PHOTO CAPTION: Physical therapy clinics are known for meeting patients where they are, which means they must be equipped to deliver a range of services to a population of widely varying functional levels, ranges of motion, and physical conditions.
Keep therapy engaging and effective by using technologies manufactured with the PT clinic in mind
By Garrett Early, PT, DPT, COMT, OCS
There is a growing need for physical therapy (PT), and it has been shown that PT is crucial for assisting patients for safe and appropriate returns to full function. Research demonstrates PT can best assist patients when the main focus is the relationship between a patient’s limitations/impairments and the desire to return to the patient’s prior level of function. This relationship creates the opportunity to develop a unique and individualized plan of care for that patient. Within this plan of care, there are a wide variety of treatment options that can be used to achieve patient goals.1
To perform successful PT treatment, there is essential equipment needed to allow for a better patient experience. During an initial evaluation, the use of measurement tools – including measuring tape, goniometer, and dynamometer – is important in setting goals. The Baseline Plastic 360 Degree Goniometer, produced by Fabrication Enterprises Inc, White Plains, NY, helps therapists select the right interventions based on the limited range of motion observed during the evaluation. The goniometer, which is shown to be as effective as a digital goniometer in measuring different body joints,2 allows for objective measurements and can be used to assess progress and proper discharge status.3
The following companies offer a range of essential products for physical therapy clinics:
Bailey Manufacturing Company
Battle Creek Equipment
Clarke Health Care Products
Hausmann Industries Inc
LightForce Therapy Lasers by LiteCure LLC
Pivotal Health Solutions
Tri W-G Inc
Strengthening is an important part of PT. Essential tools for strengthening include dumbbells and resistance bands by TheraBand, based in Akron, Ohio. A study that tested the effectiveness of dumbbells and resistance bands found the group that used bands twice a week for 30 minutes (compared to the control group that had no training) increased their strength when assessed using a dynamometer.4 The study concluded that bands and dumbbells use can enhance muscular strength and improve quality of life.5 TheraBands resistance bands are inexpensive, easily accessible, and easily adjustable, making them an optimal tool for home exercise programs, as the patient can progress throughout the program without the need for new equipment.6
In addition, resistance bands can be used by people working from home to help assist with forward head posture and increase scapular muscle strength. A study tested the success of bands with exercises completed using only bands. Increased thickness of upper traps and length in pectoralis major was noted, suggesting that the use of elastic bands reduces rounded shoulder and forward head posture.7
Stretching also plays an important role in patient care and is a critical component for preventing injuries, muscle contractures, and soft tissue restrictions. Therefore, another essential tool for PT is a stretch strap. A stretch strap like the one offered by EverStretch, Las Vegas, can be used for both upper and lower extremities to increase the patient’s limited range of motion (ROM), and can easily be used in clinic or at home to stretch important muscles like hamstrings, quads and those associated with the ankle. A study where patients tested using a stretch strap for ankle tightness concluded that after stretching for 3 weeks using the stretch strap, patients had improved active ankle dorsiflexion and plantarflexion range.8 Improved ankle flexibility can result in an improved gait pattern and decreased overall pain. Other sources that provide stretch straps to the PT market include NZ Manufacturing, Tallmadge, Ohio, which offers its StretchCordz line of dry land and aquatic stretch straps and tubing, and OPTP, Minneapolis, which provides the Stretch Out Strap for a variety of solo stretching exercises. Another manufacturer that specializes in the PT market is Stretchwell Inc, Warminster, Pa, which offers the Fit-Lastic line of therapy products including the The Facilitator: Dynamic Stretching Strap.
Foam rollers also help with flexibility and increasing upper and lower extremity ROM. A study that conducted six sessions of stretching and foam rolling showed the use of foam roller stretching resulted in an increase of hip ROM.9 The foam roller offered by TRX, San Francisco, is also another easy, accessible tool that can be used for different body parts at a low price. Likewise, OPTP provides foam rollers to the PT market in a wide variety of sizes, colors, surfaces, and prices.
In addition to stretching and strengthening, balance is another important component to the overall well-being of a patient. Balance training aids in the prevention of falls while promoting functional independence.10 One tool used in balance training is the Balance-pad by Airex of Somersworth, New Hampshire. The Airex Pad is a soft surface that challenges a patient’s neuromuscular input by forcing the body to stabilize throughout the lower extremity. In a study that tested the responsiveness of the Star Excursion Balance Test (SEBT) on an Airex Balance-pad vs firm ground, the Airex Pad provided better results regarding sensorimotor and strength training with the SEBT.11 The Airex Pad can be used at home and provides a dynamic component to balance training that contributes to the increased postural stability of the patient.
The use of massage and manual therapy is also an important element of PT, and therefore investing in a massager or an assisted massaging tool can be beneficial for patients to use on days off therapy or from home after discharge from PT. The use of the Hypervolt massaging gun, manufactured by Hyperice in Irvine, California, on plantar flexors resulted in improved ROM, and the study suggests using a hypervolt massaging gun as warm-ups for the muscles to provide increased and improved flexibility.12
Augmented Soft Tissue Mobilization (ASTYM) treatment is another essential tool for increasing patients’ ROM and providing relief. ASTYM instruments from Astym Therapy in Muncie, Indiana, target and break up scar tissue, resulting in increased ROM of the affected area, while simultaneously helping to decrease pain in that area.13 According to a study that compared the use of eccentric exercises to the use of soft tissue treatment combined with eccentric exercise in the treatment of Achilles tendinopathy, ASTYM combined with eccentric exercises was found to be more beneficial for improving the function of the patient, compared to just eccentric exercises alone.14
Finally, pain relief is an important focus of treatment during PT. One way to manage pain is with a portable Transcutaneous Electrical Nerve Stimulation (TENS) unit, like the one offered by Electricostim Medical Services based in Tampa, Florida, during which pads are placed directly on the skin of the affected area and electrical stimulation generates signals to the nerves of the patient to elicit a pain-relieving response.15 Benefits include the ability to use the portable TENS unit while participating in job-related activities, as well as decreasing the intake of pain-relieving medications.16
As mentioned before, an important aspect of patient care in PT comes from the relief of pain or symptoms that a patient may be experiencing. Physical agent modalities, such as cold packs, hot packs, and ultrasound, are other important tools for relieving pain and decreasing swelling. Cold therapy helps to limit damage of the inflamed tissue by delaying the histamine response and limiting blood flow to the area through vasoconstriction.17 Superficial thermal modalities are beneficial when used before stretching muscles, because the vasodilation and increased tissue temperature help to increase oxygen to the tissue, promoting healing and allowing for increased extensibility of the tissues.18 Many of these modalities can be applied by the patient at home and offer quick relief of symptoms.
One of the most-used staples of any physical therapy clinic is a treatment table. Nearly every person who receives physical therapy services will come into contact with a treatment table as part of an evaluation, manual therapy, or pain management treatment. The tables must be safe and durable enough to stand up to months of daily use. Tables that are reliable and highly adjustable are always in demand, and many therapists enjoy the convenience of powered tables and remote-control operation. Several manufacturers provide treatment tables engineered especially for the PT clinic in a variety of configurations that will support a wide range of weights. Among them are Hausmann Industries Inc, Northvale, NJ, which offers a series of hi-lo mat platforms, hi-lo section tables, crank hydraulic platforms and other tables to the market. Tri W-G Inc, Valley City, ND, also serves the PT market with an expansive selection of tilt tables, mat tables, and treatment tables, including bariatric motorized hi-lo tables.
Physical therapy clinics are known for meeting patients where they are, which means they must be equipped to deliver a range of services to a population of widely varying functional levels, ranges of motion, and physical conditions. These demands mean the work day for most PTs may not always be predictable, but the products and technologies they rely on to do their work should be. Using the right tool for the job is an essential part of PT practice, and an essential part of reaching the outcome the patient and therapist have in mind. PTP
Garrett Early, PT, DPT, COMT, OCS, is a clinic director and physical therapist for ATI Physical Therapy in the Spartanburg, SC market. For more information, contact PTPEditor@medqor.com.
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- Kolber MJ, Hanney WJ. The reliability and concurrent validity of shoulder mobility measurements using a digital inclinometer and goniometer: a technical report. Int J Sports Phys Ther. 2012;7(3):306-313.
- Gajdosik RL, Bohannon RW. Clinical measurement of range of motion. Review of goniometry emphasizing reliability and validity. Phys Ther. 1987;67(12):1867–1872.
- Lee HS, Lee CH. The effect of progressive resistance training with elastic band on grip strength and balance in middle elderly women. J Kor Phys Ther. 2013;25:110-116.
- Pourtaghi F, et al. Effect of resistance training using thera-band on muscular strength and quality of life among the elderly. Evidence Based Care. 2017;7(3):7-16.
- Page P, Ellenbecker TS. Strength Band Training. Human Kinetics Publishers, 2019.
- Kim TW, An DI, Lee HY, Jeong HY, Kim DH, Sung YH. Effects of elastic band exercise on subjects with rounded shoulder posture and forward head posture. J Phys Ther Sci. 2016;28(6):1733-1737.
- Jeon I, Kwon O, Yi CH, Cynn HS, Hwang U. Ankle-dorsiflexion range of motion after ankle self-stretching using a strap. J Athl Train. 2015;50(12):1226-1232.
- Mohr AR, Long BC, Goad CL. Effect of foam rolling and static stretching on passive hip-flexion range of motion. J Sport Rehabil. 2014;23(4):296-299.
- Runge M, Rehfeld G, Resnicek E. Balance training and exercise in geriatric patients. J Musculoskelet Neuronal Interact. 2000;1(1):61-65.
- Amacker A, et al. Responsiveness of the star excursion balance test on firm and unstable underground. Schweiz Z Für Sportmed Sporttraumatologie. 2015;63(2):24-28.
- Konrad A, Glashüttner C, Maren Reiner M, Bernsteiner D, Tilp M. The acute effects of a percussive massage treatment with a hypervolt device on plantar flexor muscles’ range of motion and performance. J Sports Sci Med. 2020;19(4):690-694.
- What Is Astym Treatment? Accessed May 18, 2021. Available at https://astym.com/what-is-astym-treatment-astym-treatment-is/
- McCormack JR, Underwood FB, Slaven EJ, Cappaert TA. Eccentric exercise versus eccentric exercise and soft tissue treatment (Astym) in the management of insertional Achilles tendinopathy: a randomized controlled trial. Sports Health. 2016;8(3):230-237.
- Lillas C. TENS Unit: Benefits, Side Effects, and Research. Medical News Today. Accessed May 18, 2021. Available at https://www.medicalnewstoday.com/articles/323632
- Subin PG, Balaji TS. Design of a multifrequency TENS unit for therapeutic purposes. Int J Pure Appl Math. 2018;119(15):1023-1027.
- Hanks J, Levine D, Bockstahler B. Physical agent modalities in physical therapy and rehabilitation of small animals. Vet Clin North Am Small Anim Pract. 2014;45(1):29-44.
- Heinrichs K. Chapter 16: Superficial thermal modalities. In: Millis DL, Levin D, Taylor RA, eds. Canine Rehabilitation & Physical Therapy. Saunders/Elsevier; 2004:277-288.