Hep2go is a free online Home Exercise Program alternative to VHI. That’s right I said FREE, free as in … well you don’t have to pay for anything. I have used this site for some time now and I don’t know why it just now hit me to write about ‘em.

The site is full of stretches, exercises, mobilizations, etc. etc. for just about any body part. If you can’t find the exercise you are looking for, you have the ability to make your own and upload it to the site where you have the option to make it public or keep it private.

You can still access the site if you don’t feel like signing up for an account.  Just click quick start, agree to their terms of use, and you are good to go! Easy peasy! However, I do highly recommend signing up for an account. It’s super easy and well worth it!

Read on for my experiences with Hep2go.

Orientation

Once logged in, you start off on the home page. On the homepage you’ll find several highlighted “series” of exercises, top exercises, top exercises creators, and news feed categories. Above those in the navigation menu you can either jump straight into all of the exercises by clicking “HEP2go excercises” or go into “My Stuff” which is your profile view and is where all of your saved routines, created exercises, and exercises you marked as a favorite are located.  You can also use the search box in the main navigation to search for exercises.

When you click on “HEP2go exercises”, you will see body regions appear just below the top navigation bar. The exercises are organized by region so you have Cervical, Trunk, Shoulder, Elbow / Wrist / Hand, Hip/Knee, and Ankle/Foot. Each region has its own “Quick Find Menu” on the left hand side, which breaks up the exercises into subgroups making your life that much easier.

Each exercise has a picture and a text box with a general description of the exercise pops up when you put your mouse over the picture.  You can click on the image to bring up that specific exercise and are then able to edit the description as well as set the parameters for that exercise.  You can then save it for later or add it to your print page. You are also able to click the exercise image and drag it to the top right corner where it says “My Print Page”. If you choose to go this route, you can add a bunch of exercises then click the print page and edit all of the exercises at once.

All in all the layout of the site is pretty simple and I think easy enough to navigate without getting confused. When all else fails just use the search box on the top right!

My Print Page

Once you have all the exercises you want added to your print page and you clicked the link that says “My Print Page” you are taken to a screen with all of your exercises.  This is where HEP2go really goes above and beyond what any free application should do! They let you put your own logo on the printed HEP. Talk about snazzy! You click on the “Change Logo and Add Contact Info” button and down pops a box that lets you upload your own logo and contact info. You can even create multiple “Themes” as they call it, so you could have different logos or even companies saved and choose which one you want to display on the patients HEP print out.

Once you are done playing around with your logo you can add comments to the HEP, add more exercises, or save the routine so you can reuse it if it’s a generic protocol you use often. Then you have the option to print out the HEP or send an email with the HEP attached as a PDF.

I love this site and have told anyone who will listen about it. I use it on a daily basis on my clinicals and most of the other PT’s have started using it as well.  I emailed the guys behind HEP2go and I am waiting for them to get back to me so we can get a little background info on the HEP2go team. Stay tuned!

I am sure that everyone of us has heard of working our core. The question is why are core exercises so important? Are the guys in the gym with rippling six packs an example what we mean by core stability?

Surprisingly, most of Americans (including the ones with ripped abs)  are at risk of low back injuries in the future. These core muscles include small intricate connections of muscle within the spine along with the larger strap like muscles that surround the spine and anterior portion of the abdomen. Read the full story

Pulled from: The Wall Street Journal

A year of modest aerobic exercise reversed normal brain shrinkage by one to two years in older adults and improved their memory function, according to a study published in the Proceedings of the National Academy of Sciences. As people age, the hippocampus, the brain’s memory center, loses 1% to 2% of its volume annually, affecting memory and possibly increasing the risk for dementia. A growing body of evidence has pointed to aerobic exercise as a low-cost hedge against neurocognitive decline. In this study, magnetic resonance imaging was used to measure the effects of aerobic exercise on the hippocampus in 120 Americans in their late 50s to early 80s. Half the group walked three times a week for 40 minutes, aiming for their target heart rate, while the other half did yoga and toning exercises. The hippocampus in walkers increased by 2% after a year and shrank by 1.4% in controls. Both groups showed significant improvements on spatial memory tests conducted before and after the study. This could be due to taking the test repeated times, the researchers said. In the walking group, however, changes in hippocampus volume were directly related to improved memory performance, they said.

Caveat: The study found that exercise had a selective effect on the brain, influencing the volume of the anterior hippocampus but not the posterior. Researchers suspect aerobic exercise might have the most effect on regions of the brain that show the largest decline in late adulthood, such as the anterior hippocampus.

You can find the article and its full PDF for free here

Written by: Jill Stein on February 15, 2011 (San Diego, California) for Medscape Medical News

A physical therapy program can effectively treat most patients who present with atraumatic full-thickness rotator cuff tears and shoulder pain, without the need for surgery, researchers announced here at the American Academy of Orthopaedic Surgeons (AAOS) 2011 Annual Meeting.

“If failure is defined as patients electing to undergo surgery, then our non-operative program is successful in over 90% of patients and the effect seems to last at least 2 years,” John E. Kuhn, MD, associate professor and chief of shoulder surgery at Vanderbilt University Medical Center in Nashville, Tennessee, and director of the Multicenter Orthopedic Outcomes Network (MOON) Shoulder Group, said.

In the United States, at least 10% of persons over age 60 years, or nearly 6 million people, will develop a rotator cuff tear.

To recognize this study, the AAOS will honor the MOON Shoulder Group with its Charles S. Neer II Clinical Science Award, which will be presented later this week on the association’s Shoulder and Elbow Specialty Day.

Prospective Cohort Study

The study included 396 patients age 18 to 100 years who had atraumatic full-thickness tears documented by magnetic resonance imaging and no other abnormality. The primary symptom was pain in most patients.

Patients were assigned to a physical therapy program that included daily postural exercises, active-assisted motion, active training of scapula muscles, and active range of motion, along with anterior and posterior shoulder stretching. They also performed thrice-weekly rotator cuff and scapula exercises. The program has been shown to be effective in patients with impingement syndrome.

Study participants also did manual mobilization exercises with assistance from a therapist.

Patients returned at 6 and 12 weeks. At this point they could decide that 1) treatment was successful and they needed no formal follow-up, 2) they had improved but would like to continue therapy with scheduled reassessment in 6 weeks, or 3) nonoperative treatment had failed and they would undergo arthroscopic rotator cuff repair.

Patients were contacted by telephone at 1 and 2 years to determine whether they had undergone surgery since their last visit.

Improvements on Multiple Outcome Measures

The analysis showed statistically significant improvement at 6 and 12 weeks for the American Shoulder and Elbow Society, Western Ontario Rotator Cuff Index, and Single Assessment Numerical Evaluation scores. P values for all measures were less than .0001 at 6 and at 12 weeks.

Six-week data indicate that fewer than 10% of patients had decided to undergo surgery.

Of patients in whom follow-up data were available for at least 2 years, only 2% had opted for surgery.

The analysis also revealed that patients who decided to undergo surgery generally made their decision within 6 to 12 weeks of starting physical therapy. In addition, patients did most of their physical therapy at home and usually made only 1 weekly visit to the physical therapist.

Dr. Kuhn said that important strengths of the study are its large size, the inclusion of patients from multiple practices nationwide, and its prospective cohort design. The results may be weakened somewhat by possible selection bias in that patients who were less likely to choose surgery were more likely to participate in a physical therapy program. Performance bias may also be a shortcoming, with some patients possibly receiving medications, acupuncture, or other pain-relieving treatments that were not examined, he added.

Finally, Dr. Kuhn emphasized that the physical therapy program alleviated pain without “doing anything to the tear.” The finding suggests that pain may be a less suitable indication for rotator cuff repair than is weakness or loss of function.

The hope is that future research will identify risk factors that can predict progression to rotator cuff tears and symptom onset and also which repaired tears are likely to fail, thereby helping surgeons decide better who is a good surgical candidate, he added.

This work was supported by the following: Arthrex Corporation Unrestricted Research Gift, NFL Charities — Medical Research Grant, National Institutes of Health grant no. 1K23 ARO5392-O1A1 from the National Institute of Arthritis and Musculoskeletal and Skin Diseases, AOSSM Career Development Award, and Pfizer-Scholars Grant in Clinical Epidemiology.

American Academy of Orthopaedic Surgeons (AAOS) 2011 Annual Meeting; Abstract #319. Presented February 15, 2011.

source [Medscape]

The National Institute of Neurological  Disorders and Stroke have given new light to the fact that patients who participate in intense physical therapy at home show the same amount of improvement compared to using expensive high tech body weight supported treadmill devices.

These researchers also demonstrate that these patients continue to improve walking ability up to a year following the initial stroke. This is yet another pat on the back for those of us in PT who work so hard with patients during the recovery. Neuroplasticity is a very slow and sometimes agonizing process for the therapist and patient. Read the full story

Recently I have just finished reading a book entitled Body By Science which was written by Doug McGuff M.D. and John Little. All of the chapters within the book are backed by research and the research articles are listed at the end of the chapters.

This was a very interesting read for anyone interested in the fitness realm. We have all been taught the basic strategy of weight training a body part every other day and mix in some cross fitness cardio somewhere in between. Well these guys take the latest research and really put some theories to the test. Lets dive in and take a closer look to see what kind of gold nuggets we can dig up. Read the full story

As I have began my current clinical rotation, I’ve found myself searching for tools and resources that I could use as a guide to help begin and advance exercise for patients with various conditions.  I’m sure I’m not the only one who needs a little assistance with this sort of thing so I thought, why not share what I find with our rehabstudents friends?  So here is the first of the weekly resources I have found.

This first resource comes from Centers for Orthopaedics.  They have some good general exercise protocols for different conditions, informational articles,  as well as general information for nutrition and lifestyle with which you may want to provide your patients.

You can find all of this information at the link provided below.

Center of Orthopaedics Resources

Osteoarthritis (OA) is quite a debilitating condition.  If fact, the World Health Organization (WHO) lists it in the top ten most disabling conditions.

It is well known that skilled physical therapy interventions and exercises can decrease the pain from OA, while increasing strength and range of motion.

A recent study was done looking at what happens after the patient returns home with their home exercise program (HEP) prescribed by their physical therapist.  Those patients who continued their home exercise programs were noted to have less pain, more physical function, improved performance, and a more positive outlook on their condition and their prognosis when compared to those who did not comply with their HEPs.

So as all you physical therapy students enter your clinicals and graduate and enter the workforce, make sure you express the importance of HEPs to your patients.

[source]

The Spotlight section of our website is designed to collect a grouping of articles and posts that deal with a specific pathological condition or an area of focus in the field of Physical Therapy. Read the full story

Patients with COPD can be very challenging. Just simple AROM exercises can stress them to the point of exhaustion. Recovery for them takes most of your intervention time. In this recent article I found from Medical News Today it emphasizes finding activities during the day that the patient can enjoy.

This will allow the patient to get several bouts of exercise spread out through the day and week. I think you will find it an interesting and simplistic approach to managed care for patients with COPD. Read the full story