# PWR-035 — Muscle hypertrophy and atrophy resistance: learner worksheet Release: Revision 7T · Full Tutorial Edition Estimated time: Estimated 17 min reading; practical time is provider-set Difficulty: Intermediate Equipment: Basic stationery or digital tools — Provider-checked knee-extension machine; Recorded seat, backrest, pad and range settings; Audible repetition tempo; Training log plus provider-selected muscle-size, strength and function measures; A knee-extension and outcome log for machine settings, load, range, cadence, valid repetitions, failure reason, rest, symptoms, muscle-size landmark, strength and function. Space: Desk / seated Automated structural checklist: 10 of 10 structural checks present Evidence quality/context: G4; Focused research depth Automated method-quality band: Comprehensive Method-rating basis: Structure coverage, instruction/check specificity, alternative distinctness, source troubleshooting, comparison depth and whether purpose/check fields are authored rather than derived. Editorial review: Pending manual editorial sign off ## Before you begin - [ ] I read the tutorial authority and stop conditions. - [ ] I have the required equipment/space or a declared accessible alternative. ## Canonical source context Muscle hypertrophy is an increase in declared muscle size; atrophy resistance is preservation during reduced stimulus. This lesson teaches one supervised resistance set on a knee-extension machine: reproduce the seat and lever, lift through the provider-set range without kicking, pause, lower on the full tempo and stop at the first repetition that misses range, speed or posture. The provider controls load, repetitions, sets, rest, weekly dose and whether the task is appropriate. Hypertrophy cannot be read from one hard machine set. The immediate method produces a quality-controlled knee-extension exposure; the longitudinal method compares quadriceps size at the same anatomical landmark, hydration state, side, operator and imaging settings. Strength and stair function remain different tracks. A pump, soreness, stack increase or extra forced repetition is not a size measurement. During reduced training, atrophy resistance means change from a documented size baseline, not the feeling that the thigh looks unchanged. Image quality receives a validity code before thickness is measured. A transverse or longitudinal frame must show the stored vastus lateralis landmark, consistent probe pressure, visible fascia boundaries and unchanged depth or gain settings. Compression flattens the muscle; oblique probe angle lengthens the apparent path; a moved landmark samples different tissue. These imaging errors are corrected at acquisition, never by choosing the thickest follow-up frame. During unloading, the baseline frame, follow-up frame and method error remain linked to the same quadriceps coordinate. Target outcome: The learner completes a provider-prescribed knee-extension set with every counted repetition meeting range and tempo, while muscle size, strength and function remain separate outcomes. ### Authority and setup conditions - Report knee/hip/back pain, recent surgery, swelling, weakness, illness and unusual delayed soreness. - Confirm seat, lever, range, load, repetition target, effort stop and rest. - Practise one easy repetition and verify that the machine axis/pad position is comfortable. - Copy seat, lever, pad, range and tempo settings from the knee-extension log before choosing the work load. Use an easy repetition to confirm that the knee moves comfortably through the declared arc. - Reproduce the machine setup and practise the full lift-pause-lower cadence at an easy load before the provider-set work set. ### Required or supplied materials - Provider-checked knee-extension machine - Recorded seat, backrest, pad and range settings - Audible repetition tempo - Training log plus provider-selected muscle-size, strength and function measures - A knee-extension and outcome log for machine settings, load, range, cadence, valid repetitions, failure reason, rest, symptoms, muscle-size landmark, strength and function. ## 1. Rebuild the machine setup Match the recorded seat, backrest, lever and shin-pad positions; keep pelvis and back against supports. Why: Small setup changes alter range and leverage. Success check: All settings match the log and the knee moves comfortably. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “All settings match the log and the knee moves comfortably.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 2. Start from the declared bottom Let the stack settle without losing tension or slamming; feet and hands stay in the taught positions. Why: A repeatable bottom position defines the range. Success check: The lever reaches the same marker each repetition. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The lever reaches the same marker each repetition.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 3. Lift without kicking Extend the knees over the provider-set upward count; do not throw the torso, snap the start or use momentum. Why: Momentum can inflate load while reducing controlled muscle work. Success check: The stack rises smoothly and the body stays supported. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The stack rises smoothly and the body stays supported.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 4. Reach the marked top Stop at the authorised top angle and pause briefly without forcing the knee into pain or lockout. Why: A fixed top makes range comparable. Success check: Both sides reach the marker under control. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “Both sides reach the marker under control.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 5. Lower for the full count Return the lever slowly over the prescribed count until the bottom marker; do not let the stack crash. Why: Controlled lowering is part of each valid repetition. Success check: The plates remain controlled and quiet. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The plates remain controlled and quiet.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 6. Stop at technical failure End the set when range shortens, tempo breaks, posture changes or the provider's effort limit is reached; do not add forced help. Why: Productive dose does not require uncontrolled failure. Success check: No invalid repetition is counted; the visible 'Stop at technical failure' check is satisfied. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “No invalid repetition is counted; the visible 'Stop at technical failure' check is satisfied.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 7. Track three outcomes Log valid load/repetitions and symptoms. On the provider's schedule, measure declared muscle size, task-specific strength and a meaningful function separately. Why: Size, strength and function can change differently. Success check: The record has separate rows for all three. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The record has separate rows for all three.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 8. Define the quadriceps landmark With the qualified assessor, record side, distance from the knee landmark, probe or tape orientation, body position and imaging settings used for muscle thickness or cross-sectional area. Do not move the site to find a larger image. Why: Small landmark and probe changes can mimic hypertrophy or conceal atrophy. Success check: A photo and coordinate sheet allow the same quadriceps site to be relocated at follow-up. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “A photo and coordinate sheet allow the same quadriceps site to be relocated at follow-up.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 9. Build three parallel timelines Log training exposure by valid repetitions, muscle size by the declared imaging method, and function by the chosen stair task. Date each series and compare only like with like. Why: Exercise performance, tissue size and daily function change at different rates and have different measurement error. Success check: No machine-set value appears in the quadriceps-size or stair-function column. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “No machine-set value appears in the quadriceps-size or stair-function column.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 10. Validate the muscle image first Check quadriceps landmark, probe orientation, pressure, fascia visibility, image depth and gain before tracing thickness. Reject compressed, oblique or relocated frames without searching for a favourable replacement. Why: Acquisition errors can mimic hypertrophy or atrophy at the vastus lateralis site. Success check: Each retained frame has landmark, orientation and image-quality codes set before any boundary is traced. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “Each retained frame has landmark, orientation and image-quality codes set before any boundary is traced.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## Reflection What changed? ________________________________________________________________________________ What remains difficult? ________________________________________________________________________________ What will I repeat, adapt, ask for help with, or stop? ________________________________________________________________________________ --- Completion of this worksheet demonstrates tutorial participation only. It does not establish capability, qualification, safety clearance, diagnosis, treatment or independent validation.