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February, 2011

Implementing Active Therapy and Fitness Equipment

By Perry Nickelston, DC, FMS, SFMA

One of the primary goals during patient care should be to phase treatment protocols from passive therapy to active therapy and ultimately fitness-based exercise.

The objective is to educate, teach, train and empower your patients to take an active role in maintaining their health. Implementing an on-site active therapeutic fitness program combined with a doctor-guided at-home program will add new dimension to your treatment programs.

It all makes sense, but how do you go about assessing therapy and fitness equipment best suited for your office? Legendary martial artist Bruce Lee once said, "Simplicity is the key to brilliance."

Stay Simple

The wonderful part about keeping it simple is that you don't need a lot of space to implement a successful fitness program. There is no need for large pieces of equipment with dozens of bells and whistles. "Simple" typically means inexpensive, so your initial startup investment can be more cost-effective. And patients like simple. The key principle with simple is that your patient may also use the equipment at home after your on-site, doctor-guided program. If patients feel better from what they use in your clinic and they have the opportunity to purchase one for home-use, they usually do.

Implementation Guidelines

Now let's get into some guidelines for implementing programs and action steps for assessing the right equipment for your office environment.

What should you look for in clinic rehab/fitness equipment?

  • Low cost but high quality is the key. In reality, some of the most effective functional fitness equipment you can use will be very affordable.

  • Make sure it is versatile and easy to fit into your clinic space. Create a visual rehab presence that will not disrupt the patient flow of your clinic.

  • Ask the manufacturer if there are exercise sheets, wall posters, or customizable computer software handouts that come with the equipment. These are great incentives to keep your patients doing their program at home and ensuring they can reference proper technique.

  • Maximum results in minimal time is what you are striving to achieve. Do this by using unconventional equipment that works many muscles at once during an exercise. Alternative choices makes therapy and exercise fun!

  • Search for equipment that focuses on full body movement patterns, but may also be used for isolation exercises. These allow intensive focus on functional mobility and stability while building strength. A list of some examples will be included below.

  • Create a space in your office: a minimum of a 6'x6' area. It may be an open or closed floor plan based on your patient protocols. Some clients may prefer having a private area to do their rehab and training.

The Tools

Remember the concept of simple? These are what I like to call "bang for your buck" products; simple, powerful, effective, and easy to integrate.

Kettlebells have been around for ages. Made out of cast iron, they're cannonball-shaped weights with a single handle on top. Kettlebells offer movement-based training, otherwise known as functional training. They offer full-body conditioning and rehabilitation benefits.

The body learns to work as one synergistic unit linked strongly together. Kettlebell training involves multiple muscle groups and energy systems at once thus increasing resistance to injury. Improved mobility and range of motion can be obtained by teaching basic patterns of hip joint hinging, gaining increased strength without increase of mass. Kettlebell exercisers are lean, toned and functional, not bulky—a benefit that helps prevent injury.

Indian Club swinging can be described as circular weight training but can exercise the shoulder, wrist and elbow in ways not possible with traditional linear weight training. Indian clubs are basically bowling pin shaped devices weighing 1-2 pounds used to perform circular movement patterns. Clubs will not only strengthen muscles and ligaments, maintain joint flexibility and improve range of motion but will greatly reduce risk of injury. You will also notice improved rhythm and eye-hand coordination due to the concentration and high neural demands necessary to perform the movements. Club training is one of the best tools you will find for shoulder and neural rehabilitation.

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