The resistance exercise group used Thera-Band® resistance bands or weight equipment in their home. They performed 3 to 4 upper and lower body exercises for 2 sets of 12 to 20 repetitions with progression in the resistance levels.  The aerobic exercise group performed enjoyable weight-bearing activities such as walking, jogging, or dancing. Subjects were assessed before the study, half-way through the study (6 months), and at the end of the 12 month study for body weight, aerobic capacity, muscle strength, and body fat.

Women in both exercise groups maintained or reduced their body weight while the control group gained significantly more weight. Both exercise groups also significantly increased their strength and aerobic capacity compared to the control group after 12 months. The authors concluded that both aerobic and resistance exercise training during and following cancer treatment are effective at preventing weight gain.

Even though both exercise types were effective, adherence rates in the resistance exercise group was less than the aerobic exercise group (65% vs. 79% respectively at 12 months); in fact, many in the resistance exercise group had included aerobic exercise as part of their routine. The authors suggested that the combination of aerobic and strength training during chemotherapy “may be an important goal during and following treatment to reduce cancer survivors’ risks for recurrence with other co-morbidities associated with sedentary lifestyles and being overweight.” In summary, Thera-Band elastic resistance can effectively be used to improve strength and maintain body weight in women during and after cancer treatment.

REFERENCE: Schwartz AL and Winters-Stone K. Effects of a 12-month randomized controlled trial of aerobic or resistance exercise during and following cancer treatment in women. 2009. Phys Sports Med. 3(37):1-6

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Disclosure: Thera-Band Academy provided bands for this study, but did not provide monetary funding.

An experienced physiotherapist supervised the exercises which were performed 1 to 2 times a day for 10 to 15 minutes with 2 to 4 exercises. The exercises were individually prescribed and progressed by the physiotherapist based on the pilots’ progress toward motor control and movement quality, rather than a specific number of sets and repetitions. Pilots progressed through a specific set of exercises over 6 weeks. Using Thera-Band resistance bands, the exercises gradually challenged the neck and shoulder muscle function from non-postural to postural exercises, and endurance-strength exercises. (Download the helicopter pilot exercise protocol here)

After the 6-week program, the exercise group significantly decreased their muscle activation levels (measured with EMG) of the sternocleidomastoid (SCM) muscle during the cranio-cervical flexion test compared to the control group. This suggests the participants in the exercise group were more efficient at using their deep neck flexors by reducing the contribution of the superficial neck flexors. The late Professor Vladimir Janda MD often noted that overactive SCM muscles contributes to his “upper crossed syndrome” resulting in neck pain. Pilots with higher levels of compliance had more reduction in SCM activity, indicating a dose-effect of the exercise program.

At a 12-month follow up after the program, the exercise group had reduced their incidence of neck pain within the previous 3 months from 76% to 44%, and from 38% to 15% within the previous week, whereas the incidence rates were unchanged in the control group. In addition, the exercise group was 2 to 3 times less likely to have neck pain than the control group. The authors concluded that the exercise program including Thera-Band resistance can be a “preventive strategy for military pilots.”

REFERENCE Ang BO, Monnier A, Harms-Ringdahl K. Neck/shoulder exercise for neck pain in air force helicopter pilots: a randomized controlled trial. Spine (Phila Pa 1976). 2009 Jul 15;34(16):E544-51.

Visit the Thera-Band Academy Neck Pain Resource Center here

After 1 year, the researchers determined which women were compliant or non-compliant. The remaining women who had performed exercise irregularly were excluded (46 women) from analysis, leaving a total of 35 women in the analysis. The researchers found that those women who did not perform the exercises had a greater progression of poor posture, particularly increasing in thoracic kyphosis.

The researchers noted that these results are only applicable to relatively healthy women without spinal abnormalities. In addition, they suggested that women with symptomatic spinal stenosis should not perform these exercises. While these results are encouraging, poor compliance was an issue: only 18% consistently performed the exercises. An exercise program including Thera-Band® resistance bands may improve posture in healthy older women, but more research is needed on long-term effects and compliance.

REFERENCE Ball JM, et al. Spinal extension exercises prevent natural progression of kyphosis. Osteoporos Int. 2009 Mar;20(3):481-9.

Visit the Thera-Band Academy Osteoporosis Resource Center Here

Ankle sprains

Researchers at the Mayo clinic in Rochester, Minnesota recruited patients with acute (within 4 days) Grade I or II ankle sprains.  They were prescribed a 4 to 6 week home exercise program that included cold and compression, along with progressive resisted exercises using an elastic band.  Patients performed resisted dorsiflexion, plantarflexion, inversion, and eversion with a yellow Thera-Band resistance band, completing 3 sets of 10-20 repetitions, one to two times per day. The patients progressed through the remainder of the Thera-Band color-coded progression (red, green, blue, black, and silver) as they improved in strength.  Once the patients could perform 3 sets of 10-20 repetitions of resisted plantar flexion, they began calf raises. They also performed single-leg balance exercises including standing on foam pads. In addition to the Thera-Band and balance programs that the patients received, participants were randomly assigned to one of 3 groups of stretching the Achilles tendon on increase dorsiflexion. Each group performed 3 repetitions of the stretch for different intervals: 30 seconds, 1 minute, or 2 minutes.  Download the ankle rehabilitation exercise protocol handout here.

Regardless of the length of stretching, all subjects significantly improved in dorsiflexion ROM within 2 weeks.  By 4 weeks, subjects had re-gained 10° of the active ROM necessary for walking on level surfaces.

While this study demonstrated significant improvement with the Thera-Band resisted exercises, there were several limitations to the study. First, there was no control group, limiting the ability to identify specific effects of the intervention. In addition, the examiners only measured dorsiflexion ROM outcomes, rather than examining different measures such as strength, function, and mobility. Despite these limitations, this study found that a home exercise program using Thera-Band resistance can be effective for treating acute Grade I and II ankle sprains within 4 days of injury.

Reference:  Youdas JW, McLean TJ, Krause DA, Hollman JH. Changes in active ankle dorsiflexion range of motion after acute inversion ankle sprain. J Sport Rehabil. 2009 Aug;18(3):358-74.

Click here to visit the Thera-Band Academy Ankle Sprain Resource Center

While high muscle activation levels are often desirable, what’s more important is the relative activation of other muscles during the movement. For example, Dr. Michael Reinold and colleagues suggested in their 2007 paper that a good rotator cuff exercise should produce the greatest supraspinatus activity while minimizing the deltoid activation. Theoretically, reducing deltoid activation decreases the upward shear of the humerus during arm elevation, which may be desirable when prescribing exercise to strengthen the suprapsinatus in impingement patients.

In a study published in Medicine and Science and Sports and Exercise, subjects performed 5 isometric exercises in random order while measuring the EMG activity of the deltoid, supraspinatus, and infraspinatus. The exercises were: full can, empty can, prone elevation, elastic external rotation, and prone external rotation. The researchers noted that all exercises produced similar high levels of supraspinatus activity, while the full and empty can exercises also had higher levels of deltoid activity.

External Rotation with Thera-Band

Prone External Rotation with Soft Weight

The researchers concluded that shoulder external rotation at 0° of abduction with an elastic band and prone external rotation were preferable exercises for the supraspinatus. While the full- and empty-can exercises are traditionally favored to isolate the supraspinatus, the authors noted that elastic external rotation and prone external rotation did not activate the deltoid at high levels compared to the full- and empty-can exercises. In addition, the exercises also exhibited high levels of infraspinatus activation.

In summary, clinicians should consider using Thera-Band® exercise bands for resisted external rotation and isotonic prone shoulder external rotation exercises because they preferentially activate the supraspinatus and infraspinatus without activating the deltoid, which may be more beneficial for patients with impingement.

Reference: Boettcher CE, Ginn KA, Cathers I. Which is the optimal exercise to strengthen supraspinatus? Med Sci Sports Exerc. 2009;41(11):1979-83.

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