Progressive Assistance Training is a means of improving strength often using incremental loads of assistance necessary when body weight exceeds one’s current load capacity.
For example, when someone is unable to tolerate ascending or descending a step due to pain or weakness, they will either compensate or avoid the task. This perpetuates the weakness and load intolerance, causing a lack of progress, regression, and frustration. This happens because a step up requires the ability of the individual to tolerate roughly 100% of their body weight on one leg.
In many cases, the involved limb is unable to tolerate that much load. As a result, often the individual either: 1. continues with the exercise, but compensates due to pain and weakness, and fails to improve. or 2. Is regressed to a non weightbearing exercise like leg lifts or bridges, where they also fail to progress as such movements inadequately prepare the individual for the inevitable load tolerance required for step ups.
This leaves people frustrated and unmotivated, unable to realize their full recovery and performance potential. This is like asking a child to read Shakespeare, and when they fail, having them practice the ABCs. What most need is the ability to have challenges that meet or slightly exceed their capacities, then incrementally adjust the challenge as they progress. This matches not only the physiology of adaptation, but the psychology of motivation.
The key is to find the Goldilocks’ zone to provide the optimal challenge. P.A.T. is a practical way to do this.
Below is an example of applying this concept.
Assisted Step Ups
If client with severe knee was unable to ascend a step for years due to pain and weakness, deloaded step ups could be indicated. Here, we used 50lbs of assistance with a heavy band and lower step height to allow a step with minimal discomfort. Gradually, the assistance is reduced and step height is increased.
