Researchers at the University of Kentucky evaluated electromyographic (EMG) levels of 4 exercises in total hip patients between 7 and 32 weeks post-operative. Dr. Cale Jacobs and colleagues were interested to see if there was a progression of muscle activation to guide clinical decisions about hip abduction exercise prescription. They published their findings in the Journal of Arthroplasty. The 4 exercises included 2 non-weight bearing and 2 weight-bearing exercises:

• Standing hip abduction with cuff weight at 1% of bodyweight, lifted to 30 degrees
• Sidelying hip abduction with cuff weight at 0.5% of bodyweight, lifted to 50% of leg length
• Standing hip abduction with uninvolved leg to 30 degrees
• Lateral walk with Thera-Band resistance band attached with extremity straps around ankle

Researchers used a level of Thera-Band resistance that created the same torque as the standing hip abduction exercise (1% body weight) with stretch on the band at 50% elongation. The researchers used this chart of Thera-Band elastic resistance pull forces to prescribe the appropriate color of band.

Both the sidelying abduction and weight-bearing standing abduction with the other leg produced an average of 67% maximum voluntary isometric contraction (MVIC).  The Thera-Band resisted lateral walk exercise produced an average of 63% MVIC and the non-weight bearing standing abduction produced 58%. There was no significant difference in activation between exercises, indicating no clear order of exercise progression.  The researchers suggested these exercises can be used interchangeably, particularly when balance impairment or postural position may be an issue.

In conclusion, non-weight bearing exercises involving open-chain hip abduction provide no additional benefit of gluteus medius activation compared to more functional closed-chain exercises. Thera-Band loop resisted walking provides moderate (>60% MVIC) of gluteus medius activation in post-operative total hip replacement patients.

REFERENCE: Jacobs CA, et al. Electromyographic analysis of hip abductor exercises performed by a sample of total hip arthroplasty patients. J Arthroplasty. 2009 Oct;24(7):1130-6. Epub 2008 Aug 30.

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

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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.

Visit the First Step to Active Health program website here

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

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.

Recent recommendations from the Centers for Disease Control (CDC) and American College of Sports Medicine include strengthening exercises for older adults at least twice a week. Strength training can improve muscular strength, power and endurance in older adults. In addition, strength training can increase bone mass or decrease bone mass loss which is particularly important in women with osteoporosis. Falls in osteoporotic women in particular often lead to fractures of the hip, back, and arm.

Researchers in Germany set out to determine if a well-rounded exercise program that included Thera-Band® resistance bands would be effective at increasing bone density, decreasing falls, and improving cardiovascular risk factors in older women. In the study, published in the Archives of Internal Medicine, 246 women over 65 years old were randomly assigned to either a high-intensity/low volume “well-rounded” exercise program, or a low-intensity “wellness” exercise control group. The 18 month exercise program included 2 group sessions per week and 2 home-based sessions per week.

The well-rounded exercise group protocol included cardiovascular warm-up exercises, upper body strengthening exercise using Thera-Band bands, unilateral lower extremity weight-bearing exercises, stretching, and balance exercises. The control group performed low-level cardiorespiratory exercises and a variety of activities designed not to cause physical adaptations.

At the end of the 1 ½ year exercise program, the strengthening group using Thera-Band bands significantly improved in bone density compared to the control group. They also experienced 50% fewer falls than the control group. Both groups improved their cardiovascular disease risk factors, but the well-rounded exercise group reduced their risk nearly twice as much as the control group. Interestingly, there was no significant difference in costs for either program, although the healthcare costs per participant was higher in the control group.

Reference: Kemmler W, et al. Exercise effects on bone mineral density, falls, coronary risk factors, and health care costs in older women: the randomized controlled senior fitness and prevention (SEFIP) study. Arch Intern Med. 2010 Jan 25;170(2):179-85.

Disclaimer: Thera-Band Academy supplied the bands for the study, but did not provide any financial support.

Michael Rogers, PhD

Visit the Thera-Band Academy Older Adult Exercise Center here.