November 2020 | VALD Health | Human Measurement Technologies

TeleHab exercise program for committed runners with Brad Beer

November 24, 2020/in TeleHab /by VALD

Brad Beer is a Sports & Exercise Physio with a special interest in running and related injuries.

In this series of clips produced in conjunction with TeleHab Exercise Prescription App, he shares his recommended program for committed runners.

These exercises don’t require any equipment and will assist to build strength and prevent injury.

Not a committed runner? Check out our clips for beginner runners or those returning to running.

You should be in good physical health and be able to participate in exercise before joining this activity.

If you are uncertain, seek your doctor’s clearance before participating.

If at any point you feel faint, dizzy or have physical discomfort, you should stop immediately and consult a medical physician.

TeleHab exercise program for those returning to running with Brad Beer

November 12, 2020/in TeleHab /by VALD

Brad Beer is a Sports & Exercise Physio with a special interest in running and related injuries.

In this series of clips produced in conjunction with TeleHab Exercise Prescription App, he shares his recommended program for those returning to running.

These exercises don’t require any equipment and will assist to build strength and prevent injury.

Never stopped running? Check out our clips for beginner runners and committed runners.

You should be in good physical health and be able to participate in exercise before joining this activity.

If you are uncertain, seek your doctor’s clearance before participating.

If at any point you feel faint, dizzy or have physical discomfort, you should stop immediately and consult a medical physician.

Finding the balance between prescribing home exercise programs for adaptation and adherence

November 12, 2020/in Uncategorized /by VALD

Guest blog by Dr. Sjaan Gomersall, Senior Lecturer in Physiotherapy at The University of Queensland and Clinical Consultant at VALD Performance. Article originally posted to LinkedIn – here.

Exercise is now well accepted as one of the most effective components of rehabilitation, supported by findings from systematic reviews and meta-analyses across a wide range of conditions (O’Keefe et al 2017).

Home exercise programs are a cornerstone management strategy for practitioners working in exercise rehabilitation settings.

While consultations in the clinic provide opportunities for assessment, passive therapies, education, and exercise prescription, it is the time between visits where clients are asked to complete home exercise programs that are crucial to the client’s treatment outcomes.

Exercise professionals are experts in prescribing exercise rehabilitation programs that are effective for eliciting physiological adaptation in the target system to address the client’s impairments.

Informed by exercise prescription guidelines, experience, and best-evidence, exercise professionals prescribe programs of sufficient frequency, intensity, time, repetitions, sets, and loads in order to elicit physiological adaptation in their clients.

However, the intended physiological adaptations will only occur if clients adhere to their home exercise programs.

Why is adherence so hard to achieve?

Adherence is described by the World Health Organisation (WHO; 2003) as “the extent to which a person’s behavior, which could be taking medication, following a diet, and/or executing lifestyle changes, corresponds with agreed recommendations from a health care provider”.

While adherence and compliance can often be used interchangeably, the term adherence has specifically been used here to capture the active role that clients play in their own health care and shared-decision making that underpins the exercise professional and client interactions (Hoffman et al 2020).

Adherence to home-based exercise programs is one of the biggest challenges facing exercise professionals, with average adherence reportedly as low as 30% (Essery et al. 2017).

Adherence is a complex problem that requires a multi-level approach and clients are not solely responsible for their ability to adhere to exercise programs (WHO 2003).

Clients need to be informed, motivated and skilled in order to carry out their home exercise programs, and too often practitioners may run out of time or make assumptions about their client’s motivation or skills, particularly outside of the clinical setting and their ability to transfer any skills taught in the clinic into their unsupervised, home environment.

Promoting adherence requires client-centered and individually tailored strategies to enable clients to adhere to home exercise programs and achieve optimal health-related outcomes.

A combination of evidence-based prescription for physiological adaptation and best-practice strategies to promote adherence is most likely to result in the best possible client outcomes.

What does this look like in practice?

There are many strategies that have been developed and tested with the aim of improving adherence to home exercise programs, as well as a large body of research that has explored the predictors, barriers, and facilitators of adherence in this context.

One example is the use of action planning, which involves prompting your client to make a detailed plan about how and when they will carry out their program – on which days of the week, at what time.

Recently, TeleHab and VALD Health conducted a poll on Twitter asking exercise professionals how they schedule exercises when prescribing a strength program.

Over 60% of respondents reported that they prescribe their programs ‘x’ number of times per week, as opposed to specific days per week, every ‘x’ number of days, or whenever possible.

While ‘x’ number of days per week is in line with exercise prescription guidelines, can we do better to promote client adherence?

In this example, incorporating action planning could see exercise professionals taking some time to help their clients create an action plan for when and how they will complete their home exercise program 3 days per week.

Evidence has shown that action planning can help bridge the gap between intentions to complete exercise and actually carrying out the behaviour, without which we won’t see the desired physiological adaptation.

Ask yourself: Have you tried action planning? What other strategies have you used in the clinic to try to promote adherence to your home exercise programs with your clients?

Interested in learning more about exercise adherence and adaptation?

Check out VALD Health’s two-part webinar series aptly titled; ‘Improving exercise adherence’, hosted by Dr. Sjaan Gomersall and Dr. Simon Lack, Physiotherapist at Pure Sports Medicine and Senior Lecturer at the Queen Mary University in London.

To watch part one – click here.

To watch part two – click here.

For more webinar content, sign up for the VALD Health Online Series for free – click here.

References

Bassett SF, 2015. Bridging the intention-behaviour gap with behaviour change strategies for physiotherapy rehabilitation non-adherence, New Zealand Journal of Physiotherapy. 43(3): 105-111. doi 10.15619/NZJP/43.3.05

Essery, R, Geraghty, A, Kirby, Yardley, 2017, Predictors of adherence to home based physical therapies: a systematic review. 39, pp 519-534.

Hoffman, TC, Lewis, J, Maher, C, 2020, Shared decision making should be an integral part of physiotherapy practice, Physiotherapy. 107, pp 43-49.

O’Keefe, M, Hayes, A, McCreesh, K, Purtill, H, O’Sullivan, K, 2017, Are group-based and individual physiotherapy exercise programmes equally effective for musculoskeletal conditions? A systematic review and meta-analysis. BMJ Sports Medicine. 51; pp 126-132.

World Health Organisation (2003), Adherence to long-term therapies: Evidence to action. Geneva, Switzerland.

Improving client engagement and outcomes with ForceDecks

November 10, 2020/in Case Studies /by VALD

Dr. Jacob Canright, PT, DPT, is a Sports Medicine Specialist and Physical Therapist at The Lab, a new clinic powered by Genesis Health located in the Quad Cities area.

In this case study, Jacob shares insight into how ForceDecks are currently used to assess clients, and how they have proven themselves to be an effective tool for improving client outcomes and securing new business.

Both athletic trainers and physical therapists at The Lab utilize ForceDecks for injury prevention, physical rehabilitation, and post-surgical rehabilitation.

How The Lab uses ForceDecks

Currently, both athletic trainers and physical therapists at The Lab utilise ForceDecks for physical rehabilitation, post-surgical rehabilitation, and importantly, injury prevention.

Dr. Jacob Canright explains;

“We’ve been working to develop our own test battery, incorporating the ForceDecks. As part of it, we’ll be able to run our clients through a series of baseline tests, say during pre-season, and then on an ongoing basis annually. Through these tests, we can identify any sort of risk or try stratifying that risk to determine whether a client may need additional treatment.”

Genesis Sports Medicine also offers free screening sessions with ForceDecks to identify any conditions or potential risks that might lead to injury.

“We wanted to develop a good sports medicine program within our facilities and within our area and wanted to look at different equipment that helped us to be able to paint the best picture and the best understanding of how people are performing and what kind of concerns may come up” said Jacob.

Reporting and communication with other healthcare providers

Ultimately, ForceDecks have allowed Genesis to strengthen communication between clients and external healthcare providers.

Jacob explains;

“ForceDecks help us identify those cases where somebody may be passing typical return to sport tests, but when we look at their ForceDecks data, we realize that what looks good on paper isn’t really that good.

That’s been our biggest issue with a lot of return to sport tests – they don’t necessarily give the whole picture – just because you can be within a percent of your unaffected limb, doesn’t mean that all of the quality is there that needs to be there to reduce that risk of re-injury.”

By identifying these otherwise hidden factors, practitioners at The Lab can paint a clearer picture of a client’s condition, and offer their recommendations to coaches, sports medicine physicians, orthopaedic surgeons, and the like with greater certainty and authority.

Engaging clients with ForceDecks

ForceDecks have proven themselves to be an effective marketing tool for The Lab, helping to improve customer experiences and outcomes, along with securing new business.

Currently, free screening sessions with ForceDecks are being offered to clients in order to identify any conditions or potential risks that might lead to injury.

Jacob explains “while marketing through Facebook and Google is beneficial, we believe that in-person contact and building relationships by allowing potential clients to witness first-hand what the technology can do is the most important thing – they will market it themselves at that point.”

Further, as ForceDecks can be used to measure balance, they have also been incorporated into the everyday care of clients.

An effort that has garnered an increasingly positive response from clients.

“Everyone who gets to see and try out the ForceDecks really likes it because of its ability to show data in real-time” said Jacob.

It’s with this visualization of data that clinicians at The Lab can instantaneously transition between assessment and treatment.

“If a client performs a test, and we find that they’re landing rigid through one side, we can justify that they need to work on their eccentric strength with some eccentric loading type activities.”

Summary

The addition of ForceDecks has provided clinicians at The Lab with more objective data on their clients’ rehabilitation and physical wellbeing.

By providing clients with instant insights backed by objective data, clinicians at The Lab can prescribe exercise and rehabilitation activities with greater accuracy and certainty, ultimately leading to greater client satisfaction.

Interested in learning more about ForceDecks?

For further information on how ForceDecks can help your clinic, visit our ForceDeck’s page – here.

Download this case study as a PDF:

Genesis Health Case Study – ForceDecks

TeleHab exercise program for beginner runners with Brad Beer

November 6, 2020/in TeleHab /by VALD

Have you always wanted to get into running, but don’t know where to start?

Sports & Exercise Physio Brad Beer, in collaboration with TeleHab, shares some tips and tricks for beginner runners.

These exercises don’t require any equipment and will assist to build strength and prevent injury.

Not a beginner runner? Perhaps our clips for committed runners or those returning to running might suit better.

You should be in good physical health and be able to participate in exercise before joining this activity.

If you are uncertain, seek your doctor’s clearance before participating.

If at any point you feel faint, dizzy or have physical discomfort, you should stop immediately and consult a medical physician.

Integrating Blood Flow Restriction training into post-surgical rehab programs

November 2, 2020/in Case Studies /by VALD

Movement Rx is a cutting-edge physiotherapy and sports medicine clinic located on the Moreton Bay Peninsula in Queensland, Australia.

Damian, co-founder of MovementRx, is an experienced clinician with over a decade’s worth of experience in private practice, along with extensive sports physiotherapy experience having worked directly with various professional sporting teams throughout his career.

Read on to learn more about Damian’s application of Blood Flow Restriction (BFR) and AirBands for post-surgical rehabilitation in his practice.

How have you integrated Blood Flow Restriction (BFR) training into your rehabilitation programs?

BFR offers a great way to help reduce muscular atrophy post-surgery/injury in a load compromised area.

We frequently use BFR with patients who are immobilised and are unable to bear weight or have weight-bearing restrictions to increase the effectiveness of low load/demand exercises.

These may include significant ankle sprain, lower limb fracture, surgical fixation of a syndesmosis, ACLR, arthroscopic knee surgery, hip surgery (labral trim or repair).

BFR can also be an effective tool in the rehabilitation of degenerative conditions of the hip, knee, or ankle.

Again, allowing a form of resistance training that produces strength gains whilst minimising load bearing of a degenerative joint can lead to some great success.

We’ll often also use BFR as an intermediary training tool to help settle pain and swelling, develop some muscular strength and endurance which can then be transferred to more traditional training.

What does a typical session utilising BFR look like?

A BFR training session for the patient described above usually follows some manual therapy to reduce swelling and improve range of motion.

Then, the cuff is appropriately fitted and the occlusion pressure is set.

Once set, the patient will circuit through 3-4 specific exercises at a rep range pre-determined based on their stage of healing, level of pre-injury fitness, and how familiar they are with BFR and RPE.

Do you only apply BFR in your clinic, or do you prescribe at-home BFR exercises as well?

Given the nature of load-controlled exercises, exposing our patients to the BFR stimulus more frequently ultimately leads to greater results.

So, we encourage our patients to use BFR as a part of their at-home or independent rehabilitation to maximise the effectiveness of their efforts.

Now with the availability of AirBands, the ease of use has made this far more practical and accessible to more of our clientele.

How do you explain the benefits of BFR training to skeptical or hesitant clients and get them on board with the idea?

It’s quite normal for a client to be hesitant when a physiotherapist presents a model of training that they’re unfamiliar with, especially one that describes occluding blood flow.

So, we take the time to explain in detail why we believe it will be an effective tool for their recovery, the modes with which it works, and as always, the risks.

Then, a practical demonstration of how it is applied often follows.

Finally, we’ll often provide some material to read or videos to watch to help them understand and make the most informed decision.

And as is the case with all rehabilitation, providing the patient with the autonomy and right to make that informed decision is often vital to their success.

If they are truly hesitant we will move on to another form a rehabilitation.