Over the course of the last several weeks we have been discussing
how to leverage technology for the assessment of movement and treatment of
movement dysfunction. Most of the
technologies we discussed can be easily implemented into treatment and are
relatively inexpensive. Those that are
used for the assessment of movement dysfunction can, many times, also be an
additional billable service that can be added to your athlete’s episode of
care. To conclude this series, we will
be discussing the use technology for HEPs and tracking of compliance with the
athlete.
One of the first we will discuss is the ACL Play It Safe Program. In
full transparency, this is one that I have been personally involved in but have
no financial tie to. This is a program I
developed to address the preventable non-contact lower limb injury epidemic in
sports. Although the name suggest this
is ACL specific, this program is movement specific. This means this addresses the biomechanics and
movements that are associated with non-contact lower kinetic chain injuries,
one of the most recognized of which is the anterior cruciate ligament (ACL)
injury. In addition to mitigating injury
risk, these same movements are also associated with a decrease in athletic
performance. So, this program is
specifically designed to improve the efficiency of athletic movement which
results in reducing injury risk and improvements in athletic performance
(specifically vertical jump and sprint speed).
This program was
developed in conjunction with Theraband® and Cramer®. The ACL Play It Safe program is a
comprehensive program that can be implemented with an athlete as a part of
their home exercise program. This
program includes:
·
Gender
specific kit – There is variance in the male and female athlete based on
the peer reviewed literature. The
research indicates there are variances in strength and proprioception among the
male and female athletes which is accounted for in the male and female kit.
·
Standardized
equipment - This standardized kit is designed for the individual
athlete. Having standardized equipment
ensures that the athlete is using the same equipment each time and has the
equipment available for every exercise.
This improves outcomes since the athlete will not be using different
equipment each time and/or skip an exercise because the equipment is not
available.
·
Equipment
included – each kit includes the following:
o
CLX – this is the latest development in
resistance band technology and was developed by Theraband®. Use of the CLX allows us to perform very
creative exercises like the spiral technique.
This particular technique allows us to perform single limb training
while increasing Gmed recruitment during this activity.
Spiral Technique
o
Padded Cuffs – allows us to perform closed
kinetic chain gmed and core strengthening.
o
Stability trainer – allows us to work on single
limb proprioception and core stability training
o
Biofreeze – to do the aggressive nature of this
program, this allows us to control muscle soreness and irritation that may
develop as a normal part of an athletic season.
·
Standardized program – the ACL Play It Safe Program is a
progressive program that is designed to be implemented as a part of your team’s
practice or training. This program
includes two very distinct parts.
o
Pre-practice
routine – Neuromuscular resetting – this is designed to prep the system for
movement or participation in sport. This
only includes three movements but are full lower kinetic chain movements that
add in improving lower kinetic chain mobility while at the same time initiating
the proper movement patterns. This
routine takes 3-5 minutes.
o
Post-practice
routine – Fatigue state training – we know that most injuries occur later
in the game and that athletic performance is negatively impacted by
fatigue. What the literature tells us is
that training in a fatigued state will have a better carry over and impact to
the athlete’s movement in a fatigued state.
This means they move better, are at reduced risk for injury and they
perform at a higher level. This routine
takes 15 minutes.
·
ACL Play It Safe App – as a part of the ACL Play It Safe Program,
we have developed the ACL Play It Safe App.
Knowing the importance of proper instruction in movement and corrective
exercises, we have found that providing this in a comprehensive video was one
of the most effective means of doing so.
The ACL Play It Safe App was developed in conjunction with Theraband®
and Cramer®
and is an easy way to provide a video for every exercise included in this
program in an app. The ACL Play It Safe
app can be found on IOS or Android by searching “PhysioSports” and is
free. The ACL Play It Safe app
provides:
o
Level I – IV exercises
o
Specific order in which the exercise should be
performed
o
Specific technique for each exercise
o
Number of sets and reps for each exercise
*Note – it should be noted that this is a web-based app due
to the number of videos included. This
means that you will need access to the internet or cell service in order to run
this app.*
In addition to the ACL Play It Safe App, another technology
that is being used in home exercise programs for correcting of movement
dysfunction is Fusionetics. Fusionetics
was developed by Mike Clark, DPT. For
those in athletics and familiar with movement assessment, Dr. Clark has been an
innovator in the area of movement assessment, corrective exercise and
technology. Fusionetics is his latest
innovation and is quickly becoming a great platform for distribution of quality
research based content and provides a tool by which we can track the athlete’s
progress and compliance.
Fusionetics is a web-based platform that that provides some
very unique features. Once the athlete’s
movement has been assessed, the athletic trainer, physical therapist or
personal trainer can then build a profile in the software for the athlete. This allows the provider to assign or
prescribe exercises and the frequency at which these are done. The athlete is then provided with a link that
allows them to set up their individual profile and to access the Fusionetics
App. When the athlete logs into their
individual profile on the app, they are then provided all the exercises the
provider has prescribed to them along with comprehensive videos of each
exercise. Once the athlete performs the
exercises, they then log in the app that the exercises were performed and how
they are progressing with the exercises, the level of difficulty and if they
experienced pain with.
For the provider, once they log into their account, they can
instantly see all their athletes, which ones are doing the exercises, who they
are progressing and whether or not they should be progressed on
their
exercises. This is an invaluable tool,
especially for those of us who need to track multiple athletes or for athletes
that we are only able to see occasionally or who travel with their team. The Fusionetics platform provides the
provider with some invaluable information and a way they can continue to engage
the athlete throughout their training and season.
As we have seen, there is a rapid progression of technology
in the area of sports medicine. The
technologies that have been mentioned throughout this blog series is only a
small portion of the technologies that are available. In addition to the aforementioned
technologies, there are additional telemedicine technologies emerging on the
market. One such technology is
Player's Health, which is a mix between an athletic training EMR and telemedicine
platform. This technology allows the
provider to have a much more robust engagement with the athlete, team
physician, coach and manager/athletic director.
With the integration of their app, this allows:
·
Communication of information to the athlete
about their care or physician appointments
·
Team physician to quickly see where each athlete
is in the health care continuum and get updates
·
The coach to see which athletes on are on the
DL, where they are in the process and their anticipated RTPlay date
·
The athletic director/manager to see what athletes
are injured, how long they have been on the DL and their anticipated RTPlay
With the emergence of technologies such as this, it creates
a greater level of transparency of care and improved communication. For those of us involved in treatment of the
athlete, we know how challenging this can be and how vital consistent and clear
communication is. These technologies
simply allow us to do what we do but even better and with improved efficiency.
We hope you have enjoyed this blog series and thank you for
sharing the passion for movement and prevention.
Dr. Nessler is a practicing physical therapist with over 17 years sports medicine clinical experience and a nationally recognized expert in the area of athletic movement assessment. He is the developer of an athletic biomechanical analysis, is an author of a college textbook on this subject and has performed >3000 athletic movement assessments. He serves as the National Director of Sports Medicine Innovation for Select Medical, is Chairman of Medical Services for the International Obstacle Racing Federation and associate editor of the International Journal of Athletic Therapy and Training.
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