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October 7, 1950


Author Affiliations

St. Louis

From the Division of Physical Medicine, Washington University School of Medicine.

JAMA. 1950;144(6):458-460. doi:10.1001/jama.1950.02920060020006

The first report on the use of progressive resistance exercise in poliomyelitis is that of De Lorme, Schwab and Watkins in 1948.1 Every report since that time has been an enthusiastic confirmation of the value of this form of treatment, without a single dissent.2 As a result of my experience with the method since the early part of 1947, I believe that it is by far the most important contribution yet made to the treatment of this disease.

The physiological basis for progressive resistance exercise is the well demonstrated fact that muscle cells respond to overload exercise by hypertrophy—increase in size, not number, of contractile units. This increase in size is accompanied with increase in work capacity. A good example is left ventricular hypertrophy in the presence of increased peripheral resistance (aortic stenosis or hypertension). A corollary statement is that unless the load is optimal hypertrophy and increase