New! Stability Trainer Balance Products Rocker and Wobble Boards New! www.thera-band.com
Rocker and Wobble Boards The Hygenic Corporation 1245 Home Avenue, Akron, Ohio 44310 USA 330.633.8460 1.800.321.2135 Fax 330.633.9359 www.thera-band.com www.thera-bandacademy.com Thera-Band GmbH Schiesheck 5 D-65599 Dornburg-Frickhofen, Germany Tel. +49 (0)6436 9 44 94 0 www.thera-band.de Create and print customized patient exercise programs and hand-outs at www.thera-bandacademy.com THERA-BAND, the Color Pyramid and the Associated Colors are trademarks of The Hygenic Corporation. Unauthorized use is strictly prohibited. 2008 The Hygenic Corporation. All rights reserved. Made in China. P0 4055 Rev. 1/08. INSTRUCTION READ ALL INSTRUCTIONS BEFORE USING MANUAL
ROCKER AND WOBBLE BOARDS ROCKER AND WOBBLE BOARDS The Thera-Band Rocker and Wobble Boards offer an unstable and sensory-stimulating surface designed to facilitate balance and proprioceptive training and automatic postural reactions. The Rocker and Wobble boards are part of the Thera-Band System of Progressive Balance Training, beginning with Thera-Band Stability Trainers, advancing to the Rocker Board and then to the Wobble Board (each sold separately). The boards were developed based on the specifications of the late Professor Vladimir Janda, a Czech physician and researcher, well known for his approach to muscle imbalances and movement impairment. He developed the balance training rehabilitation program, Sensorimotor Training, using Rocker and Wobble Boards (see page 3). The boards smaller angles of deflection are designed to simulate the challenges of walking on uneven ground. Features Tactile stimulation (specially textured surface) to affect proprioceptors in the sole of the foot Provides single plane challenge (Rocker Board) and multi-plane challenge (Wobble Board) Anti-slip surface to prevent shifting of board during training Applications for lower extremity, upper extremity and spine rehabilitation Small size and light weight makes boards portable and easy to store Smaller degree of instability replicates walking on unstable surfaces Durable material for extended use Thera-Band Rocker Board: single plane rocker that allows one plane of instability at a time Angle of Deflection is 30 degrees 22º Angle of Deflection 30º Angle of Deflection Thera-Band Wobble Board: multiple plane Wobble Board that allows multiple planes of instability Angle of Deflection is 22 degrees Clinical uses Balance and proprioceptive training for upper and lower extremities Ankle and knee injury prevention/strengthening Ankle and knee rehabilitation Core strengthening and stability Ankle range of motion and flexibility Sensorimotor training Precautions Weight limit is 300 lbs. for the Rocker Board and Wobble Board. Patients with poor balance or vestibular dysfunction should use only under close supervision of a healthcare professional. Persons over age 50 should approach these exercises with caution and/or with the help of a physical therapist or healthcare provider. Use a sturdy outside support (such as a chair) to help maintain balance as necessary. Avoid fatigue and compensations during exercise. Do not stack the Rocker Boards or Wobble Boards during exercise. Do not use on wet surfaces. If the surface of the board is too painful, wear socks. 1 2
EXERCISE DESCRIPTIONS Many exercises can be achieved with the Thera-Band Rocker and Wobble Boards by combining different positions and activities. The exercises listed here are examples of how different combinations can be used to progress individually. Each exercise is named by (1) Board (Rocker or Wobble); (2) Orientation of Board to Body (Sagittal, Frontal, or Oblique Planes); (3) Posture (1-leg, 2-leg); (4) Movement/Activity. For best results, perform balance training without shoes or socks to ensure maximal proprioceptive input from the textured surface of the boards Orientation of the Body & Board (Rocker Board Only) The alignment of the body in relation to the board s Rocker bottoms will change the plane of instability, thus targeting different muscles Stage 1 Progress first on two legs through three planes of the Rocker Board, then to the Wobble Board. 2-leg Stance Stand with both feet in line with Rocker bottoms. Keep board parallel to ground. Keep your back and neck straight. Avoid hyperextending (locking) your knees. Sagittal Plane The feet are placed in the same direction as the Rocker bottoms. Frontal Plane The feet are placed perpendicular to the Rocker bottoms. Oblique Plane The feet are placed oblique (at an angle) to the Rocker bottoms. 2-leg Stance Stand with both feet perpendicular to Rocker bottoms. Keep board parallel to ground. Keep your back and neck straight. Avoid hyperextending your knees. Janda s Sensorimotor Training with Balance Boards progresses through three stages: Stage 1: Maintain postural stability on Rocker and Wobble Board in bilateral and unilateral stance. Add progressive challenges in these positions by shifting weight, closing eyes and adding head movements. Stage 2: Once postural stability is achieved in Stage 1, progress to adding extremity movement and resistance on the Rocker Board (using Thera-Band resistance bands or tubing for the upper or lower extremity, FlexBar or Soft Weight, sold separately) then progress these exercises to the Wobble Board. Stage 3: Progress to functional movements on the Rocker Board, then progress exercise on the Wobble Board. 2-leg Stance Stand with both feet oblique to Rocker bottoms. Keep board parallel to ground. Keep your back and neck straight. Avoid hyperextending your knees. 2-leg Stance Wobble Board Stand with both feet centered on board. Keep board parallel to ground. Keep your back and neck straight. Avoid hyperextending your knees. 3 4
Progress to Single-Leg Stance in each condition. Progress the balance exercises above by adding additional challenges such as shifting weight, closing eyes, or adding head movements. Use caution when adding additional challenges. 1-leg Stance Stand on one leg with foot in line with Rocker bottoms. Keep board parallel to ground. Keep your back and neck straight. Avoid hyperextending your knee. 2-leg Stance + Weight Shift (in Frontal Plane) Stand with both feet in line with the Rocker bottoms. Keep your knees straight and lean to one side without letting the board move. Avoid twisting your back or hips. 1-leg Stance Stand on one leg with foot perpendicular to Rocker bottoms. Keep board parallel to ground. Keep your back and neck straight. Avoid hyperextending your knee. 1-leg Stance + Closing Eyes Stand on one leg with foot oblique to Rocker bottoms. Close your eyes. Keep board parallel to ground. Keep your back and neck straight. Avoid hyperextending your knees. 1-leg Stance Stand on one leg with foot oblique to Rocker bottoms. Keep board parallel to ground. Keep your back and neck straight. Avoid hyperextending your knee. 1-leg Stance Wobble Board Stand with one foot centered on board. Keep board parallel to ground. Keep your back and neck straight. Avoid hyperextending your knee. 2-leg Stance + Turning Head Stand with both feet in line with Rocker bottoms. Keep board parallel to ground. Turn your head left and right. Avoid hyperextending your knees. 5 6
Stage 2 Progress to adding extremity movement and resistance on the Rocker Board (using Thera-Band resistance bands for the upper or lower extremity, FlexBar, or Soft Weights), then progress these exercises to the Wobble Board. Remember: each exercise pictured can be adapted with different body alignments or boards. Bilateral Shoulder Flexion Stand with both feet oblique to Rocker bottoms. Place Thera-Band resistance band under your feet and lift band forward with elbows straight. Slowly return. Keep board parallel to ground. Keep your back and neck straight. Hip Extension Wobble Board Stand with one foot centered on board. Securely attach one end of the band near the floor to a sturdy, unmovable object or door. Extend your hip against the band and slowly return, keeping your knee straight. Keep board parallel to ground. Keep your back and neck straight. FlexBar Oscillation Stand on one leg with foot in line with Rocker bottoms. Oscillate the FlexBar while keeping board parallel to ground. Keep your back and neck straight. Avoid hyperextending your knee. Stage 3 Progress to functional movements on the Rocker Board, then progress to exercises on the Wobble Board. Remember, each exercise pictured can be adapted with different body alignments or boards. 1/2 Step Begin with board slightly in front of you with Rocker bottoms aligned with your feet. Step up onto board with short-foot, (maintaining a normal arch in the foot) keeping your knees, back, and neck aligned, and abdominals slightly tightened. Keep the board parallel to the ground. Slowly return to starting position. 2-leg stance MiniSquat Stand with both feet perpendicular to Rocker bottoms. Keep board parallel to ground. Perform mini-squat, slightly bending your hips and knees. Keep your back and neck straight. VARIATION: Perform 1-leg minisquat. Lunge Begin with board in front of you with Rocker bottoms aligned with your feet. Step onto board, keeping the board parallel to the ground. Lower your hips to the floor, keeping your trunk vertical and flexing your knees. Slowly return to starting position. Soft Weight Plyo-toss Stand on one leg with foot perpendicular to Rocker bottoms. Toss the Soft Weight from hand-to-hand, person-to-person or to a plyotramp while keeping board parallel to ground. Keep your back and neck straight. Avoid hyperextending your knee. Step Down Begin standing on board with both feet perpendicular to Rocker bottoms. Keep board parallel to ground and step down to floor with one leg. Return to standing on both legs on board. Keep your back and neck straight. 7 8
UPPER BODY CLOSED-CHAIN EXERCISE / PROPRIOCEPTIVE TRAINING Remember, each exercise pictured can be adapted with different body alignments or boards. Quadruped Stabilization Begin in quadruped position. Place Rocker Board directly under your shoulders with rocker bottoms in line with your body. Place one hand on center of board. Gently rock board forward and backward with your hand, keeping your elbow straight. Keep your back and neck straight. Avoid scapular winging (where the shoulder blade comes up off the back). UPPER BODY CLOSED-CHAIN EXERCISE / PROPRIOCEPTIVE TRAINING Closed Chain Protraction/ Retraction Begin in quadruped position. Place Rocker Board directly under your shoulders with Rocker bottoms perpendicular to your body. Place hands on either side of the board. Gently rock board side to side with your hands, keeping your elbow straight, and pushing the arm downward. Keep your back and neck straight. Avoid scapular winging. Quadruped with Arm Raise Begin in quadruped position. Place Rocker Board directly under your shoulder with Rocker bottoms in line with your body. Place one hand on center of board. Keeping board parallel to ground, lift opposite arm forward with elbow straight. Slowly return. Keep your back and neck straight. Avoid scapular winging. Push-Up Align Rocker Board with rocker bottoms in line with your body, placed under your shoulders. Assume push-up position with knees on floor, and hands stabilized on sides of Rocker Board. Keeping the board parallel to the ground, perform a push-up at the knees. Keep your back straight. Step Up and Over Begin in quadruped position. Place Rocker Board directly under your shoulders with Rocker bottoms perpendicular to your body. Begin with both hands on floor next to board. Step up onto board with one hand at a time, and then step down with one hand at a time. Repeat in opposite direction. PROGRESS to a push-up at the feet, keeping your back and knees straight. 9 10
SPINAL STABILIZATION EXERCISES SPINAL STABILIZATION EXERCISES Abdominal Crunch Place Rocker Board under your hips and low back with Rocker bottoms aligned with your body. Keep your knees bent and feet flat on the ground. Keep board parallel to the ground as you perform a curl-up. Hold and slowly return. PROGRESS to the Wobble Board. Bridge Stabilization Align Rocker Board with Rocker bottoms perpendicular to your body. Begin lying on back with knees bent and both feet stabilized on board. Lift your hips off the floor, keeping the board parallel to the ground. Hold and slowly return. PROGRESS to Wobble Board. Quadruped Arms & Legs Begin in quadruped position. Place Rocker Board directly under your shoulder with Rocker bottoms perpendicular to your body. Place one hand on center of board. Keeping board parallel to ground, lift opposite arm and leg. Slowly return. Keep your back and neck straight. PROGRESS to Wobble Board. Prone Plank Stabilization Align Rocker Board with Rocker bottoms perpendicular to your body, placed under your shoulders. Place your forearms on the board with elbows directly under your shoulders (A folded towel may be used for comfort). Assume plank position with toes on floor. Keep board parallel to the ground. Keep your back and knees straight. PROGRESS to Wobble Board. Side Bridge Stabilization Align Rocker Board with Rocker bottoms aligned with your body, placed under your shoulders while lying on your side. Place your forearm on the board with elbow directly under your shoulders (A folded towel may be used for comfort). Lift your hips off the floor to assume side-bridge position with knees on floor. Keep board parallel to the ground. Keep your back straight. PROGRESS to Wobble Board. 11 12
SPORT-SPECIFIC BALANCE TRAINING ANKLE RANGE OF MOTION Tennis Swing Stand with both feet in line with Rocker bottoms. Keep board parallel to ground. Perform tennis forehand or backhand. Golf Swing Stand with both feet perpendicular to Rocker bottoms. Keep board parallel to ground. Perform golf swing. Sitting Ankle Inversion/ Eversion While sitting, place Rocker Board with Rocker bottoms perpendicular to foot. Keep your knee steady and rock the board side to side with your ankle motion. Sitting Ankle Dorsiflexion/ Plantarflexion While sitting, place Rocker Board with Rocker Bottoms in line with your foot. Keep your knee steady and rock the board forward and backward with your ankle motion. PROGRESS to Wobble Board. While sitting, place Wobble Board under foot. Keep your knee steady and rock the board forward and backward, side to side, and in circles with your ankle motion. Baseball Pitch Stand with both feet oblique to Rocker bottoms. Keep board parallel to ground. Perform pitching motion. Soccer Kick with Thera-Band Resistance Band Wobble Board Stand with one foot centered on board. Securely attach one end of the band near the floor to a sturdy, unmovable object or door, and the other end to your ankle. Kick against the band and slowly return, keeping your knee straight. Keep board parallel to ground. 2-leg Stance and Ankle Inversion/ Eversion Stand with both feet perpendicular to Rocker bottoms. Begin with board parallel to ground and rock board from side to side by bending your knees and ankles. Keep your back and neck straight. 2-leg Stance and Ankle Dorsiflexion/ Plantarflexion Stand with both feet in line with Rocker Bottoms. Begin with board parallel to ground and rock the board forward and backward, bending your ankles. Keep your back and neck straight. PROGRESS to Wobble Board. Stand with both feet centered on board. Begin with board parallel to ground. Rock the board forward and backward, side to side, and in circles by bending your ankles and knees. Keep your back and neck straight. 13 14