Research and News
Balance Boards
Neuromuscular exercise program effective for ACL Rehabilitation
Mar 16th
Rehabilitation after ACL reconstruction usually involves 6 months of physical therapy, including strength and balance exercises. Traditional ACL rehab has focused on increasing strength of knee and lower extremity muscles. More recently, “neuromuscular” exercise programs that de-emphasize strength training have been used successfully in Europe.
Physical therapy researchers in Norway compared 2 types of ACL rehabilitation in 74 post operative patients. In the study, published in the American Journal of Sports Medicine, patients were randomly assigned to a traditional exercise program or a neuromuscular exercise program. The neuromuscular program (described in a separate study) included balance exercises on foam pads, wobble boards, and mini-trampolines. Download their rehabilitation protocol here. Plyometric and agility exercises were also included. Each group was tested for their strength, pain, function, and quality of life.
At a 2-year follow-up, the neuromuscular exercise group significantly increased in function and pain compared to the strengthening group, while the strengthening group only improved in hamstring strength. The authors suggested that both balance and strength exercises be included in ACL rehabilitation program. Thera-Band® Stability Trainers and balance boards are ideal for use in a neuromuscular rehabilitation program.
Reference: Risberg MA, Holm I. The long-term effect of 2 postoperative rehabilitation programs after anterior cruciate ligament reconstruction: a randomized controlled clinical trial More >
It’s not too late to exercise years after knee arthroscopy
Feb 22nd
Meniscus tears in the knee are relatively common, particularly in middle-aged athletic individuals. Arthroscopic surgery is often performed to remove damaged cartilage. Surprisingly, some orthopedic surgeons do not prescribe physical therapy after knee arthroscopy, feeling patients can recover on their own with a few simple exercises. Unfortunately, this may lead to long-term deficits in strength, range of motion, and function. Such deficits may predispose patients to knee osteoarthritis as well.
Scandinavian researchers wanted to evaluate the effects of a functional proprioceptive-based exercise program several years after arthroscopic meniscectomy. 30 patients at 4 years after their surgery were randomly assigned to the functional training group or a non-exercising control group. Both groups were tested for functional performance, strength, and self-reported pain and quality of life before and after the 4 month study.
The exercise group was led by a physiotherapist 3 times per week. A neuromuscular exercise program was developed including foam pads, balance boards and mini-trampolines. The program emphasized closed kinetic chain exercises, muscular coactivation, reactive neuromuscular training, and functional alignment. After 4 months, the functional exercise group had significantly better function and strength than the control group.
While improvements in strength and function can be expected in an exercise group compared to a non-exercising More >
Proprioceptive Exercises: Are they effective?
Feb 4th
Neuromuscular and proprioceptive exercises are increasing in popularity during rehabilitation following sports injuries such as ankle sprains and ACL tears. These interventions typically include balance exercises such as Thera-Band® kicks and balance board training. Researchers from Germany completed a systematic review of studies evaluating the effectiveness of proprioceptive and neuromuscular training. 15 clinical trials involving ankle sprains and ACL rehabilitation met the researchers’ inclusion criteria.
The authors concluded that proprioceptive exercise and neuromuscular training are effective at improving function, decreasing symptoms of instability, and preventing re-injury after ankle sprains. Surprisingly, the authors concluded that neuromuscular training was not more effective than strengthening exercise for post-operative ACL reconstruction. In addition, proprioceptive training after injury had no effect on muscle strength, muscle activation or edema, and had more impact on dynamic balance than static balance. There was conflicting evidence on training effects on joint position sense and muscle reaction.
The researchers recommended that training must last 6 to 12 weeks, but the wide variety of exercise and prescription (volume and intensity) made it difficult to recommend specific dosages of exercise. They also commented on the poor methodological quality, lack of applicable studies on shoulder exercises, and need for more research. Based on the evidence, there is moderate evidence that proprioceptive exercises should More >
Balance Training Reduces Ankle Re-Injury
Dec 3rd
Approximately 23,000 ankle sprains occur daily in the United States, and about one half require some form of medical treatment. Research has shown that athletes are twice as likely to re-injure their ankle within one year. According to a study in the British Medical Journal, athletes with ankle sprains who receive additional proprioceptive training after ‘usual care’ are 35% less likely to suffer a recurrence over the next year. Over 500 athletes in the Netherlands were randomly assigned to usual care (the control group) or usual care plus 8 weeks of balance board exercises. The ankle exercises were performed 3 times per week, 30 minutes per session as part of normal warm-up before sports. The program gradually increased in difficulty.
Download the balance board ankle exercise program here.
The authors concluded that the 8 week balance training program would benefit both athletes and the general population after suffering an ankle sprain. The results of this study were similar to findings in a 2004 study where volleyball players in the Netherlands significantly reduced their risk of re-injury after a balance board training program. Another study on American high school football players with a history of ankle sprains reduced their risk of reinjury by 77% by training with the More >
