D.a.p.r.e, Cryokinetics, Cryostretch 463k4b
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Daily adjustable progressive resistance exercise technique
D.A.P.R.E.
D.A.P.R.E. To Develop Strength
The athlete must perform some progressive resistive exercises on a regular basis if an increase of strength is desired The D.A.P.R.E. technique takes advantage of the fact that strength can be redeveloped much more quickly than it was developed initially. Patients perform maximal repetitions during their third and fourth sets, with the number or repetitions performed used as a basis for adjusting the resistance for the fourth set and next day, respectively. Each side of the body should be worked independently
Prevents the injured limb from depending on the non-injured one It establishes a functional strength-development goal for the injured side.
D.A.P.R.E. Set
Portion of working weight used
Number of repetitions
1
1/2
10
2
3/4
6
3
Full
Maximum*
4
Adjusted
Maximum**
*The number of repetitions performed during the third set is used to determine the adjusted working weight for the fourth set, according to the guidelines in the next table
**The number of repetitions performed during the fourth set is used to determine the adjusted working weight for the next day, according to the guidelines in the next table
Adjustment of Working Weight Number or repetitions performed during set
Fourth set*
Next day**
0-2
Decrease 5-10 lb. and perform the set over
Keep the same
3-4
Decrease 0-5 lb.
Increase 5-10 lb.
5-7
Keep the same
Increase 5-15 lb.
8-12
Increase 5-10 lb.
Increase 10-20 lb.
13 to…
Increase 10-15 lb.
Set
Portion of working weight used
Number of repetitions
1
1/2
10
2
3/4
6
3
Full
Maximum*
4
Adjusted
Maximum**
Number or repetitions performed during set
Fourth set*
Next day**
0-2
Decrease 5-10 lb. and perform the set over
Keep the same
3-4
Decrease 0-5 lb.
Increase 5-10 lb.
5-7
Keep the same
Increase 5-15 lb.
8-12
Increase 5-10 lb.
Increase 10-20 lb.
13 to…
Increase 10-15 lb.
Cryokinetics in Rehabilitation of t Sprains
Cryokinetics
Effects
Cold decreases pain Exercise increases blood flow Exercise reestablishes neuromuscular function
Cryokinetics
Advantages
Cryokinetics allows exercise much sooner than normally would be the case. Cryokinetics retards muscular atrophy and neural inhibitions. Cryokinetics reduces swelling dramatically through muscular “milking action” You can progress at the patient’s speed
Cryokinetics
Disadvantages
Ice is very painful during the initial ice immersion.
Cryokinetics
Indications
Ankle sprains Finger sprains Shoulder sprains Other t sprains
Cryokinetics
Contraindications
Do not perform any exercise or activity that causes pain Do not use ice on a person who is hypersensitive to cold.
Cryokinetics
Precautions
Pain must be used as a guideline With lower extremity injuries, patients may limp if not frequently reminded to refrain from limping. There may be an increase in pain 4 to 8 hours after treatment.
Cryokinetics
Equipment Needed
Slush bucket or ice packs Toe cap Towel
Application Procedures
Numb the Body Part
Use ice immersion, ice massage, or coldpack application Numbing generally takes 12-20 min. The patients sensation is more significant than the time of application Use a toe cap
Application Procedures
Exercise the numbed body part
All exercise should be
Exercise should last 2 to 3 minutes, the duration of the numbness
Active Progressive Pain-free
Renumbing takes 3 to 5 min.
Begin with simple rang-of-motion activities and progress through full-sport activity. With some injuries, progression through full-sport activity will take place in a single treatment session, while with others it may take weeks.
Exercise Progression For an Ankle Strain
Non-weight-bearing range of motion Weight-bearing Weight-bearing range of motion Walking Strengthening the ankle musculature Jogging Hopping and jumping Sprints Hopping and sprinting without ice application Team drills
Relieving Acute Muscle Spasm: Cryostretch
Cryostretch
Combines three techniques for reducing muscle spasm:
Cold application Static stretching The hold-relax technique of PNF
Its purpose is to decrease muscle spasm, thereby allowing increased flexibility. Is similar to cryokinetics in that exercise is performed while the body part is numbed.
Cryostretch
Effects
Ice diminishes pain and muscle spasm Static stretching overcomes the stretch reflex, decreasing muscle spasm. Relaxation is often greater after a nearmaximal muscular contraction than it was before the contraction.
Cryostretch
Advantages
The combination of the three components into one procedure is more effective than any of the parts independently. Ice is relatively inexpensive; exercise is free.
Cryostretch
Disadvantages
Ice is painful to some people Melting ice can be messy.
Cryostretch
Indications
Any muscle with residual muscle spasm First-degree muscle strain A muscle that is stiff from prolonged disuse (immobilized)
Cryostretch
Contraindications
Do not perform any exercise or activity that causes pain. Do not use ice on a person who is hypersensitive to cold.
Cryostretch
Precautions
Pain must be used as a guideline. The patient should not attempt to consciously or willfully overcome pain. There may be an increase in pain 4 to 8 hours after treatment. Muscles may tear or pull if the static exercise begins too quickly or suddenly. There must be a gradual build-up to a maximal conatraction.
Summary Of Cryostretch Technique
ICE - Until numb (20 minutes maximum) Exercise Bout
First Stretch
Rest - 20 seconds Second Stretch
20 sec. 5 sec. 10 sec. 5 sec. 10 sec. 5 sec. 10 sec.
(Same as first stretch)
Renumb with 3 to 5 minutes ice application Exercise Bout
Static stretch Isometric contraction Static stretch Isometric contraction Static stretch Isometric contraction Static stretch
Total of 65 sec.
Two stretches (65 sec.) with a 20 sec. rest between stretches
Renumb with 3 to 5 minutes ice application Exercise Bout
Two stretches (65 sec.) with a 20 sec. rest between stretches
D.A.P.R.E.
D.A.P.R.E. To Develop Strength
The athlete must perform some progressive resistive exercises on a regular basis if an increase of strength is desired The D.A.P.R.E. technique takes advantage of the fact that strength can be redeveloped much more quickly than it was developed initially. Patients perform maximal repetitions during their third and fourth sets, with the number or repetitions performed used as a basis for adjusting the resistance for the fourth set and next day, respectively. Each side of the body should be worked independently
Prevents the injured limb from depending on the non-injured one It establishes a functional strength-development goal for the injured side.
D.A.P.R.E. Set
Portion of working weight used
Number of repetitions
1
1/2
10
2
3/4
6
3
Full
Maximum*
4
Adjusted
Maximum**
*The number of repetitions performed during the third set is used to determine the adjusted working weight for the fourth set, according to the guidelines in the next table
**The number of repetitions performed during the fourth set is used to determine the adjusted working weight for the next day, according to the guidelines in the next table
Adjustment of Working Weight Number or repetitions performed during set
Fourth set*
Next day**
0-2
Decrease 5-10 lb. and perform the set over
Keep the same
3-4
Decrease 0-5 lb.
Increase 5-10 lb.
5-7
Keep the same
Increase 5-15 lb.
8-12
Increase 5-10 lb.
Increase 10-20 lb.
13 to…
Increase 10-15 lb.
Set
Portion of working weight used
Number of repetitions
1
1/2
10
2
3/4
6
3
Full
Maximum*
4
Adjusted
Maximum**
Number or repetitions performed during set
Fourth set*
Next day**
0-2
Decrease 5-10 lb. and perform the set over
Keep the same
3-4
Decrease 0-5 lb.
Increase 5-10 lb.
5-7
Keep the same
Increase 5-15 lb.
8-12
Increase 5-10 lb.
Increase 10-20 lb.
13 to…
Increase 10-15 lb.
Cryokinetics in Rehabilitation of t Sprains
Cryokinetics
Effects
Cold decreases pain Exercise increases blood flow Exercise reestablishes neuromuscular function
Cryokinetics
Advantages
Cryokinetics allows exercise much sooner than normally would be the case. Cryokinetics retards muscular atrophy and neural inhibitions. Cryokinetics reduces swelling dramatically through muscular “milking action” You can progress at the patient’s speed
Cryokinetics
Disadvantages
Ice is very painful during the initial ice immersion.
Cryokinetics
Indications
Ankle sprains Finger sprains Shoulder sprains Other t sprains
Cryokinetics
Contraindications
Do not perform any exercise or activity that causes pain Do not use ice on a person who is hypersensitive to cold.
Cryokinetics
Precautions
Pain must be used as a guideline With lower extremity injuries, patients may limp if not frequently reminded to refrain from limping. There may be an increase in pain 4 to 8 hours after treatment.
Cryokinetics
Equipment Needed
Slush bucket or ice packs Toe cap Towel
Application Procedures
Numb the Body Part
Use ice immersion, ice massage, or coldpack application Numbing generally takes 12-20 min. The patients sensation is more significant than the time of application Use a toe cap
Application Procedures
Exercise the numbed body part
All exercise should be
Exercise should last 2 to 3 minutes, the duration of the numbness
Active Progressive Pain-free
Renumbing takes 3 to 5 min.
Begin with simple rang-of-motion activities and progress through full-sport activity. With some injuries, progression through full-sport activity will take place in a single treatment session, while with others it may take weeks.
Exercise Progression For an Ankle Strain
Non-weight-bearing range of motion Weight-bearing Weight-bearing range of motion Walking Strengthening the ankle musculature Jogging Hopping and jumping Sprints Hopping and sprinting without ice application Team drills
Relieving Acute Muscle Spasm: Cryostretch
Cryostretch
Combines three techniques for reducing muscle spasm:
Cold application Static stretching The hold-relax technique of PNF
Its purpose is to decrease muscle spasm, thereby allowing increased flexibility. Is similar to cryokinetics in that exercise is performed while the body part is numbed.
Cryostretch
Effects
Ice diminishes pain and muscle spasm Static stretching overcomes the stretch reflex, decreasing muscle spasm. Relaxation is often greater after a nearmaximal muscular contraction than it was before the contraction.
Cryostretch
Advantages
The combination of the three components into one procedure is more effective than any of the parts independently. Ice is relatively inexpensive; exercise is free.
Cryostretch
Disadvantages
Ice is painful to some people Melting ice can be messy.
Cryostretch
Indications
Any muscle with residual muscle spasm First-degree muscle strain A muscle that is stiff from prolonged disuse (immobilized)
Cryostretch
Contraindications
Do not perform any exercise or activity that causes pain. Do not use ice on a person who is hypersensitive to cold.
Cryostretch
Precautions
Pain must be used as a guideline. The patient should not attempt to consciously or willfully overcome pain. There may be an increase in pain 4 to 8 hours after treatment. Muscles may tear or pull if the static exercise begins too quickly or suddenly. There must be a gradual build-up to a maximal conatraction.
Summary Of Cryostretch Technique
ICE - Until numb (20 minutes maximum) Exercise Bout
First Stretch
Rest - 20 seconds Second Stretch
20 sec. 5 sec. 10 sec. 5 sec. 10 sec. 5 sec. 10 sec.
(Same as first stretch)
Renumb with 3 to 5 minutes ice application Exercise Bout
Static stretch Isometric contraction Static stretch Isometric contraction Static stretch Isometric contraction Static stretch
Total of 65 sec.
Two stretches (65 sec.) with a 20 sec. rest between stretches
Renumb with 3 to 5 minutes ice application Exercise Bout
Two stretches (65 sec.) with a 20 sec. rest between stretches
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