Tuesday, November 19, 2013

Elastic Upper Body Adapted Resistance Workout for Therapeutic Recreation, Ideas

The link to our PDF presentation

Resistance training with elastic bands or tubing Therapeutic Recreation Ideas



Resistance training with elastic bands or tubing
Description of the Activity
by Christina Serpa, Justin Kelly, Kim Tremblay and Jimmy Larocque
Adaptations for the activity summary and quotes
What is Resistance Training?
According to the medical author Richard Weil MEd, CDE, “Resistance training is any exercise that causes the muscles to contract against an external resistance with the expectation of increases in strength, tone, mass, and/or endurance. The external resistance can be dumbbells, rubber exercise tubing, your own body weight, bricks, bottles of water, or any other object that causes the muscles to contract.”
How Does Resistance Exercise Work?
The author Richard Weil wrote the following definition “Resistance training works by causing microscopic damage or tears to the muscle cells, which in turn are quickly repaired by the body to help the muscles regenerate and grow stronger. The breakdown of the muscle fiber is called catabolism, and the repair and re-growth of the muscle tissue is called anabolism. Anabolic means to grow, and that's exactly what happens after you break down the muscle fibers with resistance exercise.. With muscles, testosterone, insulin-like growth factor, growth hormone, protein, and other nutrients rush to the muscle after a resistance-exercise session to help repair the muscles to make them stronger. Importantly, your muscles heal and grow when you aren't working out, and so that's why it's necessary to leave time between workouts for recovery.”
What is Resistance Training with Elastics?
            The above quotes demonstrate general definition of resistance training. In strength training with an elastic band, the external force required in creating the muscular damage or tears is done through the contractile force exerted through the manipulation of the band in a controlled manner.
Efficiency of using Elastic Bands to cause strength gains
Dr. Sundstrup and colleagues at the National Research Center for the Working Environment in Denmark compared 2 intensities of a lateral raise exercise withTheraBand tubing with handles. They were specifically interested in comparing training to failure versus non-failure training in untrained individuals. The researchers hypothesized that a ‘high level of muscle activity could be reached without the perceived discomfort of going to failure, thereby making strengthening exercises performed with elastic resistance an easy-to-use alternative to traditional training equipment” outside the gym. They published their findings in the Journal of Strength and Conditioning Research.
The researchers noted that, “training to complete failure is not necessary to fully recruit the entire motor unit pool. Elastic resistance exercise can provide the intensity necessary to increase strength and power without experiencing the discomfort of training to complete failure, making TheraBand elastic tubing an efficient resistance exercise and a feasible and practical alternative to traditional resistance equipment.” (July 2012) The authors also concluded, (July 2012) “Untrained individuals with a busy time schedule may find regular strength training in a fitness center challenging, and consequently, strength training coaches need an easy-to-use resistance training alternative to provide clients with home-based exercise.”
Benefits of using Elastic Bands for strength training
According to author Rachel Alessi, “Recent research has shown that strength training with a resistance band will actually raise your body’s metabolism by around 15 percent which means that the average woman can burn an extra 200 to 300 calories each day while resting. This form of exercise, combined with a sensible weight loss programme will deliver a greater weight loss than a low calorie diet alone.”
The following points were paraphrased from the article Benefits of Resistance band training by the author Madhu that was updated on June 11, 2013:
·         They are an inexpensive and versatile way to get started with resistance exercise.
·         You can do lots of exercises with them and even use them in a chair if you don't get around very well on your feet.
·         By using a assistive devices you can do more exercises with tubing than you can with free weights or dumbbells.
·         They come in colors to denote the tension.
·         They are portable and you can pack them in your bag for vacation or leave a set at your office for an occasional set of biceps curls when no one's looking!
·         They don't dent the floor if you drop them.
·         You can store them easily in a drawer, closet, or other convenient, out-of-the-way location.
·         Safe exercise: there is no risk of dropping a heavy weight and injuring yourself.

·         Modifies familiar exercise: The resistance band training is often based on training exercise which you are familiar with.
What are the disadvantages of exercise tubing?
·         Bands may lose some of their elasticity and may need to be replaced.
·         If a band rubs up against a sharp object, they can snap.



Benefits of using Elastic Bands in a Therapeutic Recreation environment

The ability to adapt each exercise to the client, gives the client the opportunity to control his or her environment. This opportunity to take responsibility and modify his or her intensity allows the client to develop a sense of perceived control over his or her life journey .Therefore resistance training with elastics  can be linked back to the TR theory of flow  “As enjoyment comes under one’s own power, it offers an orientation for making the most of one’s circumstances, and enhancing the quality of life” (Dattilo & Kleiber, 1993).
  With the rising cost of equipment, the lower cost of exercise bands compared to free weight and machines, allows the TR to develop a group resistance class within a tighter budget. Elastic bands a potable and adaptable, allowing then to be used in a transitional environment.
Different types of elastic resistance bands, assertive devices and additional accessories
            There are three main types of resistance bands. There are Tube resistance bands, Flat resistance bands and Loop resistance bands. Tube resistance bands have handles on both extremities and measure 4-5 feet long. These tube bands can be used for lower body exercises. They also can replicate cable-machines. Flat resistance bands measure 4 feet long and are usual made of stretchy material such as latex or rubber. Flat bands are mostly involved in therapy training, for instance, physiotherapy and help rehabilitate people with injuries. They are also used for lower body, rehabilitation and strengthening exercises.
Loop resistance bands are exactly like the flat resistance bands, the only difference is that the ends are connected together creating a loop. They are often used for lower body exercises. These bands have different resistant levels depending on their colour. Light (3-5lbs) and medium (8lbs) resistance bands are good for beginners, while heavy bands (12lbs) and extremely heavy bands (16lbs) are usually used by people who have high level of strength and experience.         Different muscle groups require higher or lower resistance in order to properly workout.
Associations, organizations and certifying procedure for elastic resistance training
            In comparison to Canada, Therapeutic Recreation has a larger potential client base in the United States of America due to the higher population. We will therefore begin the report on the USA certifying personal trainer and group fitness associations. Resistance training with elastic bands can be taught to various clienteles and has various steps in the certification process.
            In order to teach to various different clienteles an instructor must obtain insurance and responsibility coverage. Insurance companies require verification of training and skills in order for an instructor to be assigned a prescribed amount of liability coverage. This coverage is often paid for on a yearly basis and certification is often renewed at the same time. This is the case in both Canada and the USA. The certification process is an exam based verification of an instructor’s skills, knowledge and professionalism in a specific field.
            As a Therapeutic Recreation worker, one may be called upon to higher an allied health instructor for a group environment such as in a community centre, hospital, long term rehabilitation centre or corporate setting. It is imperative that a qualified, certified, and professional individual be chosen to work along side the TR. The chosen professional must execute the purposed activity and end result needed to offer a feeling of security and perceived control in the clientele. A Recreation worker may simply refer a client to a certified professional, this referral represents an extension of the knowledge the TR has, it is therefore important to have a certified and competent individual deliver the prescribe service, An additional option for the TR may be to obtain these credentials themselves and offer services to their clientele.
            According to the IDEA health and fitness association the following certifications and agencies offer specialities in special populations;
·         American Fitness Professionals Association (AFPA), AFPA Trainer of Special Populations Certification Program
Canadian Fitness Professionals (CANFITPRO) offers a general personal trainer certification as well as a group fitness instructor certification. According to their website under the Accreditation section, an ACE certified personal trainer or fitness instructor can receive an equivalent title with canfitpro, without having to go through the theoretical exam. A practical exam may be required. The American Council on Exercises doe not offer the reciprocal service or equivalency. 
Prior to obtaining the specialized certification, an instructor must obtain certification as a personal trainer or group fitness instructor with the same association. Once these 2 credentials are obtained specialized continuing education is obtained in Elastic Resistance Training. A few institutions offering elastic band educations are:
·         Fitness Consulting Group (FCG),  Resistance Band Training (RBT)
·         Thera-Band Academy,  Various Levels
·         International Fitness Professionals Association (IFRA), Strength Band Training Specialist
A recommended certification process for an instructor wishing to be licensed to teach resistance band training to the largest possible clientele in Canada and the USA would be as follows;
·       Step 1 Obtain ACE personal trainer or group fitness certification.
·       Step 2 Apply for Canfitpro Theoretical exam equivalency and obtain a passing mark on the practical exam, receiving canfitpro certification
·       Step 3 Succeeding in passing the ACE Advanced Health & Fitness Specialist certification or ACE Therapeutic Exercise Specialist
·       Step 4 Picking the best liability Insurance provider for your area of practice
·         Step 5 Taking a Resistance Band Training (RBT) certification or Thera-Band Academy workshop.
Program applications in TR
            Due to the high versatility of tubing and bands along with their accessories, resistance training with elastics can be easily modified to accommodate almost any goal, setting, environment, budget or clientele. Examples of a possible TR modification would be to follow the Optimizing Lifelong Health model developed by Wilhite, Keller and Caldwell (1999). “The OLH has clients become active agents in securing and maintain their own well-being over time, while maximizing their individual capabilities for growth and creative adaptations.” (Wilhite, Keller &Caldwell, 1999)
            Using the Leisure Education and the OLH model, resistance training with elastics can offer an activity that is adaptable, modifiable and can grow to fit the personal needs of a TR client. A progressive program adaptation may go as follows; after a professional relationship and proper individual evaluation is completed, a Therapeutic Recreation specialist believes that strength training in a group setting would be ideal for the client. Using elastic bands or tubing is purposed due need to start training within the confines or the hospital room. The TR has a certified Instructor on staff with the required background and works with that individual and physiotherapist to create an effective recommendation of movements and notes. The client is not only taught about the benefits of the activity, but that recovery requires rest and healthy nutrition choices, the TR taking on more of an educator or coaching role. This encourages the client to take an active role in his or her healing evolution.
A client may begin one-on-one with a guide correcting and educating them on proper form and movement. The guide’s goal it to encourage independence and autonomy in executing the exercises, a teaching role is needed in order to accomplish a perceive competence in the activity. A client may then graduate to group classes that use the same equipment that they have been taught to use. Additionally, a client can also have exercises taught to them, that once mastered can be totally done on their own, offering them a perceived control over their routine, because they may chose when they wish to engage in it. Variations can be offered to the client, such as a guided video, in place of a group class, that can be done with friends within their own home.
Examples of fitness programs / uses with rubber bands
·         Rehabilitation Exercises post injury
·         Pilates Exercises
·         Sports Specific Exercises (martial arts, golf, tennis etc..)
·         Weight loss programs
·         Balance and functional fitness
·         Fall Prevention
·         Upper body
·         Lower Body
·         Strength gains
·         Mommy fitness
Etc..

Program modifications
An elastic exercise band is an adaptable piece of equipment in of it’s self. The program modifications for various clients are brought about in way the instructor chooses to teach the routines. Prior to recommending a group or independent execution of resistance training with bands, the client must have obtained the ability to execute basic concepts and key principles of an elastic strength workout. Confidence is built in the first phase of learning. This first phase is where modifications occur.
 For individuals who are required to be in a seated position, movements are picked for their efficiency, individual health benefits, and ease of execution. Exercises that require complicated set-up or help from another person to complete should be avoided, in order to encourage complete independence.
 Clients that have visual impairments will require both a physical an auditory approach. A detailed explanation for each movement using metaphors and imagery is highly recommended. If the person is efficient in brail, a brail explanation of the exercises for the client is recommended. If the client has given permission to be touched, the use of touch to guide them in executing each movement, while describing the exercise, is highly recommended.
Individuals with hearing difficulties would be encouraged to use all other senses to learn the repertoire chosen for them. Instructors should have visual aids to help the client remember and study the band movements. The aids may be pictures and descriptions of the exercises, videos or large posters. Visual live demonstrations of the movements should be preformed in front of the client, as with client with visual impairments, physical touch and guidance it a highly recommended tool, if permission was granted to touch the client.
Although the purposed modifications have specific recommendations for various types of clients with limitations, when an instructor is teaching a resistance band routine, all available tools to communicate effectively and encourage an autonomous client the primary goal of a TR using the OLH model .
Books on Band Training
  • Strength Band Training by Phil Page and Todd Ellenbecker
  • The Resistance Band Workout Book by Ed Mcneely and David Sandler
  • The Great Resistance Tubing Handbookby Andre Noel Potvin (Author)
  • Resistance Band Workout: A Simple Way to Tone and Strengthen Your Muscles by Milligan James
  • Resistance Band Workbook: Illustrated Step-by-Step Guide to Stretching, Strengthening and Rehabilitative Techniques Paperback by Karl Knopf M.D.
  • The Scientific and Clinical Application of Elastic Resistance Book by Page and Todd Ellenbecker


Dattilo, J. and Kleiber, D.A. (1993). Psychological perspectives for therapeutic recreation research; The psychology of enjoyment. In M.J. Malkin and C. Z. Howe (Eds.), Research in therapeutic recreation; Concepts and methods (pp. 57-76). State College, PA: Venture Publishing, Inc.

Weil, R. (n.d) Resistance Trainig. Emedecinehealth. Retrieved November 04, 2013, from http://www.emedicinehealth.com/strength_training/article_em.htm#what_is_resistance_training

Sundstrup E, et al. Muscle activation strategies during strength training with heavy loading vs. repetitions to failure. J Strength Cond Res. 2012 Jul;26(7):1897-903

Madhu (June 11, 2013) Benefits of resistance band training. Benefitof. Retrieved November 03, 2013, http://benefitof.net/benefits-of-resistance-band-training/
Alessi, R. (August 23 2011)


Wilhite B., Keller, M.J., and Caldwell, L. (1999). Optimizing lifelong health and well-being: A health enhancing model of therapeutic recreation. Therapeutic Recreation Journal, 33(2), 98-108.