March 2019

The Therapeutic Power of Elastic Bands

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Here’s why resistance therapy with these low-tech tools is gaining prominence—for youth soccer players, geriatric patients, and everyone in between.

By Keith Loria

Elastic resistance bands are increasingly popular in physical therapy as the modality is being used to treat a wide number of lower-extremity problems on a diverse patient population that covers everyone from youth sports players to seniors. Experts point to 3 important features that have contributed to the rise of elastic bands (here, called simply “bands”) in therapy: They are inexpensive; don’t take up much storage space; and are easy to transport.

Furthermore, because of the properties of bands and because they can be used alone or in combination with free weights, a range of people (from the patient to the athlete) can use them. Keep in mind, however, that it is important to have a high percentage of total load come from the bands; otherwise, the benefit of using the bands will vanish and the effect will instead be similar to using free weights alone.

A Tool for Loading During Exercise…

Vidar Andersen, associate professor of education, arts and sports at the Western Norway University of Applied Sciences, has performed several studies1,2 examining the effects of elastic bands on muscle activation, maximal strength, and explosive parameters.

“In general, our findings show that elastic bands yield similar effects as more conventional free weights,” Andersen told LER. “However, when analyzing different parts of the movement, elastic bands seem to be more advantageous in the upper parts of the ascending movement. This could be useful in both therapy and exercise for those wanting to emphasize these parts of the movement.”

For example, some patients might have a problem performing the squat, or similar exercises, with free weights, due to high torque at the beginning of the upward movement. Elastic bands can, in these cases, be a valuable alternative because they reduce torque in the early upward phase but still stress muscles in the upper parts of the movement, when patients have no problem performing the squat or other exercises.

“In general, our findings show that elastic bands yield similar effects as more conventional free weights…”

Andersen led a 2018 study3 that examined the effects of full-body elastic resistance band training in young female team handball players. In the study, 12 players completed an 11-week control period, followed by 9 weeks of elastic resistance band training, during which they performed 6 exercises as part of the team’s standard training sessions.

All exercises were done with 3 sets of 6 to 10 explosive repetitions. Maximal power output was tested in squat and bench press, jump height, throwing velocity and repeated agility run, before and after control and training periods. The researchers found that a brief, explosive, full-body elastic resistance band program, incorporated into regular handball training sessions for 9 weeks, improved explosive lower-limb performance in young female handball players more than handball training alone.

“I think the elastic bands could be strong for many injuries and rehab situations,” Andersen said. “The elastic bands don’t create a great torque when going from a descending to an ascending movement, but more gently increase the torque as the bands are stretched. Further, we have performed several interventions with the elderly performing explosive training and our experience is that in these situations, the elastic bands are very useful.”

…and for Unloading

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Another important aspect of the utility of bands is that they can be used to unload. For example, if a patient isn’t able to perform a chair rise or squat because of pain or lack of muscle strength, bands can be used to reduce some of the body weight, thus assisting the person in performing the exercise.

“The research on this topic has increased in the recent years and I believe the interest among experts has increased simultaneously,” Andersen said. “For me, elastic bands have become more prevalent and will be in the years to come.

“However, I don’t think we should regard elastic bands as a replacement for free weights, but more as an alternative or variation in situations where the properties of the elastic bands could be useful.”

A Means to Boost Functional Performance

Eduardo Lusa Cadore, PhD, professor at the physical education school of the Federal University of Rio Grande do Sul, Porto Alegre, Brazil, led a study4 that provided evidence that resistance training using elastic bands is an easy, effective tool for inducing marked functional performance in older people.

“Specifically, we observed marked improvements in tests that included the ability of sit-to-stand, walking, dynamic balance, upper-body muscular endurance and flexibility,” Cadore explained to LER. “This is an important finding since elastic bands are easy to carry and may be used in any space, including at home.”

Cadore described how bands can be used to treat femoroacetabular impingement (hip impingement syndrome). For example, patients can hold the bands at the ankles and perform exercises for various hip muscles, in an isometric or dynamic manner (if the syndrome allows them to exercise dynamically). This approach has the potential to prevent or delay the need for surgery and can be used to rehabilitate the hips postoperatively.

“These bands help, because it is a kind of resistance that can be used to train, as any kind of resistance,” Cadore said. “Of course, [a band has] some upper threshold of resistance, and one wouldn’t use it for training a competitive weightlifter. Nevertheless, for people searching for health and neuromuscular function improvements, it can be used.”

Cadore foresees bands becoming even more prevalent because the number of studies using resistance training with elastic bands in exercise-intervention models is growing.5,6 In addition, the number of studies validating and quantifying loads—in each elastic band color (ie, each color denoting a progressive increase in resistance), with different initial lengths, and in various lengths of elastic deformation—is also increasing. He noted that this is an important matter because, to prescribe resistance training using elastic bands, exercise professionals need to know how to quantify the intensity of the tool.

“Another important aspect of these bands is that the workload is always progressive when bands are deformed,” Cadore said. “In some joints, [the band] won’t respect the biomechanical characteristic of a muscle group. For example, during a knee extension, the internal torque produced by the knee extensors increases from 90° of knee flexion to full extension, whereas the band provides progressive resistance. So, the use of the band in this movement is not impeditive, but this issue must be taken into consideration.”

Bands Have Utility in Older Patients

Latest Research…

Resistance Exercise to Forestall Cognitive Decline?

“As a preventative tool [for Alzheimer’s disease], resistance exercise improves memory, attention, spatial awareness, reaction time, planning, and information processing. Improvements in cognitive performance following resistance exercise and training may be mediated by peripheral elevations in … physiological biomarkers (ie, neural and vascular).”

Source: Marston KJ, Brown BM, Rainey-Smith SR, Peiffer JJ. Resistance exercise-induced responses in physiological factors linked with cognitive health. J Alzheimers Dis. 2019:68(1):39-64.

Maurício Krause, PhD, professor in the department of physiology at the Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, recently led a study on uncomplicated band exercise training for elderly people.7

“The age-related loss of muscle mass and function arise from an imbalance between protein synthesis and protein degradation, resulting in muscle atrophy and consequent increases in morbidity and mortality, and can be accelerated by a combination of factors, which include a reduced physical activity level and a suboptimal nutritional profile,” Krause said. “Concerns with the impact on the healthcare system due to increased economic and social costs associated with possible loss of independence with aging have brought attention to alternative exercise interventions as an effective way of delaying the negative effects of aging on functional and metabolic parameters.”7,8

In this way, physical activity—in particular, resistance exercise—is an established countermeasure to attenuate the decline in lean body mass that occurs with aging. In fact, Krause said, resistance exercise training can induce several benefits in older people, including:

  • increased muscle strength and power
  • improved insulin sensitivity
  • enhanced mitochondrial function
  • reduced inflammation
  • muscle-mass growth.

Krause and colleagues’ study7 sought to determine the effects of 12 weeks of resistance exercise training, plus protein supplementation on body composition, markers of muscle atrophy and hypertrophy, and heat-shock response (a molecular pathway involved in cellular protection, having an important anti-inflammatory role) in 38 healthy, older (mean age, 63.5 ± 4.4 years) adults.

“Our group demonstrated that 12-weeks of traditional [resistance exercise], using professional gym equipment, in diabetic elderly people is an effective tool to improve muscle function, metabolism, and immune system functionality,” Krause said. “However, the use of specific exercise equipment is not always available. So, we tested a nontraditional, body weight-based, elastic-band resistance training to test if this type of exercise would also be effective to improve muscle metabolism, body composition, and muscle function in healthy elderly people.”

To test that hypothesis, the researchers designed a 12-week training protocol using only body weight and elastic bands as sources of resistance. The training was conducted in a gymnasium on 3 nonconsecutive days a week by qualified sport and exercise scientists; each session lasted 45 to 60 minutes and consisted of a warm-up period, body weight- and elastic band-based resistance exercise training, and a cool-down period. Primary exercises used throughout the program included squats, lunges, hip abduction, shoulder press, latissimus dorsi pull-down, bicep curls, calf raises, pushups, triceps dips, and lumbopelvic stabilization exercises.

“Among the findings were that body weight/elastic bands-based resistance exercise training increases muscle mass and function in healthy elderly people, independently of protein supplementation,” Krause said. “This indicates that exercise training, using body weight and elastic bands, is an efficient way to maintain and even increase muscle mass in elderly people, especially at the lower limbs.”

Participants in the exercise training also saw their muscle function-testing scores improve. When protein supplementation was added to their diet, additional gains were detected, including lower fat mass and changes in skeletal-muscle signaling (eg, protein synthesis pathways and the heat-shock response).

State of the Art: Uncomplicated, Under Supervision

Krause summed it up: “The use of elastic bands and body weight as resistance exercise is receiving more attention from exercise experts because [bands offer] an uncomplicated way to exercise at any place—home, work, outside, etc. However, it is important that people receive an appropriate orientation and supervision on how to use [bands] correctly, how to choose the individual load, and how they should progress with the training.”

Keith Loria is a Washington, DC-based freelance writer.

REFERENCES
  1. Andersen V, Fimland MS, Kolnes MK, et al. Elastic bands in combination with free weights in strength training: neuromuscular effects. J Strength Cond Res. 2015;29(10):2932-2940.
  2. Saeterbakken AH, Andersen V, Kolnes MK, et al. Effects of replacing free weights with elastic band resistance in squats on trunk muscle activation. J Strength Cond Res. 2014;28(11):3056-3062.
  3. Andersen V, Fimland MS, Cumming KT, et al. Explosive resistance training using elastic bands in young female team handball players. Sports Med Int Open. 2018;2(6):E171-E178.
  4. Cadore EL, Pinto RS, Bottaro M, et al. Strength and endurance training prescription in healthy and frail elderly. Aging Dis. 2014;5(3):183-195.
  5. Iversen VM, Mork PJ, Vasseljen O, et al. Multiple-joint exercises using elastic resistance bands vs. conventional resistance-training equipment: A cross-over study. Eur J Sport Sci. 2017;17(8):973-982.
  6. Kubo T, Hirayama K, Nakamura N, et al. Effect of accommodating elastic bands on mechanical power output during back squats. Sports (Basel). 2018;6(4):pii:E151.
  7. Krause M, Crognale D, Cogan K, et al. The effects of a combined bodyweight-based and elastic bands resistance training, with or without protein supplementation, on muscle mass, signaling and heat shock response in healthy older people. Exp Gerontol. 2019;115:104-113.
  8. de Lemos Muller CH, Rech A, Botton CE, et al. Heat-induced extracellular HSP72 release is blunted in elderly diabetic people compared with healthy middle-aged and older adults, but it is partially restored by resistance training. Exp Gerontol. 2018;111:180-187.
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