Introduction
Muscle strengthening exercises involve tightening or tensing of muscles without moving body parts (isometric contractions). They increase muscle tension but do not change the length of muscle fibers.
Definition
Muscle strengthening exercise is a specialized physical exercise using resistance to induce muscular contraction which builds the strength, endurance, and size of skeletal muscles.
Purposes
- Improves the joint stability.
- Enhances psychological well-being.
- Results in higher resting metabolic rate.
- Improves weight loss and maintenance.
- Reduces the risk for injury.
- Prevents osteoporosis.
- Lessens chronic low back pain and arthritic pain.
- Aids in childbearing.
- Help to lower blood pressure and controls blood sugar level.
Indications
- Obesity.
- Musculoskeletal disorders such as;
- Osteoporosis.
- Arthritis.
- Chronic low back pain.
- Muscular weakness.
Contraindication
- Cardiac disorders.
Types
| Type | Examples | Purpose |
|---|---|---|
| Bodyweight Exercises | Push-ups, squats, lunges, planks, pull-ups | Build strength using your own body as resistance |
| Free Weights | Dumbbell curls, barbell squats, kettlebell swings | Improve coordination and engage stabilizer muscles |
| Resistance Bands | Band rows, lateral walks, bicep curls with bands | Portable and joint-friendly resistance training |
| Weight Machines | Leg press, chest press, lat pulldown | Controlled movement; good for beginners |
| Isometric Exercises | Wall sits, static planks, yoga poses | Strengthen muscles without joint movement |
| Plyometric Exercises | Jump squats, box jumps, clap push-ups | Build explosive power and fast-twitch strength |
| Suspension Training | TRX rows, suspended lunges | Uses gravity and bodyweight for dynamic strength |
| Functional Training | Farmer’s carry, medicine ball slams, battle ropes | Mimics real-life movements; improves core and balance |
Procedure
| Nursing Action | Rationale | |
| 1. | Explain the procedure. | Relieves anxiety and encourages patient cooperation. |
| 2. | Assist to a comfortable position | Reduces stress and promotes patient participation. |
| 3. | Provide privacy. | Prevents patient embarrassment. |
| 4. | Instruct to perform the following isometric exercises as prescribed. | Gradual buildup of exercise repetitions improves both muscle strength and endurance. |
| 4a. | Quadriceps isometric exercise | |
| Assist the patient to supine recumbent position. | Quadriceps muscles enable a person to ambulate and get out of chair, large muscles of thigh (quadriceps) must be strong enough for the patient to extend knees and stabilization. | |
| Instruct to press back and the knees against mattress while trying to lift from bed. | ||
| Hold muscles tightly contracted for 5-15 seconds and then relax completely for several seconds. | ||
| Repeat exercise. | ||
| 4b. | Gluteal muscle isometric exercise | |
| Assist the patient to supine position. | Improves patient’s balance when sitting. | |
| Instruct to hold gluteal muscles together for 5-15 seconds, and then relax completely for several seconds. | ||
| Repeat exercise. | ||
| 4c. | Abdominal muscle isometric exercise | |
| Have the patient pull abdominal muscles in, as tightly as possible. | Improves trunk stability. | |
| Hold for 5-15 seconds. Release muscles gradually. | ||
| Repeat exercise. | ||
| 4d. | Foot muscle isometric exercise | |
| Instruct to flex foot toward and away from knee, holding muscle tightly in each position for 5-15 seconds. | Increase muscle activity in leg and thereby promote venous return. | |
| Repeat exercise. | ||
| 4e. | Hand muscle isometric exercise | |
| Obtain sponge rubber ball (e.g., depending on size of patient hand). | Strengthen grip to hold onto crutch or walker more effectively. | |
| Have the patient grip ball with the entire hand 5-10 times. | ||
| Grip each fingertip, one at a time, into ball 5-10 times each. | ||
| Gradually increase frequency of exercise until the patient can grip ball and exercise once or twice a day. | ||
| 4f. | Biceps isometric exercise | |
| Have the patient raise hands across to shoulder height and interlock fingertips of both hands. | Strengthen biceps and thereby help with ambulation if ambulatory assistive device is used. | |
| Use arm muscles to try to pull hands apart. | ||
| Hold for 5-15 seconds. | ||
| Relax muscles. | ||
| Repeat exercise. | ||
| 4g. | Triceps muscle isometric exercise | |
| Arm exercises Have the patient raise arms to shoulder height. Make one hand flat and place against palm of other hand. Push hands together as hard as possible and hold for 5-15 seconds. Relax and repeat exercise. | Strengthen triceps to assist with transfer techniques and use of crutches or walker. Patient must have enough strength to extend and stabilize the elbows when lifting or shifting body weight. | |
| Sitting exercises. Assist the patient to sitting position on the edge of the bed or in chair. If the mattress is soft, blocks are placed on the bed under patient’s hands. Instruct the patient to try to lift buttocks off bed, for example, seat of chair by pressing down on mattress or chair seat with hands. Hold muscles tight for 5-15 seconds and then relax. Repeat exercise. | Patient must have enough strength in the triceps to extend and stabilize the elbows while lifting or shifting body weight. | |
| 5. | Observe ability to perform exercises. | Demonstrates patient’s training. |
| 6. | Evaluate level of energy, muscle strength, and comfort following exercises. | Determines whether the patient is performing exercises accurately and whether the exercises are increasing muscle strength. |
| 7. | Obtain vital signs after one or two repetitions. | Determines patient’s tolerance to activity. |
| 8. | Document the procedure which includes type of isometric exercises performed, length of time contractions were held, number of repetitions of each exercise, assessment of the patient’s muscular strength and comfort after exercises, vital signs, subjective statements regarding muscular strength, and ability to perform exercise. | Documentation serves as legal evidence and prevents duplication of work. |
Special Consideration
- Focus on controlled movements and correct posture to prevent injury.
- Learn techniques from a certified trainer or physical therapist if needed.
- Begin with 5–10 minutes of light cardio (e.g., walking) to prepare muscles.
- End with gentle stretching to reduce soreness and improve flexibility.
- Exhale during exertion (e.g., lifting) and inhale during release.
- Avoid the Valsalva maneuver, which can dangerously raise blood pressure.
- Allow 48 hours between sessions targeting the same muscle group.
- Overtraining can lead to fatigue, joint pain, or injury.
- For older adults or those with chronic conditions, start with low resistance and progress gradually.
- Consult a healthcare provider before beginning a program, especially if you have cardiovascular disease, arthritis, or osteoporosis.
- Avoid locking joints; keep a slight bend in knees and elbows during exercises.
- Use isometric or resistance band exercises for joint-friendly strength training.
- Stop if you feel sharp pain, dizziness, or unusual fatigue.
- Modify or skip exercises that feel unsafe or uncomfortable.
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
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