Research and News
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Researchers encourage proprioceptive exercises for shoulder rehabilitation
Apr 27th
Proprioceptive exercises are commonly prescribed for lower extremity rehabilitation. More recently, sensorimotor (SMT) proprioceptive exercises have been used for shoulder rehabilitation. It’s thought that shoulder injury (in particular, shoulder instability) is related to proprioceptive deficits. Researchers speculate that deafferentation (loss of sensory information) from the mechanoreceptors of the shoulder joint capsule and altered proprioceptive information create these sensorimotor deficits (Lephart et al. 1997; Tibone et al. 1997)
A review paper in Athletic Training and Sports Healthcare discussed the adaptations of the sensorimotor system following shoulder rehabilitation. The authors used the PEDro system for inclusion criteria to review 23 articles. The most common techniques the paper reviewed included:
- Joint repositioning
- Closed-kinetic chain exercises
- Proprioceptive Neuromuscular Facilitation (PNF)
- Plyometrics
- Joint Perturbations
- Activation of muscle through elastic tubing, free weights or oscillation
The authors concluded that sensorimotor rehabilitation after shoulder injury is crucial, and that the sensorimotor system is, in fact, trainable. A proprioceptive and sensorimotor training program including Thera-Band® elastic bands and tubing, FlexBar® Oscillation, and closed-kinetic shoulder exercises with Stability Trainers should be included as part of a shoulder rehabilitation or prevention program.
Reference: Myers JB, and Oyama S. 2009. Sensorimotor training for shoulder injury. Athletic Training & Sports Health Care. 1(5):199-208.
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Balance training program effective for basketball players
Apr 15th
Several studies have shown that balance exercises and “neuromuscular training” are effective at reducing injuries in athletes. Neuromuscular exercises typically incorporate products such as Thera-Band® Stability Trainers, Stability Discs, balance boards, and exercise balls. Athletic training researchers wanted to determine if a neuromuscular training program was effective at improving balance in high school athletes.
Two groups of female basketball players were assigned to either a 6-week neuromuscular exercise program or a control group (the subjects weren’t randomized; they were assigned to a group based on their school). Athletes were tested for their static balance and dynamic balance; the static balance test (BESS) used foam pads to create an unstable surface to evaluate postural stability.
The exercise group completed a twice a week, 6-week program that included 4 training stations: functional strengthening, plyometrics, agility training, and balance training. Each session lasted about 1.5 hours. The functional training station utilized elastic band loops and exercise balls, and the balance station utilized foam rolls.
After analysis of the 50 athletes completing the study, the authors found significant improvements in both static and dynamic balance. While these results may sound intuitive, other studies have shown no increase in balance with more simple balance exercises, possibly due to a More >
Systematic review suggests how to improve balance with specific balance exercises
Apr 13th
Balance training for rehabilitation and sports performance enhancement has increased in popularity over the past few years, yet there remains little evidence on the optimal exercise dosage and prescription for balance training. Poor balance has been associated with falls in older adults, as well as injuries in other populations. Balance training has been shown in numerous studies to improve balance, reduce falls, and reduce injuries. Unfortunately, there is little consensus on the optimal dosage of balance training in terms of volume and intensity.
A systematic review in the Journal of Strength and Conditioning Research provided a systematic review of balance training in healthy individuals. Using the PEDro scale for analyzing studies, the authors evaluated the quality and effect sizes of 16 articles involving healthy individuals. 2 types of balance training for postural stability were identified: static and dynamic balance. Static balance is defined as the ability to maintain the center of gravity within the base of support. Dynamic balance is defined as the transition from dynamic activity to a static position. The authors also identified 2 types of surfaces used in balance assessment to quantify postural stability. Stable surface assessments utilize force platforms or single-leg balance time, while unstable surface assessments utilize tilting platforms.
The More >
Balance training effective at reducing falls and improving function
Apr 6th
Fall prevention exercise programs are becoming increasingly popular. Research has demonstrated the effectiveness of strength and balance exercises in reducing the risk of falls in older adults. National organizations such as the National Council on Aging (NCOA) and the Centers for Disease Control (CDC) recommend a multi-factoral approach to fall prevention because of the numerous risk factors. Approximately 1/3 of older adults sustain falls every year in the United States, costing over $19 billion in healthcare costs.
Physical therapist researchers at Cal State University Northridge performed a study to determine the effectiveness of a balance exercise training program on strength, balance, gait, and fall risk in 23 healthy community-dwelling older adults at risk for falls. Subjects were randomly assigned to an exercise group or non-exercising control group. The exercise group performed a small group-based balance program, “A Matter of Balance” for 12 weeks, three times a week in a class setting at the PT department.
According to the authors, the exercises included balance exercises standing on foam surfaces and balance boards, as well as squats with an exercise ball. Interestingly, there was no resistive strengthening component in their description of the exercise program, although the original “A Matter of Balance” program developed at Boston More >
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 >
