Functional Stability Training

Фото: Functional Stability Training

FUNCTION, FUNCTIONALITY, FUNCTIONAL STABILITY

Based on the characteristics of the sport, basketball players are required to react to unforeseen physical stress, oftentimes occurring with the athlete left in a compromising physical position. These reactions include speed acceleration, deceleration, stopping and starting, changing direction, taking position relative to the opponent, and most importantly, the transfer of horizontal inertia to vertical motion. Eat all times, the “control,” the balance is very important, etc. It becomes imperative that athletes become proficient at controlling their bodies in multi-planar directions. In order to accomplish this proficiency, the athletes must develop the ability to stabilize their bodies during phases of both acceleration and deceleration. This ability will now be referred to as functional stability. Functional stability is a fundamental part of how the body moves. If you consider the body as a kinetic chain and it’s links (joints), functional stability allows the chain to function in an effective and secure way.

Functional stability is composed of three main parts.

1. An Anatomical and Mechanical part: composed of both limiting and enabling factors. These factors are the joints and their structure (passive part) and their corresponding muscle groups (active part). It’s the structure.

2. An Information Part, that receives information from three receptors of the postural control system. It’s the input.

• Vision: very precise
• Inner ear: controls emergency reflexes with slow, imprecise actions.
• Proprioceptive system: the fastest and most precise way to send information to the “black box.”

3. A “black box” composed of nervous centers in the brain that receives signals from vision and other receptors and integrates this information, and then sends the output to the muscles for the stabilization.

The proprioceptive system is the most important informer of the Postural Control and only an efficient Dynamic Postural Control allows the Anatomical and Mechanical part to work with efficiency. Prof. Dario Riva, President of International Society of Proprioception and Posture resumes with simplicity the previous concepts with the following tab. Thus, not only an injury with an anatomical damage can produce instability, but also an inefficient proprioceptive system will produce functional instability. The result will often be a weakness of a body district, or in other links of kinetic chain. An example could be the weakness of medium gluteus after an ankle sprain, resulting in reduced stability of the LHP (Lumbo-Hip-Pelvis) Complex on the transverse plane and consequent low back pain. Therefore, a bad Postural Control can elicit a bad alignment, with a wear and tear of the anatomical structure. Besides, high- level athletes repeat the same physical motions continuously. They prefer and chose a sensory channel for the balance and this channel is often vision.

INJURY PREVENTION OR PERFORMANCE IMPROVEMENT?

Vern Gambetta, the American pioneer in functional training, backs up his theory that proprioception is the base to improve the quality of the human moves, and that proprioceptive system trainability is very high. Prof. Dario Riva defines the role of the proprioceptive training as a very important factor for the fluidity of the moves. This fluidity is broken if the athlete chooses an “inner ear” strategy, which is a very low quality moves control strategy. Indeed, if the athlete uses the visual proprioceptive strategy, the quality of the moves control is really higher than “inner ear” strategy.

OUR EXPERIENCE

We collected data on our team during the 2006-07 and 2007-08 season. Our team, Cantu Basketball, plays in the top Italian division. During those two seasons, our technical staff introduced a systematic proprioceptive training and functional stability- training program. Twenty athletes took part in this training, and they have been tested on the Delos® Postural Proprioceptive System (Turin, Italy), and this same testing device has been used for the proprioceptive training sessions during the two seasons.

OTHER INFORMATION COLLECTED

We also noted how many players injured their lower limbs and how many players were using artificial stabilization (taping, braces). Here are some results:

• INJURIES: 14 of 20 (70%) players had serious ankle sprains, 4 had serious knee sprains.
• ARTIFICIAL STABILIZATION: 7 players (35%) used taping or ankle braces and were injured, 13 players didn’t use the artificial stabilization, and 7 (35%) were injured.
• BEHAVIOR: Players that used artificial stabilization used it all the time, and only a few players from this group followed a specific workout following the injury rehabilitation period. The players that didn’t use the artificial stabilization followed a constant and specific workout after injury rehabilitation. Thus, artificial stabilization often facilitates a passive behavior and this could be dangerous, because with artificial stabilization arises a functional instability from decreased proprioception.

INSTRUMENT DESCRIPTION

Delos Postural Proprioceptive System is composed of:

1. DEB (Delos Equilibrium Board), an instability board, with oscillation and translation.
2. DAD (Delos Assistant Desk), a Help Bar, with an infrared cell that reads the help time.
3. DVC (Delos Vertical Controller), a device that informs about the trunk movement on two different planes.

These instruments are interfaced with specific software to a personal computer and it is then possible to analyze the player’s static and dynamic postural stability.

ASSESSMENT OF THE FUNCTIONAL STABILITY

We use the following evaluation test:

• STATIC RIVA TEST: this test tracks the static postural strategy and whether or not the player depends on vision for proprioception.
• DYNAMIC RIVA TEST: this test defines whether the player is able to manage the off balance situations and how they respond to these situations.
• SEAT DYNAMIC RIVA TEST: this test shows the postural control of the trunk
• RIVA-BOTTA TEST: this test defines the stability of lower limbs and it defines the Postural Economy of the player. If the players reach a good level of stability, this test makes it possible to understand the level of fatigue.

WHEN TO ASSESS FUNCTIONAL STABILITY

The functional stability assessment should be done:

1. Pre-season.
2. Ten days before the beginning of the first official game.
3. In the middle of the season.
4. End of the season.
5. After every injury.

We repeat a “follow up” special test (RIVA - BOTTA Test) every week following an off day from practice, because we want to avoid an overtraining syndrome. This test uncovers excessive fatigue.

HOW WE ANALYZE THE DATA

It is possible to obtain a functional stability level for the left and right leg and we use the mean value (R+L) 2. The precision is lower but the data is like a picture of every single player and his Functional Stability.

COMMENTING ON THE RESULTS

Players in the previous picture have shown a low Functional Stability. A small part of the sample uses the correct strategy for the management of the out-of-balance situation. When the Postural Control is low, the players have a high exposure to traumatic and overuse injuries.

PROPRIOCEPTIVE TRAINING: PRACTICAL INFORMATION

We introduce individual proprioceptive training in the weekly program two to three times a week, with training sessions lasting 30 to 40 minutes.

Postural strategy average improvement has been 18% in three months.

The players have drastically decreased the time lost to practice and games due to injury. We use specific proprioceptive exercises and drills in the team warm up and practice sessions.

However, the core of the proprioceptive training is the individual sessions.

During these sessions every player does High Frequency Visual Proprioceptive Exercise using Delos DPPS.

This individual part must be based on the assessment previously described. Every player has their own personal proprioceptive workout and they will have different targets, work and rest time.

TARGET PROGRESSION

A target progression will be:

1. Decrease Vestibular Strategy.
2. Decrease Visual Dependence.
3. Increase and refinement of proprioceptive strategy.
4. Decrease of proprioceptive decline after fatigue.

HOW WE WORK

We divide the team in work groups. Every work group has five players and every player works on a DEB Board.

They can use the DEB Board:

• One foot stance.
• Two foot stance.
• Side by side.
• Front and back.
• ± 45° Diagonal.
• Seat.

Every time we do strength training, we also incorporate a short proprioceptive session. We don’t do any proprioception exercises after practice because we want a quality response from each session. Extreme fatigue will decrease the expected response.

ENDING

For players that use artificial stabilization (taping, braces), the High Frequency Visuoproprioceptive Training is fundamental. This helps avoid a proprioceptive regression and will allow an increase of functional stability. The assessment of functional stability is as important as tests for strength, mobility, quickness, and agility.

REFERENCES

• International Society of Proprioception and Posture (www.ispp.eu), you can find some articles of Prof. Dario Riva on proprioception, posture, and sport.
• Journal of Athletic Training 2006, 41(1):7478 NATA.
• V. Gambetta Athletic Development, Hum. Kin. 2007.
• NASM Course Guideline “Integrated Neuromuscular Stabilization Training.”
• ISPP Course June 2008, Torino, “Competitive Advantage in Sport.”