Is ankle proprioception targeted by exercises on an unstable surface?

Everyone who has ever experienced an ankle sprain knows the exercises done on unstable surfaces, such as wobble boards. This is aiming to improve proprioception. Proprioception is defined according to Physiopedia  as: Proprioception is the sense of the relative position of body Read more

Swiss ball enhances lumbar multifidus activity in chronic low back pain

This study investigated the effects of sitting surfaces on the cross-sectional area of lumbar multifidus (LM) in patients with Chronic Low Back Pain (CLBP) and healthy controls (HC). 40 age and sex matched, sporting participants aged 18-45 years, recruited Read more

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Is ankle proprioception targeted by exercises on an unstable surface?

Everyone who has ever experienced an ankle sprain knows the exercises done on unstable surfaces, such as wobble boards. This is aiming to improve proprioception.

Proprioception is defined according to Physiopedia  as:

Proprioception is the sense of the relative position of body segments in relation to other body segments. Unlike the six exteroceptive senses (sight, taste, smell, touch, hearing and Balance) by which we perceive the outside world, and interoceptive senses, by which we perceive the pain and the stretching of internal organs, proprioception is a third distinct sensory modality that provides feedback solely on the status of the body internally. It is the sense that indicates whether the body is moving with the appropriate effort and  where the various segments of the body are located in relation to each other.

However, a study done by Kiers et al. (2011) concluded that these exercises do not target ankle proprioception as thought by most people. It was even found that on foam, the effect of triceps surae vibration on mean center of pressure (CoP) velocity was significantly smaller than on a solid surface, while for paraspinal musculature vibration the effect was bigger on foam than on solid surface. Similar effects were seen for mean CoP displacement as outcome. They rather challenge the capacity of the central nervous system to shift the weighting of sources of proprioceptive signals on balance. The study does however not mention what exercises can be done instead to target ankle proprioception. Hence, further research needs to be done in this field.

Therefore, in the daily practice, the therapist should take in mind that improvement may result from improvement of paraspinal musculature and the capacity of the central nervous system rather than the ankle proprioception. This does not mean that proprioception exercises do not benefit ankle sprains but that the benefit might have a different cause for balance improvements.

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Swiss ball enhances lumbar multifidus activity in chronic low back pain

This study investigated the effects of sitting surfaces on the cross-sectional area of lumbar multifidus (LM) in patients with Chronic Low Back Pain (CLBP) and healthy controls (HC). 40 age and sex matched, sporting participants aged 18-45 years, recruited from private physiotherapy practice patients (n=20 CLBP, 16 male, 4 female, and n=20 healthy controls, 16 males and 4 females) took part in the study. Swiss Ball (SB) was more effective at stimulating LM than a Stable Surface (SS) in both groups: CLBP:SB:12.3(cm(2)) (SD:3.6), SS:10.15 (SD:2.6), p<0.0001; HC:SB:12.5 (SD:2.7), SS:11.3 (SD:2.9), p<0.0001). There weren’t any significant differences between groups to note. No differences between left and right side cross-sectional areas between or within groups were noted.

Cross-sectional area of LM increased as the lability of the surface increased, showing that SB was more effective at stimulating LM activity than a non-labile surface. This confirms current clinical practice and supports the use of a labile surface in spinal rehabilitation. The lack of LM asymmetry within and between groups is discussed.

Swiss ball enhances lumbar multifidus activity in chronic low back pain.

- See more at: http://www.physiospot.com/research/swiss-ball-enhances-lumbar-multifidus-activity-in-chronic-low-back-pain/#sthash.7wkK7P5s.dpuf 

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Fall Prevention and measures

 Facts

  • About one third of the elder population over the age of 65 falls each year, and the risk of falls increases proportionately with age. At 80 years, over half of seniors fall annually.
  • Those who fall are two to three times more likely to fall again.
  • About half (53%) of the older adults who are discharged for fall-related hip fractures will experience another fall within six months.
  • 20% to 30% of seniors fear falling.
  • 90% percent of falls that do not result in injury can still have a detrimental impact on health and well-being. 30-50% of elders report that fear of another fall results in loss of confidence and self-imposed restriction of activities, thereby increasing the risk of falls.

Learn more here

  • In older adults, the incidence of falls increases steadily with advancing age.
  • Chronic medical conditions associated with falls: cognitive impairment and arthritis (more common in older adults)
  • Physiologic changes of normal aging might also increase the risk of falls.
  • Influencing factors whether a fracture occurs; the fall descent, fall impact, and bone strength.

Berry et al. 2008 

Factors & prevention

Osteoporosis

  • consume sufficient calcium – broccoli, soybeans, almonds
  • Get sufficient Vitamin D – sunlight, supplements
  • Weight-bearing exercises on a regular basis

Lack of physical activity

  • Stay active at least every other day for 15 minutes – walking, swimming etc.
    • If you need help with that contact you physiotherapist to ensure you have a safe and adjusted exercise routine!
  • Wear good footwear
  • Move safely – take your time, position yourself

Impaired Vision

  • Get your eyes checked regularly
  • Highlight your aids (handrails etc.) and stairs at home
  • Keep your glasses clean!

Medications

  • Know all common side-effects
  • Ask physician/pharmacist about risk of falls
  • Avoid consuming alcohol with medication

Environment

  • Repair cracks and abrupt edges
  • Install handrails on stairs and steps and grab bars in bathrooms
  • Keep the floor clear of clutter, rocks and tools
  • Use highlighting for changes in surface or level
  • Sufficient lighting – bedlights, nightlights, motion-sensitive lighting
  • Anti-slip mats – bathtubs, shower rooms, tile floors
  • Bath-shower seats
  • Keep commonly used items within easy reach
  • Use a stable step stool
  • Make sure bed, chairs and couches are easy to get in and out (not too low)

Always have a phone nearby, install electronic emergency response systems (emergency watch, etc.)

For healthcare professionals

Falls efficacy scale – to measure Fear of falling

Berg Balance Scale – to assess balance

Timed up and go test - Assesses mobility, balance, walking ability, and fall risk in older adults

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Low back Pain Prevention

Low back pain is a very common symptom in the general population and among athletes. At some point in their lives up to 85% of the population suffer from Back pain and leads to annual cost of over 40 billion US $ in the United States (Brukner et al. 2012). Most people who experience activity-limiting low back pain have recurrent episodes. Approximately once a year a recurrence occurs in 24% to 80%. Environmental and personal factors influence the onset and course of low back pain. Other risk factors might be low educational status, stress, anxiety, depression, job dissatisfaction, low levels of social support in the workplace and whole-body vibration. It has been found that the incidence of LBP is highest in the third decade, and overall prevalence increases with age until the 60-65 year age group (Hoy et al. 2010).

There are 3 different types of low back pain, acute, recurrent, and chronic. Acute LBP comes on suddenly and typically lasts less than 3 months. Recurrent low back pain occurs with frequent episodes of acute LBP. Chronic LBP typically lasts longer than 3 months.

Possible causes of Low Back pain are overuse, strain, or injury. However, it is mostly caused by the inability of your back’s muscles, ligaments, and joints to work as they should. More often than not, the cause of LBP just isn’t clear. Much less frequently, LBP may be the result of a specific health condition, such as degenerative disk disease (a flattening and stiffening of the disks between the vertebrae), lumbar spinal stenosis (a narrowing within the vertebrae of the spinal column, resulting in too much pressure on the spinal cord), or osteoporosis (a thinning of bone tissue and loss of bone density over time). Rare, but serious LBP symptoms include incontinence or difficulty urinating, poor balance, numbness, or weakness in the legs. See a physician immediately if you experience any of these symptoms. It is worth repeating, however, that most LBP is not serious and may be resolved or managed effectively by using a conservative approach, such as physical therapy (American Physical Therapy Association 2012).

These precautions can help prevent LBP in your daily life (read more here American Physical Therapy Association 2012) .

Lifting

  • Position your body directly in front of the object.
  • Bend your knees rather than your back.
  • When carrying do not twist your back to turn, move your feet.

 

 

 

Wearing Backpacks

  • For children it is suggested that backpack contents should be limited to 10 to 15% of the child’s body weight.
  • Wear both straps to keep weight distributed properly.
  • The backpack should rest evenly in the middle of the back—it should not extend below the lower back.
Gardening
  • Support your back by bending at the knees to avoid straining.
  • Keep one foot on the ground while kneeling.
  • Use knee pads when kneeling to absorb some of the pressure.
  • Use a wheelbarrow to move heavy items.
  • Change positions frequently to reduce stiffness.

 

At the Office
  • Use an upright chair that has good back or lumbar support.
  • Postion the monitor for your head and shoulders to be able to relaxed and you don’t have to crane your neck.
  • Keep your mouse close to your body.
  • Do easy exercises at your desk (backward shoulder rolls, and get up frequently to stand straight and/or walk).

 

Traveling
  • During long drives, stop every hour or so to stand up and move around.
  • You can also place a rolled up towel behind your back at approximately waist level to provide lumbar support while driving.

 

In the long-term you should consider physical exercise, which is recommended and proven to prevent low back pain. High intensity programmes, which comprise both an educational/skills programme and exercises, can be recommended for patients with recurrent and persistent back pain. Against general belief, lumbar supports or back belts are not recommended (Eurpopean Guidelines for prevention in Low Back Pain 2004).

American Physical Therapy Association: Low Back Pain: Management and Prevention Guideline
Bruckner P, Kahn K. Brukner & Khan’s Clinical Sports Medicine. 4th ed. Australia: McGraw-Hill Australia; 2012. p. 463-492
Eurpopean Guidelines for prevention in Low Back Pain
Hoy D, Brooks P, Blyth F, Buchbinder R. The Epidemiology of low back pain. Best Pract Res Clin Rheumatol. 2010 Dec;24(6):769-81.

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Kinesis Stroke Trial

 

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Imoove

Imoove® is a device with a broad spectrum of functional rehabilitation applications. It represents a major evolution in the rehabilitation field. Associated with your experience, Imoove® enables you to treat a large number of osteo-muscular pathologies.

-Read more here

 

The observation of the movement of the vertebrae ones on others, the elispheric® movement of the plate reproduces the natural spiral movements of muscles and joints patterns of the body.
The Elispheric® Movement stimulates a deep proprioception and restores the musculopostural balance of the body: functional exercises proposed by IMOOVE® take advantage of the instability of the plate and through the sollicitation of all functions of proprioceptive and biomechanics adaptation, train control motor and postural of the body as well as joint flexibility. 

The control of instability, in a context of fully controlled disbalance, combined with the attentional mobilization tasks, restores and develops proprioceptive skills and generates musculoskeletal health of the body.

-Read more here

 

 

 

 

 

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Alter G – Anti gravity treadmill

Thanks to its precise unweighting technology, the AlterG® Anti-Gravity Treadmill® allows you to push your training and physical therapy rehabilitation further than ever before.

You can:

  • Reduce gravity’s impact by selecting any weight between 20% and 100% of your body weight by 1% increments

  • Rehabilitate lower extremity injuries with less pain and less impact

  • Improve mobility, strength and safety for those with neurological conditions

  • Provide a safe way to lose weight and exercise more intensively while unweighted

  • Train without pain and reduce the stress to joints and muscles

  • Recover effectively and with less pain after training or competition

The innovative AlterG Anti-Gravity Treadmill is a game changer in physical therapy rehabilitation. Whether you’re a patient or an athlete dealing with lower body injuries, chronic pain or neurological conditions that inhibit mobility, you can benefit from the unweighting capabilities. The Anti-Gravity Treadmill helps a broad spectrum of people – top level athletes, orthopedic and neurologic patients,pediatric, geriatric and those looking to lose weight – to achieve their personal health, wellness or performance goals.

Read more here 

Recent studies in patients with muscular dystrophies suggest positive effects of aerobic and strength training. These studies focused training on using bicycle ergometers and conventional strength training, which precludes more severely affected patients from participating, because of their weakness. We investigated the functional effects of combined aerobic and strength training in patients with Becker and limb-girdle muscular dystrophies with knee muscle strength levels as low as 3% of normal strength.

Eight patients performed 10 weeks of aerobic and strength training on an anti-gravity treadmill, which offered weight support up to 80% of their body weight. Six minute walking distance, dynamic postural balance, and plasma creatine kinase were assessed 10 weeks prior to training, immediately before training and after 10 weeks of training. Training elicited an improvement of walking distance by 8 ± 2% and dynamic postural balance by 13 ± 4%, indicating an improved physical function. Plasma creatine kinase remained unchanged. These results provide evidence that a combination of aerobic and strength training during anti-gravity has the potential to safely improve functional ability in severely affected patients with Becker and limb-girdle muscular dystrophies.

Read more here

 

 
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Fitness is like Lego

If you look at how far you have to go in your goals, you’re likely to get discouraged. LEGO fans can look at a box with a complex build and don’t easily get discouraged. NerdFitness suggests applying that do your fitness goals:

“Today I want you to stop worrying about that final plan, and instead focus on just putting the next LEGO brick in the right spot. THAT’S IT.” That’s pretty much how you build with LEGO. One brick at a time,placed in the right place. Don’t worry about the next brick. Just the brick in front of you. 

Read more http://lifehacker.com/fitness-is-like-lego-you-build-it-brick-by-brick-1684283107

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Know someone that has a Stroke?

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