By Eric Edelman, PT

Rehab can seem like a battle of attrition for clients who may feel the need to summon equal parts of tenacity, focus, and faith in their physical therapist to push through a months-long program. Along that continuum clients are likely to spend time on some of the workhorse technologies of the PT gym. One such well-known technology is the treadmill. Mention that universal piece of workout and rehab equipment, and watch eyes roll at the thought of dull sessions made tolerable only by tunes and TV reruns. Treadmill technologies have been updated, however, to offer exceptional versatility and provide activity sessions that leverage modern design features. Among those features are self-powered capabilities, a weighted sled, resistance parachute, and harness system all in one space-efficient package.

An example of this technology is the S-Drive Performance Trainer by Matrix Fitness. This treadmill is equipped with all the previously mentioned “bells and whistles,” but as a rehab mechanism its primary benefit is to provide full control to patients over speed and resistance. These aspects are paramount for a wide base of users, from athletes and non-athletes who are returning to sports after an injury, to elderly patients looking to improve balance and coordination.

When used as a low-impact trainer, the S-Drive provides a way to safely challenge and progress gait training for the elderly and neurologically compromised, as it has a self-driven belt rather than a motor-driven belt. The latter can be frightening and at times dangerous for these populations.
And in terms of those “bells and whistles,” for athletes, consider the array of key features incorporated into the design of this piece of equipment to assure versatility. Those features include a sled brake with eight settings for a true weighted sled pushing experience that provides conditioning for upper and lower body and core. A parachute brake with 11 settings is also included to simulate the feel of actual parachute resistance, providing the ultimate in resistance training for patients with lower-extremity injuries. An adjustable harness for complete upper-body range of movement is also built in.

The right technology in the PT gym can help successfully prepare clients to get back to their sport safely. An example of this is one of the practice’s clients who needed ACL repair due to a soccer injury. The final stages of her rehab included sports-simulated drills. With use of a self-powered performance trainer, she could accelerate the rehab process. This was also the case with another patient who benefited greatly from the same fitness machine while recovering from a sports-related knee injury.

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Safe Activity for Joints and Therapy

Treadmill exercise that allows for complete user regulation, zero start motion, and full-length handrails makes it easier going on joint impact, since it absorbs shock. And for seniors who have eliminated past outdoor walks/runs due to increased difficulty negotiating uneven terrain, traffic, or animals, a treadmill workout can be the ticket to sustaining and improving health.

In evaluating the benefits this type of equipment offers to older clients, the increasing emphasis on the benefits of adding resistance training to an exercise regimen should be considered. Among those benefits are increased bone mineral density, improved strength, and greater ability to perform activities of daily living. For seniors, resistance training may also translate into increased independence and decreased risk of falls and injuries, which helps keep them safe at home and in the community. The contribution in preventing chronic disease and enhancing the mood is also worth noting.

Updated technologies that have made treadmills safer, more convenient, and more interesting to use have rolled out across the market. Among manufacturers who have developed such technologies is Spirit Fitness, Jonesboro, Ark, which offers the MT200 Gait Trainer Treadmill, built with a removable step-up to assist users as they enter the treadmill. The MT200 can have the belt speed set as low as 0.1 mph and, as an additional patient safety measure, the motor is locked anytime the belt is not moving. Full-length handrails are also featured on the MT200 to provide safety up to 34.5 inches of height, and up to 31 inches of width.

The safety features and operating variations of the Dynamic Stair Trainer (DST) 8000-PRO Dynamic Stair Trainer from Clark Health Care Products, Oakdale, Pa, can be useful for non-athlete physical therapy clients who need to build walking and mobility skills. The steps and platform are covered with non-slip tread for added safety, and the device is built with long handrails, adjustable ramps, and width-adjustable handrails. This stair trainer can monitor, track, and display data about gait and performance while the stairs are in use that can be included in documentation. Data measures include stair height, time frames for ascents and descents, and treatment date.

Treadmills engineered for the needs of the PT market are also available from SportsArt, Mukileto, Wash, such as the Treadmill T655M. Among the rehab-specific features of this treadmill is a 3% decline and 15% incline range, and a belt that can operate in reverse at up to 3 miles per hour. The belt’s carbon weave is manufactured for low friction, and the deck is cushioned to provide increased shock absorption to help protect joints.

Safety and Stability By Design

Similar benefits apply to non-athletes. In fact, the S-Drive can provide great advantage to geriatric clients who are working toward maintaining functional health. Full-perimeter guardrails make for easy entry and exit, and handrails run the full length of the machine, providing full stability from start to finish of a workout. Combine that feature with a zero mile-per-hour starting speed and the natural gait inherent to self-powered design, and you have equipment that is safe enough for users of all fitness levels.

Features that provide good utility for athlete clients include a 7-degree incline and natural ground reaction force that builds strength and power bursts in sprint-training without changing the athlete’s natural gait. Since the track is user-powered, operators can work on their form for forward, reverse, and lateral movements; and the 60-inch-long x 22-inch-wide training surfaces makes it easy to keep a natural gait.

Its design includes the pushing and pulling range of a traditional sled but on a much smaller space footprint. Multiple sled brake settings add to the workout and allow trainers/coaches to keep tabs on the user’s progress. For resistance, a parachute brake with 11 resistance levels replicates outdoor parachute resistance; and an adjustable harness lets users enjoy a complete range of upper body motion and at the same time allows trainers/therapists keep an eye on sprint stages. The brake is useful for resisted sprint drills and eliminates the need for the extra gear or access to a wide track/open area typically required for this type of advanced resistance training. The sled and parachute features can be used separately, but when operated in concert they can provide both cardio and strength building workouts intermittently.

Versatile Resistance and Balance

Though Shuttles aren’t necessarily known for high-tech features, they can provide effective resistance training in the PT gym. The Shuttle MVP, available from Shuttle Systems, Bellingham, Wash, is often popular as a tool to train athletes for developing explosive power. The device design and operation offer protection to joints and the spine by minimizing impact. It is designed to provide the function of a supine leg press, plyometric jumping, as well as general and early-stage rehabilitation in a single device platform. The Shuttle Recovery is built to be used with a range of body types, including bariatric rehabilitation users, and can be outfitted to provide up to 300 pounds of resistance. A wider back rest than other Shuttle models expands the unit’s support, and an optional wedge backrest is available.

When clients need an unstable platform that is also safe to use, the Shuttle Balance offers a solution that has a small footprint and is affordable. The device is designed to provide secure footing for up to 500 pounds, and the adjustable balance platform perturbates in both standing and seated positions. The device is built with bars to provide security and safe balance training, and accessories such as foam pads, DynaDiscs, and BOSU Balls can be used to vary activities.

Safe Support Platforms

Clients and patients expect the PT clinic to be outfitted with equipment that is safe to use and up to date. This is as important for treatment tables as it is for equipment in the PT gym. A great number of clients and patients will spend time on a treatment table during some portion of their care program, so the condition of this equipment as well as the convenience it provides therapists and patients is important.

A range of options is available by manufacturers that provide treatment tables to the PT market. PHS Medical by Pivotal Health Solutions, Watertown, SD, provides a line of mat tables, treatment tables, bariatric tables, and hi-lo therapy tables appropriate for PT clinics. The (LAST) Leg and Shoulder Treatment Cabinet from PHS Medical is built to support bilateral training as well as specific anatomical positioning. In addition, the LAST Table has cabinets in maple or oak finish built below the treatment platform where equipment can be stored in close reach of the therapist.

Another provider, Everyway4all, Chino, Calif, offers the EU25 (Tristar) 3-Section Treatment Table, equipped with an electric lift mechanism and available with hand control or foot control. The EU25 is built with twin pillars to increase stability and has individual leveling on all four corners. Likewise, it features twin gas struts for head and leg section support. Tri W-G, Valley City, ND, offers its TG2708 Motorized Hi-Lo table with safety belts and a foot platform that folds down to convert to a treatment table. The TG2708 features a pneumatic hand switch, angle indicator, weight capacity of 350 pounds, and a tilt range of 0 to 86 degrees.

Superior Clinic Experience

Whether your clients are elite athletes determined to achieve their ultimate potential, injured recreational sports lovers looking to return to player status, or geriatric patients in need of gait and balance control, it’s important for clients to know they are using technologies that are up to date and provide optimum safe use. These qualities are also important to therapists, who must reflect the confidence they have in the clinic’s ability to provide care that is effective and valuable. While marketing is an important aspect of any outpatient clinic’s business plan, there is nothing that speaks quite so clearly and directly as a client’s superior experience in your clinic. PTP

Eric Edelman, PT, is the owner of Peak Physical Therapy & Sports Performance with locations in Scituate, Norwell, Quincy and Hanover, Mass. For more information, contact [email protected].