Research and News
Balance Boards
Are unstable surfaces appropriate for rehabilitation of low back pain patients?
Jun 15th
If you're new here, you may want to subscribe to our email updates for new blog posts. Thanks for visiting!
Unstable surfaces have been suggested to be used in training trunk and core stability. However, the use of unstable surfaces in training has come under question lately with research suggesting lower levels of activation compared to stable surfaces (Behm et al., 2010). The instability requires additional muscle activation to maintain stability. Therapists sometimes prescribe exercises using unstable surfaces such as Thera-Band® Stability Trainers and Stability Discs for patients with low back pain.
Researchers measured trunk muscle activity, lumbar range of motion, and balance during 5 common lumbar stabilization exercises performed on stable and unstable surfaces using an inflatable disk: quadruped, side bridge, modified push-up, squat, and shoulder flexion.
They found that patients with low back pain had adaptive recruitment patterns while maintaining similar levels of balance and lumbar range of motion compared to healthy subjects. There was little increase in electromyographic (EMG) activation among low back pain patients between the stable and unstable surface, and some exercises actually increased lumbar range of motion on unstable surfaces, which is not desirable during lumbar stabilization exercise. Based on these findings, the researchers questioned the need and More >
Improving Function after Total Knee Arthroplasty (TKA) with Balance Training
May 31st
Exercises with Thera-Band elastic bands have been shown effective at improving strength and function in knee osteoarthritis patients before total knee replacement (TKR) surgery. Dr. Robert Topp and his colleagues have published several research papers on their “prehabilitation” pre-operative exercise program using Thera-Band that benefits total knee replacement patients before and after surgery.
Knee osteoarthritis patients are expected to receive 3 million total knee replacements per year by 2020 in the United States. Unfortunately, over one third of total knee patients experience deficits in function one year after surgery (Franklin et al 2008). Few exercise intervention studies have evaluated the effectiveness of balance training in combination with traditional rehabilitation exercises after early post-operative rehabilitation. Most total knee replacement patients receive in-patient exercises and some outpatient rehabilitation for a few months after surgery. Previous research has suggested that total knee rehabilitation patients plateau at 3 months after surgery (Mizner et al. 2005).
Researchers at the University of Pittsburgh wanted to determine the feasibility of a balance exercise program in total knee replacement patients 2 to 6 months post-surgery. They randomly assigned 43 patients to either a ‘functional’ training group or a functional training group with additional balance exercises. Each group completed 6 weeks of supervised exercise over More >
Intensive two-week exercise program benefits stroke survivors
Mar 28th
Patients suffering a stroke are often left with residual deficits in strength and gait. Depending on the severity of the stroke, patients are left with a wide range of disabilities. It was once thought that stroke survivors would never regain use of their paretic extremities; however, research continues to demonstrate the benefit of exercise after a stroke. Researchers in Norway were interested to see if a two-week, intensive exercise program for stroke survivors at least six months post stroke was effective and feasible. 12 hemiparetic patients (27-62 years old, average 46.5 years old) completed two weeks of group exercise for six hours a day at an inpatient rehabilitation hospital. The patients exercised in groups of three or four patients supervised by one or two therapists (physical and/or occupational therapists). Their exercises consisted of transfers, weight-bearing on the paretic limb, and stepping exercises for 90 minutes. Balance activities including rocker board and foam balance exercise were performed for 60 minutes. Gait training and strength training exercises were performed for 75 minutes each. Strengthening activities included functional tasks and exercises for the ankle, knee, hip and trunk. Patients were pre-tested 16 days and three days prior to the intervention, and post-tested three More >
Wobble board exercises can reduce ankle injuries in soccer players
Jan 18th
Neuromuscular training has long been performed in Europe as part of sports training and injury prevention. Neuromuscular training involves progressive balance training using unstable surfaces such as Thera-Band® Stability Trainers, Stability Discs, and Balance Boards. Several studies have reported that proprioceptive exercises and training reduce injuries in athletes.
Researchers in Hungary evaluated the effects of a 20-month proprioceptive training program in 10 female handball players. Their ankle proprioception was compared to a control group of 10 competitive athletes. The program included static and dynamic balance exercises using wobble boards. At the end of 20 months, the training group had completed 780 hours of the proprioceptive exercise. Their ankle proprioception, measured by ankle joint position sense, was significantly better compared to the control group. In addition, the training group experienced a 50% reduction in injuries. Proprioceptive training progression including Thera-Band Wobble Boards can improve ankle proprioception and may decrease ankle injury rates in contact sports.
REFERENCE: Kynsburg A, Pánics G, Halasi T. Long-term neuromuscular training and ankle joint position sense. Acta Physiol Hung. 2010 Jun;97(2):183-91.
Rehabilitation for Shoulder Instability Update
Dec 2nd
Shoulder instability is a common cause of shoulder pain. Shoulder instability patients have been traditionally diagnosed from 2 groups: from traumatic, unilateral instability, resulting in surgery (TUBS), or atraumatic, bilateral multi-directional instability best managed with rehabilitation (AMBR). However, a new classification scheme suggests there are 3 groups of shoulder instability patients: 1. Traumatic structural; 2. Atraumatic structural; 3. Muscle patterning / non-structural. Traumatic shoulder dislocation (Group 1) is best managed through surgery. Atraumatic structural instability (Group 2), while best managed through rehabilitation, may improve with surgery after failed rehab. However, surgical intervention in Group 3 patients with non-structural instability often results in failure.
Jaggi and Lambert provide an excellent review of the examination and management of all 3 groups of instability. In their article, the authors describe physical therapy management of Type 2 and 3 shoulder instability, including biofeedback, postural taping, and rotator cuff strengthening with elastic bands and dumbbells. In addition, exercise balls and wobble boards serve as unstable surfaces to “enhance neuromuscular control at a reflex level. They emphasize that core stability is a vital component to rehabilitation of Type 3 (“muscle patterning”) shoulder instability. According to the authors, rehabilitation of Type 2 and 3 shoulder instability requires an average of 6 months of rehabilitation. More >
