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 Number of repetitions
weight used
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 Fourth set* Next day**
performed during set

0-2 Decrease 5-10 lb. and Keep the same

perform the set over

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 Number of repetitions
weight used
1 1/2 10
2 3/4 6
3 Full Maximum*
4 Adjusted Maximum**

Number or repetitions Fourth set* Next day**

performed during set
0-2 Decrease 5-10 lb. and Keep the same
perform the set over
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 Joint 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 patients
speed
 Cryokinetics
Disadvantages
Ice is very painful during the initial ice
immersion.
 Cryokinetics
Indications
Ankle sprains
Finger sprains
Shoulder sprains
Other joint 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 cold-
pack 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
Active
Progressive
Pain-free
Exercise should last 2 to 3 minutes, the duration of the
numbness
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 near-
maximal 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 Total of 65 sec.
Static stretch 20 sec.
Isometric contraction 5 sec.
Static stretch 10 sec.
Isometric contraction 5 sec.
Static stretch 10 sec.
Isometric contraction 5 sec.
Static stretch 10 sec.
Rest - 20 seconds
Second Stretch (Same as first stretch)
Renumb with 3 to 5 minutes ice application
Exercise Bout
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