Research and News
Posts tagged rehabilitation
Rehabilitation for Shoulder Instability Update
Dec 2nd
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Shoulder instability is a common cause of shoulder pain. Shoulder instability patients have been traditionally diagnosed from 2 groups: from traumatic, unilateral instability, resulting in surgery (TUBS), or atraumatic, bilateral multi-directional instability best managed with rehabilitation (AMBR). However, a new classification scheme suggests there are 3 groups of shoulder instability patients: 1. Traumatic structural; 2. Atraumatic structural; 3. Muscle patterning / non-structural. Traumatic shoulder dislocation (Group 1) is best managed through surgery. Atraumatic structural instability (Group 2), while best managed through rehabilitation, may improve with surgery after failed rehab. However, surgical intervention in Group 3 patients with non-structural instability often results in failure.
Jaggi and Lambert provide an excellent review of the examination and management of all 3 groups of instability. In their article, the authors describe physical therapy management of Type 2 and 3 shoulder instability, including biofeedback, postural taping, and rotator cuff strengthening with elastic bands and dumbbells. In addition, exercise balls and wobble boards serve as unstable surfaces to “enhance neuromuscular control at a reflex level. They emphasize that core stability is a vital component to rehabilitation of Type 3 (“muscle patterning”) shoulder instability. According More >
Thera-Band® products featured in evidence-based shoulder rehabilitation
Nov 29th
Shoulder impingement and rotator cuff injuries often respond well to physical therapy exercises. The success of the exercise program will depend on an accurate clinical assessment and an evidence-based approach to prescribing appropriate interventions. Two expert physical therapists and clinical researchers published an excellent review on the rehabilitation of shoulder impingement syndrome and rotator cuff injuries in the British Journal of Sports Medicine.
Drs. Todd Ellenbecker and Ann Cools offer a well-detailed description of the literature behind range of motion limitations, scapular dyskinesis, and muscle balance. Both authors have published extensively in these areas of clinical research, giving them an excellent perspective at translating evidence into practice by sharing their expertise. Ellenbecker and Cools provide some unique exercises for restoring shoulder muscle balance, including the “external rotation oscillation” exercise using Thera-Band® tubing and a FlexBar®. Dr. Ellenbecker recently completed an EMG study on this exercise, finding moderate levels of infraspinatus muscle activation. Another exercise researched by Dr. Ellenbecker, a 90-90 plyometric external rotation with a Thera-Band soft weight was highlighted in the article as well, and was featured previously on the Academy blog.
Simple and effective Thera-Band products can be a valuable part of an evidence-based shoulder rehabilitation program.
REFERENCE: Ellenbecker TS, Cools A. Rehabilitation of shoulder More >
Balance exercises for chronic ankle sprains effective
Aug 31st
Chronic ankle sprains have been attributed to poor sensorimotor control, resulting in “functional ankle instability.” First described in the 1960’s by Freeman and Wyke, functional ankle instability has been postulated to result from a lack of proprioceptive information from the ankle due to “deafferentation.” Functional ankle instability is associated with chronic ankle sprains; patients with functional ankle instability may have normal strength and ligament structure, yet continue to suffer ankles sprains. Progressive balance exercise programs have been shown effective at reducing functional instability and recurring ankle sprains. Sensorimotor training programs for ankle instability often include balance exercises that use foam pads such as Thera-Band® Stability Trainers.
Researchers at the University of Kentucky developed a progressive balance training program for patients with chronic ankle instability. The program lasted 4 weeks and focused on dynamic balance stabilization in single-leg stance. Exercises included progressions in hops and single-leg balance using foam pads and 6-pound medicine balls. The results of their first study, published in Medicine and Science in Sports and Exercise in 2008, found that their program significantly improved function and postural control in chronic ankle sprain patients. In their more recent study, 29 subjects with chronic ankle instability were randomly assigned to either an exercise group or More >
Functional rehabilitation of chronic ankle instability effective
Jul 12th
It’s been reported that athletes suffering an ankle sprains re-injure their ankle 70% to 80% of the time. This leads to chronic ankle instability or ‘functional ankle instability’. Rehabilitation for chronic ankle sprains often includes functional exercises including dynamic closed-chain activities. Thera-Band® products such as elastic resistance bands, stability trainers and balance boards are used for functional rehabilitation.
Researchers at the University of Toledo performed a systematic review of functional exercise interventions for their effectiveness. They identified 6 studies that met their criteria for the review, including 4 that used balance boards and elastic resistance strengthening. The researchers concluded that functional rehabilitation improves dynamic balance and self-reported function in patients with chronic ankle sprains. The exercise programs from the reviewed studies generally lasted 4 to 6 weeks and were performed 3 to 5 times a week. Finally, they pointed out that wobble board training in rehabilitation programs is “supported by the literature”; therefore, Thera-Band balance boards should be a standard component of chronic ankle instability rehabilitation program.
REFERENCE Webster KA, Gribble PA. Functional rehabilitation interventions for chronic ankle instability: a systematic review. J Sport Rehabil. 2010 Feb;19(1):98-114.
Visit the Thera-Band Academy Ankle Sprain resource center here
