Jan 29, 2015Your Expert Opinion
New treatments and training tools arrive on the market daily. As an athletic trainer, you will need to provide opinions on them.
By Dr. Greg Frounfelter
Greg Frounfelter, DPT, ATC, CSCS, is an Athletic Trainer and Physical Therapist in the Physical Medicine Department at Agnesian Healthcare-Waupun Memorial Hospital in Waupun, Wis. He can be reached at: [email protected].
For anyone with a computer, an almost unlimited amount of information about training modalities is just a mouse-click away–and that includes your future clients. Ready or not, you will need to be able to answer their questions about the latest training ideas and equipment.
So how do you assess new training modalities and establish recommendations about them? And how can you incorporate those thoughts into practice as you serve your future clientele?
My strategy is to follow a series of steps when evaluating a new training product. First, I examine content validity by looking over the device and analyzing whether it looks like it can do what it claims to be able to do. I use what I know about anatomy, movement, and rehab to make this assessment.
If the product looks and sounds feasible, I then read any reviews of it that are available. I start by looking for scientific research through Medline, PEDRO, and the Cochrane Library databases. If I don’t get many results, I do a standard Web search. I usually use the MSN search engine, playing with search phrases until I find something that looks worthwhile.
Ideally, I would like peer-reviewed articles about the product, which means a panel of academics in kinesiology or sports medicine examined the text before it was approved for publication. It also means the article’s authors must reveal any financial ties with the manufacturer of the product.
I also see if any randomized, controlled trial studies have been performed, although this is less common with newer products. These studies help us develop evidence-based practices that allow us to determine the best treatment and practice patterns with the equipment.
Sometimes, I only find research conducted by the manufacturer of the product. Though these studies can be biased, I don’t automatically assume they are flawed. I look at how the study was performed and how the researchers drew their conclusions. If their methods and analyses are based in science, I will take their conclusions seriously.
If possible, I also take the time to personally try out the equipment. This gives me a hands-on feel for how the product works. It can also help answer any questions I have about content validity and the research I’ve read.
Finally, I will consider whether the product is worthwhile for my clients. Before purchasing, I ask: Does the equipment fit in my facility? Will my athletes and patients actually be able to use and benefit from it? How much does the product cost and will my budget allow me to purchase or rent it? How will staff learn to use the product properly and teach others about it?
Let’s take kettlebells (KBs) as an example. I had heard of KBs through reading about Soviet sports training programs, but I didn’t know their specifics until I saw a presentation about them at the NSCA National Conference and Symposium. As I watched the demonstration, I began to consider their content validity.
Supporters claim KBs are a functional, easy-to-use training modality that can produce resistance training with cardiovascular effects. The demonstrator showed that there are two basic exercises, the swings and grinds. On the swing motion, the athlete lets the KB swing to the rear between the legs and then uses the leg and back muscles to explosively bring the KB to the front. The weight then falls back to the starting position and the next rep starts. This can be performed with one or two hands holding the KB and there are many variations on the swings. From this basic exercise, cleans and snatches can be performed. As I watched, I found this type of activity very specific to sports performance and felt it could easily be used in late-stage rehab or with relatively lighter KBs to provide a cardio workout.
The second basic exercises are grind motions, which are performed in a controlled manner without the ballistics of the swings, and can be used for general strengthening and conditioning. Exercises include various squats, chest presses, overhead presses, and even Turkish get-ups or windmills. The KB grinds seemed to be perfect for core strengthening, especially when done unilaterally. They also appeared to be very valuable for training trunk stability in patients with back pain.
I was impressed with how many areas the demonstrators were working when using KBs. I also was able to see how the exercises could be incorporated into both training and rehabilitation. The wonderful thing about learning about KBs at a conference was there were vendors at the exhibit hall who sold them. This allowed me to try them first-hand, as well as check out different styles. From the presentation and my own practice with them, at that point, I was confident I had verified the product’s content validity.
After the conference, I searched the Internet and review-based article databases to further investigate the efficacy of KBs. The peer-reviewed articles did not have much information, but I did find out more about the use of KBs through various fitness Web sites. One of the sites also sold KBs, so I was wary of the information. But I kept searching and found two independent Web sites that verified the claims. Although I couldn’t find all the information I wanted about KBs, I had enough to keep thinking about their use.
Next, I determined whether KBs would work with enough of our clientele to make the investment worthwhile. I concluded that:
• Because they have many uses, KBs would work well with our diverse clientele. • Because they strengthen the core, they would be a good tool for our many patients with back injuries. • Because they come in small weights, they would be a good fit with our patients with low strength thresholds. • Because they take up very little space, they would work well with our floor plan.
We have bought KBs and they have worked well. But I am very glad I took the time to analyze their validity and uses beforehand. By following a logical progression when assessing new equipment, you too will be able to make solid recommendations based on fact and physiological training principles. In the midst of the information age, our clients will expect nothing less of us as allied health professionals.