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A better way to prescribe shoulder rehab exercise intensity?
Aug 31st
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OMNI-RES Scale
Physical and occupational therapists often use both elastic and dumbbell resistance during shoulder rehabilitation exercises. Unfortunately, many therapists arbitrarily assign resistance levels to patients during their exercises based only on clinical experience. In the fitness setting, RPE (Rating of Perceived Exertion) scales have been used successfully in dosing the intensity of both isotonic and Thera-Band® elastic resistance exercises (Colado & Triplett, 2008). In addition, RPE has been shown to be similar between Thera-Band and isotonic resistance of similar EMG activation during shoulder exercise in healthy subjects (Andersen et al, 2010). Most recently, as discussed on the Academy Blog, the OMNI-RES scale for perceived exertion was shown to be valid when used to prescribe elastic resistance exercise in healthy individuals.
Todd Ellenbecker DPT
Scientific Advisory Board memberTodd Ellenbecker, DPT from the Physiotherapy Sports Clinic in Scottsdale Arizona wanted to see if he could use RPE during rehabilitation exercises for his shoulder patients. He presented the results of his pilot study at the 13th annual TRAC meeting in San Francisco.
31 shoulder patients including 21 post-operative and 10 non-operative patients were in the study. They were asked to More >
Can we use perceived exertion to dose elastic exercise intensity?
Aug 30th
Several studies have suggested that Thera-Band® resistance is as effective as isotonic resistance (Andersen et al. 2010, Colado & Triplett 2008) with regard to muscle strengthening, power, endurance as well as its’ impact on body composition. One of the difficulties in comparing elastic and isotonic training programs is ensuring each group exercises at the same intensity level. While isotonic strengthening programs are usually dosed using a percentage of maximal strength (% repetition maximum), elastic resistance is often dosed by color progression without clinicians necessarily having a clear understanding of the resistive properties of bands and tubing. For a true comparison between groups using different types of resistance, the intensity must be similar.
Juan Carlos Colado, PhD
In 2008, Scientific Advisory Board member Dr. Juan Carlos Colado from the University of Valencia in Spain used the OMNI-RES scale to solve this disparity between 2 groups using isotonic or elastic resistance, proving that both Thera-Band elastic bands and isotonic resistance machines used at similar intensities can successfully improve strength and muscle mass in middle-aged women (Colado & Triplett 2008). This study first gave some validity to the use of the OMNI scale in prescribing elastic resistance exercise intensity.
OMNI-RES Scale
At the TRAC 2011 meeting, Dr. Colado presented More >
A better exercise for trapezius muscle balance?
Aug 29th
Trapezius muscle balance is important for normal shoulder function. Often in patients with impingement, the lower trapezius is much weaker than the upper trapezius. Traditional exercises to strengthen the lower trapezius such as prone shoulder flexion may cause further impingement, creating a “catch 22” for clinicians: Is there a better exercise for the lower trapezius that doesn’t impinge the shoulder?
Scientific Advisory Board member, Sue Falsone, PT, ATC, Vice President of Athletes’ Performance in Phoenix presented a pilot study of EMG activation of the upper and lower portions of the trapezius muscle during prone flexion with a cuff weight and 3 novel Thera-Band® tubing exercises at the 13th annual TRAC meeting in San Francisco, California.
The “vector” principle of elastic exercise prescription creates vectors of resistance more specific to muscle function. Vector exercises for lower trapezius were developed to create a line of resistance in the direction of the fibers of the lower trapezius, and in the opposite direction of its action of retraction and depression.
In Falsone’s pilot study, 10 healthy subjects without shoulder pain performed these 4 exercises in random order while Noraxon surface EMG data was captured and then normalized to a maximal contraction:
- Prone shoulder flexion with 3 pound cuff weight
- Vector scapular retraction More >
Does Biofreeze affect blood flow after exercise?
Aug 1st
Dr. Robert Topp and his colleagues at the University of Louisville have studied the effects of Biofreeze® pain reliever on blood flow. Olive et al. (2010) showed that Biofreeze gel applied to the forearm of young healthy subjects resulted in similar decreases in blood flow as crushed ice. In addition, the reduced blood flow occurred much quicker with Biofreeze than with ice.
Different Biofreeze products contain different levels of menthol, depending on the delivery mechanism. Dr. Topp and his colleagues wanted to see if there was any difference in blood flow reduction between Biofreeze wipes containing 10% menthol, compared to 3.5% menthol in Biofreeze gel applied to the lower extremity after brief, intense resistance exercise.
16 young, healthy subjects were assessed for popliteal blood flow in both the left and right knees before performing 3 maximal repetitions of isokinetic knee flexion and extension at 90 degrees per second. Immediately after the exercise, the subjects received one of 3 randomized conditions on the right leg only: gel, wipe, and no treatment (control). Blood flow was measured again, 5 minutes after the treatment was applied. Each subject was tested once weekly until they had completed all 3 conditions.
The researchers found that both the Biofreeze gel and More >
“Tyler Twist” Exercise with Thera-Band® FlexBar® for Tennis Elbow on NPR
Jul 27th
The popular Tyler Twist exercise for tennis elbow with the FlexBar was recently featured in a story on National Public Radio (NPR). Reporter Allison Aubrey featured physical therapist Barton Bishop at Sport and Spine Rehab in Rockville, Maryland instructing a patient in the exercise. In the interview, Dr. Bishop helped demonstrate the exercise with his patient, Larry Holzman, who is having a successful rehabilitation with the FlexBar exercise. Link to the story, “A Rubber Twist on Treating Tennis Elbow Pain” here. The webpage includes a link to a video demonstration featuring Holzman and Dr. Bishop. You can also listen to the interview from NPR here.
Researchers at the Nicholas Institute of Sports Medicine and Athletic Trauma (NISMAT) at LenoxHillHospitalin New Yorkpublished an article in the Journal of Shoulder and Elbow Surgery showing that the Tyler Twist is effective at significantly reducing pain and increasing strength in patients with tennis elbow. Tim Tyler, president of the American Physical Therapy Association’s (APTA) Sports Physical Therapy Section was the lead author of the study. The Thera-Band FlexBar was recently endorsed by the APTA.
The results of the study were first released in July, 2009. Since then, many media outlets have featured the story, including the New York Times and Readers Digest. More >
