ROLAND RAMIREZ ATC, LAT, PT, SCS, CSCS Asst. Athletic Trainer Rehabilitation Coordinator Houston Texans

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1 ROLAND RAMIREZ ATC, LAT, PT, SCS, CSCS Asst. Athletic Trainer Rehabilitation Coordinator Houston Texans

2 DS2 = Dynamic Stabilization and Strengthening Platform Low friction platform initially created for Closed Kinetic Chain (CKC) shoulder exercises Can also be used for: Lower extremity Trunk/Core strengthening

3 32 in. x 32 in. Acrylic platform (1/8 thick) with a unique design printed on front and non-skid rubber backing Paired up with Nylon gloves/booties to reduce friction and allow for easier sliding Slide-Board type surface that can be used: Table Wall Floor

4 Shoulder is intrinsically unstable Humeral head is approximately 3x the radius of the glenoid fossa Instability (Davies et al 1993) Static and dynamic control of the glenohumeral joint requires a stable base of support at scapulothoracic joint When the anchoring stability of the scapula is lost more likely to have shoulder dysfunction or injury

5 Closed Kinetic Chain (CKC) shoulder exercises cause axial loading and compression in the joint, therefore, increasing stability. This causes cocontraction of muscle groups, thereby creating increased dynamic joint stability (Davies et al, 1993).

6 To balance compression and shear forces of the glenohumeral joint, strengthening of the shoulder joint in a closed pack position will result in less tensile stress of the capsular ligaments and facilitate cocontraction of dynamic stabilizing structures (Davies et al, 1993).

7 CKC activities may help improve dynamic stability through joint approximation and co-contraction. Compression from CKC activity also stimulates mechanoreceptors and helps improve proprioception (Goldbeck, Davies, 2000)

8 CKC exercises may provide large resistance with low acceleration, greater compression forces, increased joint congruency, low shear forces, and enhanced dynamic stabilization (Heiderscheit et al, 2000) CKC exercise is thought to establish early proximal stability of the joint, providing a stable base for the upper extremity to function (Dillman et al 1994)

9 Table Gravity-eliminated shoulder stretching and strengthening Lower extremity range of motion and strengthening

10 Lower Extremity ROM Table

11 Lower Extremity Strengthening - Table

12 Wall Shoulder stretching from various standing positions Shoulder strengthening exercises (Double arm/ Single Arm) from various positions, including overhead Resistive bands can be added to increase challenge and workload ***Closed Kinetic Chain shoulder stabilization and strengthening exercises with controlled weightbearing through the shoulder***

13 Single Arm Strengthening on Wall

14 Double Arm Strengthening on Wall

15 Advanced Exercise w/ Band on Wall

16 Advanced Exercise w/ Band on Wall

17 Advanced Exercise w/ Band on Wall

18 Overhead Exercise

19 Floor Upper extremity exercises with increased difficulty and load through the shoulder Lower extremity exercises (i.e. Lunges, squats, hamstring curls, etc.) Trunk/Core strengthening exercises

20 Shoulder Stabilization Exercise on Floor

21 Advanced Shoulder Exercise on Floor

22 Lower Extremity Exercises

23 Trunk/Core Strengthening Exercises

24 Versatile tool that can be used for numerous exercises Uses very little floor space as compared to slide board Simple tool that provides several different exercise options in the rehabilitation program

25 Ideal for shoulder rehab in early stages Transition from initial rehab to 2 months post-op (i.e. posterior labrum, rotator cuff, etc.) Difficult to transition from initial rehab exercises to weight-bearing exercises in a push-up position DS2 on the wall limits the amount of weightbearing or load through the shoulder, yet provides slight compression and joint congruency to protect the shoulder during this transition phase

26 How is the DS2 mounted on the wall? Mounted with Velcro Two long strips on wall (48 in.) Two short strips on back side of platform (32 in.) Allows platform to be adjustable How is velcro positioned on wall (loop velcro)? Placed 28 in. apart (Inside to Inside) and if place bottom of velcro 36 in. from floor, it will accommodate a height from 5 4 to 6 8

27 How is velcro positioned on back-side of platform (hook velcro)? Hook velcro is already adhered to platform to match dimensions on wall How many bands come with the DS2? Three 24 in. bands Handle on one end, carabiner clip on other end (Red=20 lb., Blue=25 lb., Green=35 lb.) Are nylon gloves washable? Yes *For clinic purposes, patients can wear rubber gloves underneath DS2 gloves

28 Is there a DVD available? No, but several videos and pictures on website Does DS2 come in other sizes or can it be customized? Only upon request

29 DS2 Rehab Systems, LLC 9119 Hwy 6, #127 Missouri City, TX (O) (C)

REMINDER. an exercise program. Senior Fitness Obtain medical clearance and physician s release prior to beginning

REMINDER. an exercise program. Senior Fitness Obtain medical clearance and physician s release prior to beginning Functional Forever: Exercise for Independent Living REMINDER Obtain medical clearance and physician s release prior to beginning an exercise program for clients with medical or orthopedic concerns. What