Academy Blog » strength training

Thera-Band® resistance helps female cancer survivors keep fit after chemotherapy

Dr. Phil Page — Tue, 10 Aug 2010 13:04:19 +0000

Breast cancer survivors often experience weight gain after chemotherapy, particularly pre-menopausal women. This weight gain has been associated with an increased recurrence and death from breast cancer (Chlebowski et al. 2006). Researchers at the University of Washington and Oregon Health Sciences University suggested that exercise may be a low-cost, non-pharmacologic strategy to prevent or reverse weight changes in female cancer survivors. In their randomized controlled study, 112 women newly diagnosed with cancer were randomly assigned to a resistance exercise group, aerobic exercise group, or a control group (usual care). Both exercise groups performed their routines 4 times per week at their home for 12 months. Each exercise routine took 20 to 30 minutes and the exercises used the Borg Scale to maintain a “moderate” intensity level.

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

Visit the Thera-Band Academy Breast Cancer Resource Center Here

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

Thera-Band® exercises safe and effective for patients with hemophilia and bleeding disorders

Dr. Phil Page — Tue, 29 Jun 2010 10:53:42 +0000

Bleeding disorders such as hemophilia may cause bleeding in the joints, known as ‘hemarthrosis.’ This may lead to arthritis and subsequent joint replacement surgery. Exercise is an important component in managing hemarthrosis; however, many patients are hesitant to exercise for fear of injury and resulting bleeding. Few studies have examined the effectiveness of exercise in hemophilia patients.

Previously, German researchers created a strength and proprioceptive training program using Thera-Band elastic resistance and Stability Trainers. The results, published in 2003 noted improvements in strength and proprioception. The authors felt that a balance training component was important to prevent fall-related injuries in persons with hemophilia.

More recently, researchers at the University of Tennessee Health Sciences Center created an individualized 6-week program using Thera-Band resistance in 33 patients with bleeding disorders. They used 3 levels of progression based the participant’s strength. Download the Thera-Band exercise protocol here. The patients then used a specific color of Thera-Band resistance corresponding to the prescribed intensity (% of an isometric manual muscle test). Subjects also performed stretching and cardiovascular exercise. A physical therapist supervised the program 2 days a week. At the end of the 6-week program, there were no injuries, pain, edema, or bleeding episodes reported. The patients significantly improved their range of motion, strength, and cardiovascular status without causing additional hemarthrosis.

This individualized exercise program using Thera-Band resistance in hemophilia was safe and effective; however, the study was limited by a small sample size and presence of additional health conditions among subjects. As reported by Heilberg et al (2003) the addition of a proprioceptive training component to Thera-Band strengthening may provide additional benefits, though more research is needed.

Reference: Mulvany R et al. Effects of a 6-week, individualized, supervised exercise program for people with bleeding disorders and hemophilic arthritis.Phys Ther. 2010 Apr;90(4):509-26.

Visit the Thera-Band Academy Hemophilia Resource Center here

Elastic resistance exercise program effective in high school-based exercises for teens

Dr. Phil Page — Tue, 22 Jun 2010 22:49:31 +0000

Elastic tubing has been proven as effective as free weights again; this time, in teenagers. Several studies have shown that Thera-Band® elastic resistance has similar effects on muscle activation and strength as isotonic resistance (Andersen et al. 2010; Colado & Triplett 2008). Current physical activity guidelines recommend resistance training to improve muscular fitness in youths. A randomized, controlled study in Preventive Medicine by Australian researchers was performed to compare the effects of a resistance exercise program in 15 year old boys and girls using either elastic or isotonic free weight resistance compared to a control group. During the 8-week program, both groups trained twice a week with a PE teacher with a 1:15 instructor-to-participant ratio. They began each session with 5 minutes of aerobic activity and dynamic stretching. Resistance exercises were performed for 2 sets of 8 to 12 reps (Weeks 1-4 = 10-12 reps; Weeks 5-8 = 8-10 reps) with 60 second rests between sets. The 10 strengthening exercises were performed in 40-50 minutes in the same order. Both groups used the Borg scale at 15-18 with an 8-12RM; in other words, participants used a resistance with each exercise that caused fatigue with the last repetition with an exertion level of 15-18 for 8 to 12 repetitions. Participants were tested for body composition and upper and lower body strength (1 RM test) before and after the 8-week study. After 8 weeks, both resistance training groups significantly increased their upper and lower body strength, and improved their body composition compared to the control group. There was no significant difference between the elastic and isotonic groups.

	Elastic Training		Isotonic training
	Males	Females	Males	Females
Upper Body	12%	13%	24%	17%
Lower Body	32%	19%	35%	32%

Percent increase in strength after training program

While the isotonic group had slightly higher gains than the elastic group, the adherence rate and dropout rates were lower in the elastic tubing group. This finding is very important as exercise adherence is vital to the success of any program. One limitation of this study was that subjects were tested for their 1RM strength using isotonic resistance; this may have added bias to the isotonic training group results. The authors suggested further research to investigate the “long-term adherence and effects of school-based physical activity interventions incorporating elastic tubing resistance training with goal-setting principles and strategies to enhance social support.” This was the first study to compare free weights to elastic tubing resistance in adolescents. Thera-Band resistance tubing provides a feasible and effective way to promote physical activity in secondary schools and encourage compliance of resistance training exercise programs.

Reference: Lubans et al. 2010. Exercise adherence and intervention effects of two school-based resistance training programs for adolescents. Prev Med. 50:56-62.

Visit the Thera-Band Academy Elastic Resistance Resource Center here

Thera-Band® strength training for older adults: from acute care to home exercise

Dr. Phil Page — Thu, 27 May 2010 13:43:56 +0000

One of the most common clinical mistakes is to arbitrarily assign resistance training levels to older adults, often choosing very low intensities. These low loads are often insufficient to increase muscle strength. Drs. Dale Avers and Marybeth Brown of the American Physical Therapy Association’s Section on Geriatrics published a whitepaper in the Journal of Geriatric Physical Therapy on strength training for older adults.

Both the Section on Geriatrics and the American College of Sports Medicine recommend strength training at 60% of 1 repetition maximum (RM) as the minimal intensity for strength gains. 1RM is the maximal amount of resistance an individual can move for only one repetition. Unfortunately, it’s often difficult to determine 1RM capabilities in older adults. Even using a multiple RM equation to estimate 1RM may not be accurate, since they haven’t been validated in older adults. However, using Thera-Band® resistance to quantify a multiple RM level has been validated in older adults (Manor et al.)

Using a “rating of perceived exertion” or RPE scale has been advocated to better estimate resistance exercise intensity. There are 2 popular RPE scales: the Borg scale and Omni scale. Several studies on older adults using elastic resistance have used Borg’s RPE scale to dose intensity, and both the Borg and Omni scales have been validated using Thera-Band resistance bands (Andersen et al. 2010; Colado & Triplett 2009). The RPE scale can be used to help determine the appropriate resistance by suggesting to patients that they “use a resistance at a level of 5-7 RPE that allows you to complete the exercise in 10 to 15 repetitions.”

In their whitepaper, Drs. Avers and Brown recommend the following dosage for older adult strength training programs:

Intensity: at least 60% 1RM, corresponding with at least 11 on Borg’s RPE scale, or 3 on the Omni scale
Sets: 1 set per exercise
Reps per set: depends on intensity exercise prescription (eg, 10 repetitions for a 10RM prescription)
Frequency: 2-3 times per week for the same muscle; every day if varying muscles groups (such as in-patient therapy)

The paper also suggests a well-rounded exercise program for acute care physical therapists to provide care for inpatients receiving PT 5 days per week.

Drs. Avers and Brown recommend using Thera-Band exercises at home to gain strength and maintain strength gains after discharge from physical therapy. They also suggested that baseline assessment of strength is important to determine the appropriate resistance exercise intensity; furthermore, they concluded, “Strengthening without rationale or adequate stimulus is tantamount to malpractice.”

The Thera-Band Academy offers free customized exercise program print outs for home exercise programs. When using Thera-Band resistance bands with older adults, use RPE and multiple RM to determine the appropriate intensity levels for optimal strengthening outcomes.

Reference: Avers D, Brown M. White Paper: Strength training for the older adult. J Geriatric Phys Ther. 2009. 32(4):148-152.

Visit the Thera-Band Academy Older Adult Resource Center Here

Elastic resistance exercise safe and effective for kidney failure patients on dialysis

Dr. Phil Page — Thu, 11 Feb 2010 13:28:51 +0000

The kidneys serve an important function in filtering the blood. Patients with severe kidney disease or kidney failure don’t have the ability to clean their blood. This condition is known as end-stage renal disease (ESRD), and often requires hemodialysis that cleans the blood with a machine. In 2006, over 500,000 Americans had ESRD, with over 350,000 requiring dialysis.

Dialysis patients often have reduced physical function and quality of life because of their disease complications and lack of physical activity. Unfortunately, there is little research on exercise in dialysis patients. Researchers performed a multi-center randomized controlled trial in Spain to determine the effects of a resistance training program with ankle weights and elastic bands.

27 hemodialysis patients were randomly assigned to a resistive-exercise group or a low-level aerobic exercise group. Both groups, supervised by physiotherapists, exercised 3 times a week for 6 months. Each session included 5 minutes of stretching as part of warm-up and cool down, and 25 minutes of either resistance training or stationary bike riding. The resistance training group performed training at an RPE of 12-14, and emphasized lower extremity exercise.

At the end of the study, the resistance training group significantly increased in physical function compared to the control group. The researchers concluded that an exercise program including elastic resistance and ankle cuff weights was safe and effective for hemodialysis patients.

Segura-Ortí E, Kouidi E, Lisón JF. Effect of resistance exercise during hemodialysis on physical function and quality of life: randomized controlled trial. Clin Nephrol. 2009 May;71(5):527-37.

Visit the Thera-Band Academy ESRD Resource Center Here