Research and News
Posts tagged rehabilitation
Neuromuscular exercise program effective for ACL Rehabilitation
Mar 16th
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Rehabilitation after ACL reconstruction usually involves 6 months of physical therapy, including strength and balance exercises. Traditional ACL rehab has focused on increasing strength of knee and lower extremity muscles. More recently, “neuromuscular” exercise programs that de-emphasize strength training have been used successfully in Europe.
Physical therapy researchers in Norway compared 2 types of ACL rehabilitation in 74 post operative patients. In the study, published in the American Journal of Sports Medicine, patients were randomly assigned to a traditional exercise program or a neuromuscular exercise program. The neuromuscular program (described in a separate study) included balance exercises on foam pads, wobble boards, and mini-trampolines. Download their rehabilitation protocol here. Plyometric and agility exercises were also included. Each group was tested for their strength, pain, function, and quality of life.
At a 2-year follow-up, the neuromuscular exercise group significantly increased in function and pain compared to the strengthening group, while the strengthening group only improved in hamstring strength. The authors suggested that both balance and strength exercises be included in ACL rehabilitation program. Thera-Band® Stability Trainers and balance boards are ideal for use in a neuromuscular rehabilitation program.
Reference: Risberg MA, Holm More >
Systematic review supports use of elastic resistance exercise for shoulder impingement
Mar 9th
Shoulder impingement is a common cause of chronic shoulder pain that can be treated with exercise. Impingement can be caused by a structural narrowing of the space between the humeral bone and acromion of the scapula, or by a muscle imbalance of the rotator cuff and/or scapular stabilizer muscles. These types of impingement are referred to as structural and functional, respectively.
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.
Elastic bands effective at treating neck pain and whiplash
Mar 8th
“Whiplash” injuries are defined as sudden acceleration-deceleration of the head resulting in damage to the cervical spine. While most common in motor vehicle accidents (MVA), whiplash can occur as a result of other high-speed activities such as sports. Usually characterized by long-standing chronic neck pain and disability, studies have shown that patients with whiplash-associated disorders (WAD) have specific patterns of muscle weakness and tightness. Exercise for whiplash and neck pain have been shown effective. Previous research by Dr. Jari Ylinen in Finland has shown that Thera-Band® resistance band exercises are effective at reducing chronic neck pain for up to 2 years. Click here to view Dr. Ylinen’s Thera-Band resistance band exercise protocol here.
Researchers in Norway wanted to compare 2 types of exercise programs on patients with whiplash. 25 patients were randomly assigned to a strength and endurance group or a “motor control” exercise group during 6 weeks of physical therapy. The motor control group performed 10 repetitions of deep neck flexor activation against an inflatable blood pressure cuff. The strengthening group used elastic bands to strengthen their neck muscles and dumbbells to strengthen the upper body. Each exercise was performed for 1 set of 15 to 20 repetitions; each session included a 5 minute More >
The Best Exercises for Rotator Cuff Strengthening
Mar 2nd
For years, the debate has continued on the ‘best’ exercises for strengthening shoulder muscles. Using electromyography (EMG) to measure muscle activity, researchers have attempted to determine which exercises have the highest levels of muscles activity for strengthening exercises. Several studies have examined EMG of common shoulder exercises to find the best exercises to strengthen the rotator cuff; in particular, the supraspinatus muscle. The “empty can” or “full can” exercises have been the most commonly performed exercise for supraspinatus strengthening, but controversy still exists in the literature.
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 More >
It’s not too late to exercise years after knee arthroscopy
Feb 22nd
Meniscus tears in the knee are relatively common, particularly in middle-aged athletic individuals. Arthroscopic surgery is often performed to remove damaged cartilage. Surprisingly, some orthopedic surgeons do not prescribe physical therapy after knee arthroscopy, feeling patients can recover on their own with a few simple exercises. Unfortunately, this may lead to long-term deficits in strength, range of motion, and function. Such deficits may predispose patients to knee osteoarthritis as well.
Scandinavian researchers wanted to evaluate the effects of a functional proprioceptive-based exercise program several years after arthroscopic meniscectomy. 30 patients at 4 years after their surgery were randomly assigned to the functional training group or a non-exercising control group. Both groups were tested for functional performance, strength, and self-reported pain and quality of life before and after the 4 month study.
The exercise group was led by a physiotherapist 3 times per week. A neuromuscular exercise program was developed including foam pads, balance boards and mini-trampolines. The program emphasized closed kinetic chain exercises, muscular coactivation, reactive neuromuscular training, and functional alignment. After 4 months, the functional exercise group had significantly better function and strength than the control group.
While improvements in strength and function can be expected in an exercise group compared to a non-exercising More >
