Physical and occupational therapists often use both elastic and dumbbell resistance during shoulder rehabilitation exercises. Unfortunately, many therapists arbitrarily assign resistance levels to patients during their exercises based only on clinical experience. In the fitness setting, RPE (Rating of Perceived Exertion) scales have been used successfully in dosing the intensity of both isotonic and Thera-Band® elastic resistance exercises (Colado & Triplett, 2008). In addition, RPE has been shown to be similar between Thera-Band and isotonic resistance of similar EMG activation during shoulder exercise in healthy subjects (Andersen et al, 2010). Most recently, as discussed on the Academy Blog, the OMNI-RES scale for perceived exertion was shown to be valid when used to prescribe elastic resistance exercise in healthy individuals.
Scientific Advisory Board memberTodd Ellenbecker, DPT from the Physiotherapy Sports Clinic in Scottsdale Arizona wanted to see if he could use RPE during rehabilitation exercises for his shoulder patients. He presented the results of his pilot study at the 13th annual TRAC meeting in San Francisco.
31 shoulder patients including 21 post-operative and 10 non-operative patients were in the study. They were asked to rate their perceived exertion using the OMNI-RES scale during several common shoulder exercises that were performed with both Thera-Band elastic resistance and isotonic dumbbells. They were rated at their 6th and 12the week of therapy.
The average RPE during each exercise ranged from 4 to 6 on the OMNI-RES scale. There was no significant difference in the RPE between similar exercises performed with either isotonic or elastic resistance. Based on these results, Dr. Ellenbecker suggests that shoulder exercises should be performed at an RPE of 4 to 6 with either isotonic or elastic resistance. He hopes to continue the study by adding more subjects and looking at differences between post-operative and conservative rehabilitation patients.
Read the abstract of his study here: Perceived Self-Report of Effort During Rotator Cuff & Scapular Exercise in Patients during Shoulder Rehabilitation.
Listen to a podcast interview with Dr. Ellenbecker about his project by clicking on the link below: