Muscle monitoring for optimal rehabilitation & sports performance

PowerPoint-esitys

Monitoring is the Key for Successful Muscular Rehabilitation Process

Muscle monitoring for optimal rehabilitation & sports performance

MEDICA Medicine + Sports Conference

12/13 November 2014, Germany

Petri Lehikoinen

Sports performance coach sports physiotherapist

Physio1 Inc.

Myontec Ltd.

Pro

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INTRO How to Reduce (the costs of) injuries and keep the players on pitch

Pro

LOT OF INJURIES IN LOWER BODY

ACL INJURIES

HAMSTRING & QUADS INJURIES TYPICAL IN MANY (RUNNING) SPORTS

$$$ EXPEN$IVE TO TREAT

OT OF MISSED DAYS IN $PORT$

NEW TECHNOLOGY - NEW POSSIBILITIES FOR TRAINING & REHABILITATION

INJURY PREVENTION, SCREENING

FASTER & MORE EFECTIVE REHABILITATION

RETURN-TO-PLAY FASTER & SAFER

HIGH PERFORMANCE LEVEL

PREVENT RE-INJURY

FIND THE PROBLEMS BEFORE THEY WILL FIND YOU

UNIQUE & REVOLUTIONAL SYSTEM for measuring & analyzing sports performances

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Pro

OLD SCHOOL & TOOLS

-Measurement tape

-Stop watch

-kg

-Reps

-Protocols (time based)

NEW POSSIBILITIES

-Video analysis, GPS

-HR, Recovery analysis

-wearable tech EMG

*see inside the movement

*balance

*movement quality

*activation relaxation

-More feedback

-Algorithms

Together to optimize neuromuscular function & movement (control)

-Speed up rehab & RTP

-Prevent re-injury & teach athletes

-High performance

-Save $$$ & make $$$

Old tools & New possibilities to optimize performance

IN REAL TIME and POST-EXERCISE

FOR TESTING AND TRAINING MONITORING

MORE FEED BACK-MORE DETAILED PROGRAMS > ALGORITHMS

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GO

Bluetooth

GET SET

Shorts + MCell

Mbody real-time and post-exercise analysis

Know your muscles

SEE THE RESULTS

Smart phone app

Movescount (web)

Muscle monitor (pc)

Pro

First ever INTELLIGENT TEXTILE

QUADS & HAMS

SMALL, LIGHT, Fully operational EMG DEVICE, EASY TO USE ANYWHERE

MOBILE PLATFORM BOTH ANDROID & IOS COMING

GEAR IT UP + EXERCISE

FOLLOW

REAL-TIME

SUUNTO MOVESCOUNT

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4-channel EMG

Quadriceps & Hamstrings

MBody real-time and post-exercise analysis

Muscle Load & Balance

Heart Rate

Cadence, Speed, Distance

Pro

First ever INTELLIGENT TEXTILE

QUADS & HAMS

SMALL, LIGHT, Fully operational EMG DEVICE

MOBILE PLATFORM

GEAR IT UP + EXERCISE

FOLLOW

REAL-TIME

SUUNTO MOVESCOUNT

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Advantages of Muscle Monitoring

Pro

THE MORE INFORMATION THE MORE KNOWLEDGE (AND QUESTIONS)

-Inside feedback from the movement heart rate of the muscles

-Muscle balance, LT/RT Q/H

-Quality of the movement

-Muscle activation relaxation

>> running analysis >>> sports spesific in real action

-Athlete profilation & screening

-Athletes like to see how the muscles are working -> learning & motivation

-Athletes self monitoring self confidence

-Real time analysis post exercise analysis & documentation

-Fast feedback for athlete & coach/physio

-Long distance control for coach/physio

-Co-operation between coach & physio

-Easier program progression with EMG feedback

-Sports spesific use

THE MORE INFORMATION THE MORE KNOWLEDGE


FAST FEEDBACK

LONG DISTANCE CONTROL

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Case Study by Puustinen, J., PT, M.Sc. Student,

Jylnki. P. M.Sc. Technology & Sports Science

4 ACL/PCL Operated Football Players in Finland

Pro

We selected four male adult professional football players after ACL or PCL reconstruction. Players followed a sport-specific rehabilitation protocol for soccer. We followed criterion based rehabilitation practice guidelines, soreness rules, running progression, return to sport criteria (Adams et al. 2012, Della Villa et al. 2012), so called traffic light concept as described by (Tsapralis 2014) and rehabilitation program succession of 5 phases, each characterised by the achievement of clinical and functional goals (Tencone 2012). Together with traditional rehabilitation monitoring we included EMG monitoring as a new way to monitor muscle re-training. Monitoring was done using Myontec Mbody EMG shorts measuring quadriceps and hamstrings muscle groups.

Tests

Players performed same tests as tolerated at that time, consisting measurements and tests for range of motion, muscle atrophy, isometric muscle strength testing of m.quadriceps and m.hamstring, 1 hop test, triple hop test, Yo-Yo Intermittent Recovery Test Levels 1-2 and Knee injury and Osteoarthritis Outcome Score parts Function, daily living and Function, sports and recreational activities. Myontec Mbody EMG smart shorts were used in isometric strength tests, leg press endurance test, drop jump test, Yo-Yo Intermittent Recovery Test and treadmill running test at 1 degree incline and 3 minutes steps and 2 km/h increase in the level starting from 5 km/h and ending to 13 km/h speed if tolerated.

4 KNEE OPERATED FOOTBALL PALYERS

MBODY SYSTEM

-ISOMETRIC EXT-FLX STENGTH + LEG PRESS ENDURANCE 25 REPS, DROP JUMP

-TREADMILL RUNNING 5-13 KM/H & YO YO RUNNING TEST

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CASE 1 TREADMILL BALANCE SUMMAY (ACL left, LT hamstring graft)

Pro

HAMSTRINGS UNBALANCE, LT MORE ACTIVE

LT-RT BALNCE IS NOT THE WHOLE TRUTH

Kk to month

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Treadmill 5km/h Balance %

L Quads3kk4kk5kk6kk48.044.042.046.0R Quads3kk4kk5kk6kk52.056.058.054.0L Hams3kk4kk5kk6kk76.069.072.070.0R Hams3kk4kk5kk6kk24.031.028.030.0



Treadmill 9km/h Blance %


Treadmill 11km/h Blance %



L Quads5kk6kk51.050.0R Quads5kk6kk49.050.0L Hams5kk6kk56.054.0R Hams5kk6kk44.046.0

3 months

4 months

5 months

6 months

L Quads

R Quads

L Hams

R Hams

L Quads

R Quads

L Hams

R Hams

L Quads

R Quads

L Hams

R Hams

L Quads

R Quads

L Hams

R Hams

CASE 1 TREADMILL RUNNING TEST 9km/h (ACL left, LT hamstring graft)LT/RT BALANCE

Pro

Muscle balance is improving but loot at the act-relax also

LT HAMST AKT-RELAX BETTER FROM 3 M

FOR SOME REASON SOME PROBLEMS WITH RT HAMST AT 6 MONTHS

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5km/h

7 km/h

9km/h

11 km/h

13 km/h

Case2Left leg ACL+PLC, 5 months post op; muscle distribution viewRunning on treadmill with increacing speed, incline 1 degree

Pro

PLC (postero lateral corner) BICEPS FEMORIS AVULSION

MUSCLE DISTRIBUTION ALL 100%

HYPERACT HAMSTRINGS

WHAT SHOULD BE THE DISTRIBUTION BETWEEN Q/H??

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CONCLUSIONS & ACTIONS treadmill running test

Pro

Case 1 training method was changed 5 months after operation to power training (Force Velocity). The decision was made based on EMG data and strength measurement results. EMG data indicated the diffrence between muscle firing and relaxation on right and left hamstring.

6 months after operation strength levels between right and left hamstring was identical. Subject was able to finnish the season without symptoms.

Total activation level could give wrong information, need to check

Activation relaxation

L Quads

R Quads

L Hams

R Hams

5 months

KUVIO VAIHDETTU 3 MONTHS>5 M

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CASE LEGG PRESS

Pro

Muscle activation balance during leg press exercise in all cases. Results clearly indicates that muscle activation balance is improved during rehabilitation process.

1-LEG LEG PRESS, TECHNOGYM HORISONTAL IN SITTING

25 REPS. MEASURED LAST 10

ONLY LT/RT BALANCE, NO DISTRIBUTION OR Q/H BALANCE

Kk to month

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Case1 leg press balance %

L Quads %

3kk4kk5kk6kk44.047.0R Quads%

3kk4kk5kk6kk56.053.0L Hams %

3kk4kk5kk6kk54.057.0R Hams %

3kk4kk5kk6kk46.043.0

Case 2 leg press balance %

L Quads %

3kk4kk5kk6kk43.052.055.0R Quads%

3kk4kk5kk6kk57.048.045.0L Hams%

3kk4kk5kk6kk45.051.050.0R Hams%

3kk4kk5kk6kk55.049.050.0

Case3 Leg press balance %

L Quads %

4kk5kk6kk62.049.047.0R Quads%

4kk5kk6kk38.051.053.0L Hams%

4kk5kk6kk64.060.046.0R Hams%

4kk5kk6kk36.040.054.0

Case4 leg press balance %

L Quads %

3kk4kk5kk6kk40.045.0R Quads%

3kk4kk5kk6kk60.055.0L Hams%

3kk4kk5kk6kk46.050.0R Hams%

3kk4kk5kk6kk54.050.0

CASE YO-YO

Pro

4 Months after operation

5 Months after operation

Relaxation problem with

Left Hamstring?

Running balance:

Left/Right:

Balance ok close 50/50

H/Q:

Hamstring acitivity level high 75/25

YO YO RUNNIG TEST 20M?, SPEED INCREASE

DISTRIBUTION

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CASE SKICROSS

Pro

18 yrs old Europa Cup skicross racer

Broke ACL 15.1.2013

Operated 5.2.2013, hamstring graft

Back on skis 8/13

Back on podium 12/13

Re-injury 17.12.2012, partial tear ACL

Rehab 4 weeks

Back racing 17.1.2014 w/ Ortema knee brace

Re-op 5.5.2014 -> MBody

Back on skis 8/14

SKIP THIS IF NO VIDEO

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ISOKINETIC TESTING 60/60 DEG/SEC 5 REPS

Pro

13.8.2014 Isokin 60/60 deg/sec 5reps

VOIMA-EMG KORRELAATIO??

KYRIEN MUOTO SAMA, LT VOIMANTUOTTO NOPEAMPI JA MAX ISOMALLA KULMALLA (AIKASEMMIN)? VAI MYHEMMIN, KUMMIN PIN KYRN KULMAT?

HAMST VOIMANTUOTTO PIENENEE KUN KULMA SUURENEE, MV TREENI VS CURLS TREENI NKYY?

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ISOKINETIC TESTING 240/240 DEG/SEC 30 REPS

Pro

13.8.2014 Isokin 240/240 deg/sec 30reps


Q-PUOLELLA NOPEAVOIMANTUOTTO PAREMPI, EIK VSYMIST

ISOT EROT HAMST PUOLELLA

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ISOKINETIC ECCENTRIC 90/90 DEG/SEC 5 REPS

Pro

-BIGGER DIFFERENCE IN ECCENTRIC MOVEMENT, ESPECIALLY HAMSTRINGS > change training more eccentric

13.8.2014 ECCENTRIC


LT VOIMANTUOTTOAIKA LYHYEMPI

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ACCELERATION SPRINTS 5x 50m, speed increasing

Pro

DISTRIBUTION

Kiihdytysjouksu 5x50m, nopeus kasvaa vsyminen?

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MUSCLE BALANCE Hurdle jumps, slow vs fast

Pro

DISTRIBUTION

2-leg jumps, high-slow & high-fast

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SQUAT normal & w/ Low Back Pain

Squat

5 RM

normal

Squat

w/ LBP

Front

Squat

Pro

DISTRIBUTION

1st norm squat 5x5rm 100kg? 24.9.2014

2nd sqt 5x80 deep, low back pain 13.10.2014

3rd frnt sqt 5x40, less pain

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SPORTS SPECIFIC MBody on skis

Pro

THE FUTURE

Pro

REHBILITATION PROCESS

& TRAINING

OPTIMIZATION

-how to use the new info

HAMSTRING SCREENING

-find the problems before injuries

-activation - relaxation

-fatigue?

-eccentric measurements Nordics?

VIDEO + REAL TIME DATA TOGETHER

MONITORING IS GREAT TOOL, BUT WE NEED MORE EXPERIENCE TO GET THE MAXIMUM OUT OF THE NEW MEASUREMENTS & INFORMATION

UNIQUE & REVOLUTIONAL SYSTEM for measuring & analyzing sports performances

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Pro

IF YOU WANT TO GET SOMETHING OTHERS DONT HAVE

YOU NEED TO DO SOMETHING OTHERS DONT DO

THANK YOU!

DANKE!

Petri Lehikoinen

Physio1 inc.

+41 79 7904042

[email protected]

TWITTER @FYSIO1

www.Myontec.com

www.knowyourmuscles.com

THE MORE INFORMATION THE MORE KNOWLEDGE


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Muscle monitoring for optimal rehabilitation & sports performance

Health & Medicine

Transcript of Muscle monitoring for optimal rehabilitation & sports performance