This week we discuss telerehabilitation vs in perosn rehab for chronic nonoperative shoulder pain. In this RCT, the digital health group performs 20 minute exercise sessions 3 times per week and is monitored via inertial units which give real time biofeedback. Physical therapists provide education through short written articles that can be accessed via an app, they also text and phone/video call to answer questions and ensure adherence. The in person group received 30 minute sessions of traditional physical therapy twice per week. After 8 weeks there was no significant difference their primary outcome measure, the QuickDASH. There were a lot of directions we took this article in the podcast, so be sure to check it out!

The abstract can be found here: https://pubmed.ncbi.nlm.nih.gov/37490337/

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This week we discuss reverse engineering strength and conditioning programming. Reverse engineering is a decision-making process which starts with the end goal in mind and works backwards to determine when different athletic qualities should be emphasized in a training program. While people can have a wide range of goals, different activities rely on the development of certain physical characteristics, so it is important to know the demands of the end task. Throughout the bulk of the article, the authors discuss agility development as an example of the application of reverse engineering. Agility requires decision making and change of direction speed. An athlete must be able to quickly decide how and where to produce a large amount of force in a short period of time to achieve an appropriate degree of change of direction during in-game situations. Some component pieces of agility include: maximal strength, stretch-shortening cycle mechanics, accelerative and decelerative ability, and decision making. The authors also discuss how and why coaches should screen for movement imbalances and mobility deficits throughout training. Clinicians should examine and assess qualities which are related to a patient/client’s current injury status, but also understand which qualities are important for the patient/client to achieve their long-term goals. This can be done by screening the final movement we want to see, in this case a 180 change of direction. Analysis of the end task reveals where the patient/client is currently lacking.

The abstract can be found here: https://journals.lww.com/nsca-scj/fulltext/2022/08000/reverse_engineering_in_strength_and_conditioning_.8.aspx

As always, if you enjoy what you hear, be sure to follow us on your favorite podcast platform and on Instagram @readingrehabpod. If you have any article recommendations be sure to send them our way!

This week's article is a reivew of minimal dose resistance exercise programs among the general population from the article "Resistance exercise minimal dose strategies for increasing muscle strength in the general population: an overview." Roughly 80% of the population does not meet current weeky resistance exercise minimum guidelines with about 58% of people not participating in resistance training at all. Therefore, minimal dose resistance training programs could be a potential gateway into meeting current guidelines, or at least provide some stimulus for adaptation. Five different programs are reviewed: weekend warrior, single set resistance exercise, exercise snacks, practicing the strength test, and eccentric minimal dose. Weekend warrior programs resistance train once per week, single set programs perform a single set of various exercises a few times per week, and exercise snacks are frequently implemented multiple times every day and can be as short as 9 minutes per day of exercise. Practicing the strength test involves training sets of 1 rep at a maximal intensity of either eccentric and concentric movements or maximal isometrics. Eccentric minimal dose programs accentuate the eccentric phase of lifting, and both of these last two programs are less commonly applied to the general population. All programs have shown to benefit muscle strength and hypertrophy more than no exercise, and they are generally easy to adhere to. In particular, exercise snacks were found to have a 97% adherence when done once for 9 minutes per day, with an 81% adherence when performing 9 minute sessions three times per day for a total of 27 minutes per day. These programs improve function in older adult populations, decrease reported daytime sleepiness, and decrease pain in populations with chronic neck pain. Clinically, this is likely the most common exercise prescription to give patients. Knowledge of minimal effective dosage of resistance training is important to solidly understand as a clinician because it is very likely your patients are not already meeting resistance training minimum guidelines, and prescribing optimal dosage or even these minimum guidelines will likely result in your patients not adhering to their program with poor adherence leading to worse outcomes. Offer options between these five different minimal effective dose programs to best fit the needs of the patient before you.

The abstract can be found here: https://pubmed.ncbi.nlm.nih.gov/38509414/

As always, if you enjoy what you hear, be sure to follow us on your favorite podcast platform and on Instagram @readingrehabpod. If you have any article recommendations be sure to send them our way!