Physical therapy helps to restore physical function and mobility to patients. It often leads to recovery by rebuilding lost muscle and strength. Physical therapy exercise products include a variety of fitness and treatment products that will help the patient return to a normal activity level. Some of these include but are not limited to exercise bands, resistance-training machines, and treadmills.

EQUIPMENT FOR MAXIMUM RESULTS

Whether your staff is planning care for postinjury clients or for those seeking to improve their athletic performance, they must have access to a wide variety of equipment to help them achieve their goals.

Good free weights are a must for strength training, and it is necessary to have a wide range of free weights, including body bars ranging from 3 pounds up to 45-pound Olympic barbells. Free weights are important because you have to control the weight, which calls on the stabilizing muscles and requires greater balance.

A variety of weight machines is also important. In addition, our staff PTs report positive results from equipment such as the Total Gym® [by efi Sports Medicine, San Diego] because it offers less than full weight-bearing strengthening, which promotes muscle function and lessens stress on the joints. Our facility also incorporates both spinner and standard upright bikes, which are useful for helping patients do warm-ups and work on range of motion.

In addition to strength training, it is important to focus on balance by incorporating products such as the Powerslide slide board, foam rollers, and foam balance beams into training.

Different balance tools are helpful to grade people's progression. Foam balance beams can be progressed to more advanced products in various ways. The slide board can help progress from squats to lunges by sliding a foot back into a retro lunge. This helps to progress strength without the impact traditional lunges have.

Once gravity has been conquered, manual resistance is added. The application of force by the patient in a specific direction isolates muscle groups while repetitive patterns integrate them. As patients grow stronger, more resistance and, eventually, weights can be used. Many of the items used to create a resistance load are: stretch bands (we use products from Lifeline and Thera-Band), stability balls and medicine balls, balance boards, free weights, and pulley weights, such as those available on the Total Gym.

Upper-body cycles are key for patients who cannot, or should not, work their lower bodies, such as postsurgical knee patients. Stationary bikes are good for patients who can work their lower extremities. The Star Trac Johnny G Spinner Elite bike model, by Star Trac of Irvine, Calif, is popular in our clinic for its heavier flywheel. Three of the four models weigh in at 43 pounds. The heavier flywheel provides a more realistic feel as well as continuous resistance that permits the patient to stand out of the saddle and sprint.

SMART PURCHASING

When planning to purchase various exercise equipment, take a survey of your space. A room as small as 300 square feet may do, but much will depend on the range of service you need for your base of patients. In our practice, we accommodate three treadmills, three resistance training machines, an upper-body ergometer, two therapeutic ultrasound stations, an Anodyne® Therapy station, and a full office section for the therapist. Keep in mind that when initial evaluations are being performed on a new patient, a treatment room or an enclosed area for privacy is always best.

Treadmills

The motor matters—it gets the heaviest workout. The horsepower ratings can be confusing. The figure you want to look at is the "continuous duty rating," and shop for 1.5 to 2.5 HP "continuous duty." The "peak duty" rating is less valuable. The "treadmill duty" rating falls between continuous and peak. Look for the longest warranty on the motor—1 year at least.

Test treadmills wearing your workout shoes and clothes. A shaky or jerky ride is not acceptable. The handrails should feel sturdy enough to support you and be in a good position to grip easily and not block your arm motion. The belt must be wide enough and long enough for your stride.

Boredom kills treadmill time for patients. Choose a model that has the most preset and programmable workouts to vary pace and incline. The incline and speed should be easily adjustable from the console. A pulse monitor is a benefit.

Due to the difference in cost, many people are tempted to buy a manual treadmill instead of a motorized treadmill. But manual treadmills have many drawbacks versus motorized machines. Manual treadmills are often difficult to get moving without using an extreme incline, and once moving you usually can't change the incline. This can be extremely difficult for patients beginning physical therapy due to lower-extremity limitations. An advantage for athletic patients with minor injuries is that they provide all of the motive power and get a more intense lower-body workout. With a motorized treadmill, the belt is moved by the motor so the patient doesn't have to strain to start it. In addition, on many treadmills, the patient—or the PT—can adjust the speed and incline while they are walking.

Stationary Bicycles

There are two major characteristics to consider when selecting a stationary bicycle: first, the seating position on the bicycle, and second, the method of resistance. You may choose the standard upright bicycle or the semirecumbent (sitting) stationary bicycle, which may be more comfortable for certain patients. For resistance, stationary bicycles use friction belts or wheels, magnets, hydraulics, or fans. Additionally, many bicycles are equipped with computers that will report workout data and in some cases will even direct exercise sessions. All these characteristics influence the cost of stationary bicycles.

You must consider your facility's needs when purchasing a stationary bicycle. For patients with lower back pain, mobility, or balance concerns, a semirecumbent stationary bicycle may offer a safer, more comfortable option.

EQUIPMENT IN PRACTICE

Some of the conditions that respond to physical therapy include musculoskeletal system disorders and injuries, arthritis, joint replacement, and neurological disorders or diseases.

Back pain is a common problem that can be caused from many different types of problems and can often be treated with the use of physical therapy equipment. Some of the causes for back pain include irritation of the sciatic nerve, muscular or ligament injuries, lumbar strain, herniated disk, and compression fractures. When a person suffers from pain due to the compression of the sciatic nerve, they usually have low back and leg pain. The compression is often caused by a herniated disk and can be very debilitating. Exercises with low resistance—either with free weights or with a machine—can help sciatica pain by doing stretching that strengthens the muscles in the lower back.

Osteoporosis occurs more often in women than in men and results from thinning of bone tissue. The incidence of osteoporosis can make a person susceptible to bone fractures and breakage. As a person ages, he or she does not produce enough new bone to compensate for the normal process of old bone being reabsorbed. Calcium is recommended along with Vitamin D in helping to keep the bones strong. Bone tissue can benefit from exercise and a healthy diet. Physical therapy equipment that can help the person with osteoporosis includes a treadmill for walking and a stationary bicycle. In addition, strength training exercises are the most beneficial for strengthening bone.

David Moreno, PT, is a partner at Progressive Physical Therapy in San Francisco. For more information, contact .