While physicians are the most influential at encouraging people to begin exercising, less than 50% of physicians recommend exercise as part of their patient’s treatment, and even less among those with cardiovascular disease. This number will hopefully increase as physicians understand that the benefits of physical activity usually outweigh the risks. The American College of Sports Medicine (ACSM) has launched a new initiative encouraging physicians to write prescriptions for physical activity through their “Exercise is Medicine” campaign.

German researchers at Ruhr-University in Bochum Germany have started a feasibility study on a 12-week multi-modal home exercise program including Thera-Band resistance bands. General practitioners and exercise therapists will work together to provide the well-rounded home exercise program along with physical activity counseling and exercise consultation, pedometers, educational material, telephone counseling, and home visits. Each participant receives 2 meter yellow and red Thera-Band resistance bands. Participants will be community-dwelling older adults over 70 years of age without serious cardiovascular, metabolic, pulmonary, or neurological conditions. The goal of the feasibility study is to prepare for a randomized controlled trial of the intervention with eventual dissemination in primary medical care.

REFERENCE: Hinrichs T, et al. Feasibility of a multidimensional home-based exercise programme for the elderly with structured support given by the general practitioner’s surgery: study protocol of a single arm trial preparing an RCT [ISRCTN58562962]. BMC Geriatr. 2009 Aug 17;9:37.

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

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

Fall prevention exercise programs

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 University  did use Thera-Band® resistive bands.

After the training program, the exercise group significantly improved lower extremity strength, improved their balance and functional mobility, and reduced their incidence of falls compared to the control group. The results of this program are promising, but more research is needed on larger sample sizes, as well as a cost-benefit analysis.

Simple balance training devices such as Thera-Band® Stability Trainers, balance boards, and exercise balls can be helpful at reducing falls and improving function in older adults.

Visit the Fall Prevention Center at Thera-Band Academy

 Beling J, Roller M. Multifactorial intervention with balance training as a core component among fall-prone older adults. J Geriatr Phys Ther. 2009;32(3):125-33.

Shoulder impingement is a common cause of shoulder pain that responds well to active, therapeutic exercise. A more passive “shockwave treatment” has recently been used to treat impingement. This passive modality was compared with an active exercise treatment in shoulder impingement patients in Norway. The study published in the British Medical Journal compared 12 weeks of physiotherapy and home exercise using elastic tubing with 4 to 6 treatments of Radial Extracorporeal Shockwave Treatment (REST).

64% of the exercise patients and only 36% of the shockwave treatment patients had significant improvement in pain and disability, and more patients in the exercise group returned to work. Interestingly however, there were no significant differences between groups in function or range of motion.

This study is consistent with the findings of other studies that show elastic resistance exercises are effective as part of an active care approach to shoulder impingement that includes both clinic- and home-based exercises. Thera-Band® elastic resistance and patient kits are ideal to facilitate both clinical and home exercise programs.

Engebretsen K, et al. Radial extracorporeal shockwave treatment compared with supervised exercises in patients with subacromial pain syndrome: single blind randomised study. BMJ. 2009;339:b3360.

Visit the Thera-Band Academy Shoulder Impingement Center Here

Thera-Band® resistance band exercises are commonly used in rehabilitation of shoulder impingement. In fact, nearly 75% (9 out of 13) of the studies in a systematic review of physiotherapy exercises for impingement included elastic resistance exercise for the rotator cuff and scapula. In their review, Kromer and colleagues found that passive treatments (such as modalities only) are not effective and cannot be justified when treating shoulder impingement.

The authors found that physiotherapist-led exercises were as effective as surgery for shoulder impingement. In addition, home-based exercises were as effective as physiotherapy interventions, although manual therapy in the clinic may provide additional short-term relief. Based on these conclusions, Thera-Band resistance band exercises in the clinic or home can be an effective and safer alternative to surgery.

Kromer TO, et al. Effects of physiotherapy in patients with shoulder impingement syndrome: a systematic review of the literature. J Rehabil Med. 2009;41(11):870-80.

Visit the Thera-Band Academy Shoulder Impingement Center here