. Med. Sci. Sports Exercise 30 functional diagonal pattern in collegiate baseball pitchers. J. Athl.
(4), 556 569. Train. 28 (4), 346.
Fisher, J., Steele, J., Bruce-Low, S., Smith, D., 2011. Evidence-based Palmer, C.E., 1944. Studies of the center of gravity in the human body.
resistance training recommendations. Med. Sports 15 (3), Child. Dev. 15 (2/3), 99 180.
147 162. Patterson, R.M., Stegink Jansen, C.W., Hogan, H.A., Nassif, M.D., 2001.
Fox, E., Mathews, R., 1981. The Physiological Basis of Physical Material properties of thera-band tubing. Phys. Ther. 81 (8),
Education and Athletics. Halt-Saunders. International Edition, 1437 1445.
Philadelphia, pp. 263 346. Perrine, J.J., Edgerton, V.R., 1977. Muscle force-velocity and power-
Garcı́a-Morales, P., Buschang, P.H., Throckmorton, G.S., English, J.D., velocity relationships under isokinetic loading. Med. Sci. Sports 10
2003. Maximum bite force, muscle efficiency and mechanical (3), 159 166.
advantage in children with vertical growth patterns. Eur. J. Orthod. Pincivero, D.M., Aldworth, C., Dickerson, T., Petry, C., Shultz, T.,
25 (3), 265 272. 2000. Quadriceps-hamstring EMG activity during functional, closed
Gordon, A., Huxley, A.F., Julian, F., 1966. The variation in isometric kinetic chain exercise to fatigue. Eur. J. Appl. Physiol. 81 (6),
tension with sarcomere length in vertebrate muscle fibres. J. Physiol. 504 509.
184 (1), 170 192.
538 PART | 8 Locomotion

Raikova, R., 1999. About weight factors in the non-linear objective func- Valkenet, K., van de Port, I.G., Dronkers, J.J., de Vries, W.R.,
tions used for solving indeterminate problems in biomechanics. J. Lindeman, E., Backx, F.J., 2011. The effects of preoperative exer-
Biomech. 32 (7), 689 694. cise therapy on postoperative outcome: a systematic review. Clin.
Sandler, C.X., Goldstein, D., Horsfield, S., Bennett, B.K., Friedlander, Rehabil. 25 (2), 99 111.
M., Bastick, P.A., et al., 2017. Randomized evaluation of cognitive- Van den Ende, C., Vliet Vlieland, T., Munneke, M., Hazes, J., 1998.
behavioral therapy and graded exercise therapy for post-cancer Dynamic exercise therapy in rheumatoid arthritis: a systematic
fatigue. J. Pain Symptom Manage. review. Br. J. Rheumatol. 37 (6), 677 687.
Schoenfeld, B.J., 2010. Squatting kinematics and kinetics and their appli- van der Lee, J.H., Snels, I.A., Beckerman, H., Lankhorst, G.J.,
cation to exercise performance. J. Strength Cond. Res. 24 (12), Wagenaar, R.C., Bouter, L.M., 2001. Exercise therapy for arm func-
3497 3506. tion in stroke patients: a systematic review of randomized controlled
Siff, M., 2000. Biomechanical foundations of strength and power train- trials. Clin. Rehabil. 15 (1), 20 31.
ing. Biomechanics in Sport: Performance Enhancement and Injury van Keeken, H., de Groot, S., Vegter, R., van der Woude, L., 2016.
Prevention 103 139. Biomechanics and ergonomics. Training and Coaching the Paralympic
Smidt, N., de Vet, H.C., Bouter, L.M., Dekker, J., 2005. Effectiveness of Athlete: Handbook of Sports Medicine and Science. pp. 21 52.
exercise therapy: a best-evidence summary of systematic reviews. Vinstrup, J., Calatayud, J., Jakobsen, M.D., Sundstrup, E., Jay, K.,
Aust. J. Physiother. 51 (2), 71 85. Brandt, M., et al., 2017. Electromyographic comparison of conven-
Stecco, C., Gagey, O., Belloni, A., Pozzuoli, A., Porzionato, A., tional machine strength training versus bodyweight exercises in
Macchi, V., et al., 2007. Anatomy of the deep fascia of the upper patients with chronic stroke. Top. Stroke. Rehabil. 24 (4), 242 249.
limb. Second part: study of innervation. Morphologie 91 (292), White, P.D., Goldsmith, K.A., Johnson, A.L., Potts, L., Walwyn, R.,
38 43. DeCesare, J.C., et al., 2011. Comparison of adaptive pacing therapy,
Stensdotter, A.K., Hodges, P.W., Mellor, R., Sundelin, G., Hager-Ross, cognitive behaviour therapy, graded exercise therapy, and specialist
C., 2003. Quadriceps activation in closed and in open kinetic chain medical care for chronic fatigue syndrome (PACE): a randomised
exercise. Med. Sci. Sports. Exerc. 35 (12), 2043 2047. trial. Lancet 377 (9768), 823 836.
Sundstrup, E., Jakobsen, M., Andersen, C., Bandholm, T., Thorborg, K., Whiting, W.C., Rugg, S., Coleman, A., Vincent, W.J., 1999. Muscle
Zebis, M., et al., 2014. Evaluation of elastic bands for lower extrem- activity during sit-ups using abdominal exercise devices. J. Strength.
ity resistance training in adults with and without musculo-skeletal Cond. Res. 13 (4), 339 345.
pain. Scand. J. Med. Sci. sports 24 (5), e353 e359. Wilk, K.E., Escamilla, R.F., Fleisig, G.S., Barrentine, S.W., Andrews, J.
Swart, N.M., van Oudenaarde, K., Reijnierse, M., Nelissen, R., Verhaar, R., Boyd, M.L., 1996. A comparison of tibiofemoral joint forces and
J., Bierma-Zeinstra, S., et al., 2016. Effectiveness of exercise ther- electromyographic activit during open and closed kinetic chain exer-
apy for meniscal lesions in adults: a systematic review and meta- cises. Am. J. Sports Med. 24 (4), 518 527.
analysis. J. Sci. Med. Sports 19 (12), 990 998. Winter, D.A., 2009. Biomechanics and Motor Control of Human
Taylor, R.S., Brown, A., Ebrahim, S., Jolliffe, J., Noorani, H., Rees, K., Movement. John Wiley & Sons.
et al., 2004. Exercise-based rehabilitation for patients with coronary Wright, R.W., Preston, E., Fleming, B.C., Amendola, A., Andrish, J.T.,
heart disease: systematic review and meta-analysis of randomized Bergfeld, J.A., et al., 2008. A systematic review of anterior cruciate
controlled trials. Am. J. Med. 116 (10), 682 692. ligament reconstruction rehabilitation: part II: open versus closed
Treiber, F.A., Lott, J., Duncan, J., Slavens, G., Davis, H., 1998. Effects kinetic chain exercises, neuromuscular electrical stimulation, accel-
of Theraband and lightweight dumbbell training on shoulder rotation erated rehabilitation, and miscellaneous topics. J. Knee Surg. 21 (3),
torque and serve performance in college tennis players. Am. J. 225 234.
Sports Med. 26 (4), 510 515. Yack, H.J., Collins, C.E., Whieldon, T.J., 1993. Comparison of closed
Tucker, W.S., Armstrong, C.W., Gribble, P.A., Timmons, M.K., and open kinetic chain exercise in the anterior cruciate ligament-
Yeasting, R.A., 2010. Scapular muscle activity in overhead athletes deficient knee. Am. J. Sports Med. 21 (1), 49 54.
with symptoms of secondary shoulder impingement during closed Zatsiorsky, V., 1995. Science and Practise of Strength Training. Human
chain exercises. Arch. Phys. Med. Rehabil. 91 (4), 550 556. Kinetics Publishers.
Turgut, E., Pedersen, O., Duzgun, I., Baltaci, G., 2016. Three-dimensional Zatsiorsky, V., Matveev, E., 1964. Force-velocity relationships in throwing.
scapular kinematics during open and closed kinetic chain movements Theory Pract. Phys. Cult. 8, 24 28.
in asymptomatic and symptomatic subjects. J. Biomech.