Plyometric exercise to improve your athletic performance

Plyometric exercise is a popular form of training used to improve athletic performance. It involves a stretch of the muscle-tendon unit immediately followed by a shortening of the muscle unit. This process of muscle lengthening followed by rapid shortening during the stretch-shortening cycle (SSC) is integral to plyometric exercise. The SSC process significantly enhances the ability of the muscle-tendon unit to produce maximal force in the shortest amount of time. These benefits have prompted the use of plyometric exercise as a bridge between pure strength and sport-related power and speed.

As plyometric training techniques have evolved, the description of this training and the related terminology have undergone a metamorphosis. Because the term plyometrics is a later creation in American training literature, much of the early physiological research on this type of training described it by other names. The term used by researchers in Italy, Sweden, and the Soviet Union for the type of muscle action involved was the stretch-shortening cycle. Coaches in these countries simply referred to the use of such exercises in their training programs as jump training. Based on original forms of training described by Yuri Verkhoshansky, the Russian national jump coach for track and field, plyometrics were originally developed as a shock method of training.

The Plyometrics exercises can be useful if administered carefully considering the capability of an individual.

Kinesiology Taping

Kinesio taping (KT) is a therapeutic taping technique developed by Dr. Kenzo Kase in Japan more than 25 years ago1. This technique is used as an alternative to athletic taping to support the fascia, muscles, and joints; however, unlike athletic taping, Kinesio Tape (KT) allows for unrestricted range of motion (ROM) and is also theorized to reduce the time for recovery from injury by decreasing pain and inflammation1. This unique taping method was popularized by the press at the Seoul Olympics in 19881. Since then, it has become a popular treatment modality, especially among athletes. Athletic trainers, physical therapists, and physicians have used this technique to facilitate healing after musculoskeletal injury1,2.

The KT is designed to mimic the approximate thickness and weight of skin and has elasticity of up to 30% to 40% over its resting length, which gives the tape unique properties1,3. This tape is also latex-free and features an adhesive that is 100% heat-activated acrylic1,3. The 100% cotton fibers allow for evaporation and fast drying, thereby ensuring that patients can wear the tape even in the shower or pool without the need for reapplication; this allows for a wear time of 3 to 5 days and makes the treatment more economical.

 


Role of Physiotherapy in Type 2 Diabetes

What is Type-2 Diabetes Mellitus?

Type 2 diabetes is characterised by high levels of glucose in the blood, due to insulin resistance and relative insulin deficiency. Physical inactivity and hyper-caloric food are the main contributors to type 2 diabetes.

Poorly regulated blood glucose increases the patient’s risk of developing medical complications related to diabetes. These complications include heart disease, stroke, neuropathy, foot ulcers, kidney failure and eye disease. Lower blood glucose values are associated with a lower risk of complications1.

Diabetes mellitus is a leading cause of death and disability world wide2,3. Asia and the eastern Pacific region are particularly affected4-9. Nowhere is the diabetes epidemic more pronounced than in India as the World Health Organization (WHO) reports show that 32 million people had diabetes in the year 200010. The Diabetes Prevention Project dem¬onstrated that lifestyle modification, including intensive exercise, is more effective in preventing diabetes than pharmacological therapy, and high¬lighted the role of trained professionals in motivating people to follow lifestyle interventions. Similar results have been reported by the Malmö Study, the Da Qing Study, the Finnish Diabetes Prevention Study and the Wenying Study11.

What is the role of Physiotherapy in Type 2 Diabetes?

Physiotherapy is a branch of rehabilitative health that uses specially designed exercises and equipment to help patients regain or improve their physical abilities.

The World Health Organization states that - "Physiotherapists assess, plan and implement rehabilitative programs that improve or restore human motor functions, maximize movement ability, relieve pain syndromes, and treat or prevent physical challenges associated with injuries, diseases and other impairments. They apply a broad range of physical therapies and techniques such as movement, ultrasound, heating, laser and other techniques. They may develop and implement programmes for screening and prevention of common physical ailments and disorders."

Physiotherapists offer evidence-based training interventions encompassing aerobic training and/or resistance training. Three meta-analyses showed that both of these training modalities are effective in lowering the blood glucose by 0.5-0.8% in HbA1c (blood glucose control)12-14.

Physiotherapists are able to help people plan an individualized exercise programme in order to main¬tain good blood glucose control and achieve optimal weight. Furthermore, physiotherapy leads to metabolic improvements even in the absence of weight loss, reducing the frequency of cardiovascular events and improving life expectancy. Effective exercise counselling ensures both cardio-respiratory and musculoskel¬etal fitness11.

In patients with type 2 diabetes aerobic training may increase aerobic capacity by 15% and resistance training may increase the muscle strength by 19%. Increased aerobic capacity and muscle strength is associated with improved physical performance which has great relevance to the increasing number of elderly patients with type 2 diabetes. Optimal training interventions may include training sessions three times a week for a minimum of 12 weeks. However, these interventions may be planned in different ways and include non-supervised training sessions.

Physiotherapists may also deliver beneficial interventions with lower levels of physical activity. While not all patients are attracted to aerobic or resistance training, some may prefer physical activities outside the gym. Brisk walking is an alternative that has been shown to be effective in reducing blood glucose in patients with type 2 diabetes15,16.

Physiotherapists play a crucial role in type 2 diabetes treatment programs. These structured programs encompass supervised physical training, patient counselling and patient education. They have a wealth of experience of training patients suffering from various symptoms and diagnoses. Once the non-diabetic conditions are identified and the training programs adapted, the patients can engage safely in training sessions.

Socio-economic impact

The effect of long-term physical training on blood glucose is at the same level as anti-diabetic drug or insulin therapy in patients with type 2 diabetes. Thus, if physical activity interventions are accepted by the patients, training may reduce the use of medication and thereby become a cost-saving initiative.

A 1% reduction in blood glucose control (HbA1c) is associated with a risk reduction of 21% of any complication related to diabetes1. Physical training is recognised as a method of treatment to reduce the blood glucose. Furthermore, training also reduces other morbidity and mortality risk factors suggesting that such interventions save costs on a long term basis.

Finally, training given to patients with type 2 diabetes may also be effective in combating other pre-existing health problems, including loss of bone strength, musculoskeletal pain and reduced mental health.

Conclusions

Physical training is a cornerstone in the treatment of type 2 diabetes. Training programs are cost-effective; they prevent medical complications and reduce the mortality risk. Physiotherapists play an important role in the treatment of type 2 diabetes by leading evidence-based training programs. The importance of having physiotherapist-led training programs is emphasised by the patients’ individual impairments and other disorders.

References

  1. Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 2000 Aug 12;321(7258):405-412.
  2. Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al., et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380: 2095-128 http://dx.doi.org/10.1016/S0140-6736(12)61728-0 pmid: 23245604.
  3. Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, et al., et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380: 2197-223 http://dx.doi.org/10.1016/S0140-6736(12)61689-4 pmid: 23245608.
  4. International Diabetes Federation (IDF) [Internet]. Country estimates table 2011. IDF diabetes atlas. 6th ed. 2012. Available from:http://www.idf.org/sites/default/files/EN_6E_Atlas_Full_0.pdf [accessed 7 June 2013].
  5. Rahim MA, Hussain A, Azad Khan AK, Sayeed MA, Keramat Ali SM, Vaaler S. Rising prevalence of type 2 diabetes in rural Bangladesh: a population based study. Diabetes Res Clin Pract 2007; 77: 300-5 http://dx.doi.org/10.1016/j.diabres.2006.11.010 pmid: 17187890.
  6. Saquib N, Saquib J, Ahmed T, Khanam MA, Cullen MR. Cardiovascular diseases and type 2 diabetes in Bangladesh: a systematic review and meta-analysis of studies between 1995 and 2010. BMC Public Health 2012; 12: 434 http://dx.doi.org/10.1186/1471-2458-12-434 pmid: 22694854.
  7. Shera AS, Rafique G, Khawaja IA, Baqai S, King H. Pakistan National Diabetes Survey: prevalence of glucose intolerance and associated factors in Baluchistan province. Diabetes Res Clin Pract 1999; 44: 49-58 http://dx.doi.org/10.1016/S0168-8227(99)00017-0 pmid: 10414940.
  8. Yang W, Lu J, Weng J, Jia W, Ji L, Xiao J, et al., China National Diabetes and Metabolic Disorders Study Group, et al. Prevalence of diabetes among men and women in China. N Engl J Med 2010; 362: 1090-101 http://dx.doi.org/10.1056/NEJMoa0908292 pmid: 20335585.
  9. Zhang H, Xu W, Dahl AK, Xu Z, Wang HX, Qi X. Relation of socio-economic status to impaired fasting glucose and type 2 diabetes: findings based on a large population-based cross-sectional study in Tianjin, China. Diabet Med 2013; 30: e157-62 http://dx.doi.org/10.1111/dme.12156 pmid: 23397898.
  10. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: Estimates for the year 2000 and projections for 2030. Diabetes Care 2004; 27 : 1047-53.
  11. Holman R. Should we treat impaired glucose tolerance and impaired fasting glycemia? In: DeFronzo RA, Ferrannini E, Keen H, Zimmet P, eds. International Textbook of Diabetes Mellitus, 3rd ed. John Wiley. Chichester, 2004: 771-94.
  12. Umpierre D, Ribeiro PA, Kramer CK, Leitao CB, Zucatti AT, Azevedo MJ, et al. Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: a systematic review and meta-analysis. JAMA 2011 May 4;305(17):1790-1799.
  13. Chudyk A, Petrella RJ. Effects of exercise on cardiovascular risk factors in type 2 diabetes: a meta-analysis. Diabetes Care 2011 May;34(5):1228-1237.
  14. Snowling NJ, Hopkins WG. Effects of different modes of exercise training on glucose control and risk factors for complications in type 2 diabetic patients: a meta-analysis. Diabetes Care 2006 Nov;29(11):2518-2527.
  15. Belli T, Ribeiro LF, Ackermann MA, Baldissera V, Gobatto CA, Galdino da Silva R. Effects of 12-week over- ground walking training at ventilatory threshold velocity in type 2 diabetic women. Diabetes Res Clin Pract 2011 Sep;93(3):337-343.
  16. Negri C, Bacchi E, Morgante S, Soave D, Marques A, Menghini E, et al. Supervised walking groups to increase physical activity in type 2 diabetic patients. Diabetes Care 2010 Nov;33(11):2333-2335.
Shijin Ramesh, Vasai Road (West), Maharashtra, India

Shijin Ramesh, Vasai Road (West), Maharashtra, India

“your treatment has helped me get the Bronze medal for India in the World Hip Hop Championship 2015 - USA”. My back had bothered me. The posture advice and prevention of injury exercises given to me had reduced the pain and allowed me to participate in the group event in the World Hip Hop Championship 2015, which ultimately helped get us a Bronze medal for India. I had followed the exercises suggested by you before every performance. Its far better than before now which has got me into confidence that I’ll be able to continue my dancing.

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