A user logs on to HomePrograms.Net by Rausch Physical Therapy.

In the dawning days of computer exercise software, the first programs allowed users only the ability to edit and print exercise text descriptions. PTs would then have to physically draw or affix a photocopy or sticker of the exercise to the page. Needless to say, the results were often time consuming and unclear, and left plenty of room for improvement.

The advent of graphic printers and computers with built-in DVD burners, however, has changed everything. Certain programs will work better for some practices than others and, fortunately, there is no shortage of options out there for PTs to try.

TODAY'S DYNAMIC OPTIONS

For those PTs with the time to get creative, the ProTherapy DVD system may be a good match. The system offers PTs and personal trainers the ability to create completely customizable video routines for patients by splicing together video exercises and burning them onto a DVD, which patients keep. Alternately, patients can access a Web site that provides the video routines in a digital format, which can be uploaded to a mobile multimedia device such as an iPod.

Founder Ed Chung has been in the business for more than 5 years and developed the system based on requests and recommendations from PTs. His program enables users to complete their entire routines with just a few clicks of their remote control. "Users can just pop the DVD in and follow along with the program," Chung says. "A lot of times when you see a video, you don't know how many reps to do. In our system, that can all be customized. All the patients have to do is follow through the DVD and they're done," he says.

Digital format video routines from ProTherapy DVD can be uploaded to mobile multimedia devices.

"Absolutely everything is customizable," Chung explains. These are computer-controlled videos, so PTs can insert pause time and the number of repetitions they want. That's the uniqueness of our product. It's able to do exactly what a PT or personal trainer wants," he says. Currently, PTs can choose from about 1,300 videos, but Chung will be unveiling a new version later this year that will include an additional 700, including new exercises specific to ACL injury prevention. Each exercise is shown from three different angles, removing any confusion about how it is to be performed.

PTs looking for a more Web-based solution have options as well. Founded in 2007 by Kevin Rausch, PT, Rausch Physical Therapy Inc's HomePrograms.net is the new kid on the exercise software block, but it's quickly becoming a hit with PTs looking to capitalize on their patients' ever-increasing amount of time spent online. The service allows PTs to create custom-built Web-based video exercise programs from a library of nearly 500 different exercises for patients in a matter of clicks. PTs can customize the exercises and the sequence, and can even add their practice's logo. Patients can then log on and access their exercises from any computer connected to the Internet, and replay the video demonstrations as many times as they want.

PTs looking to monitor their patients' exercise habits outside of the clinic a little more closely may be interested in one of Rausch's planned features currently in development. "We're coming up with the ability for PTs to track which patients have logged in to view their exercise program and how long they've spent viewing it," Rausch explains. Also in the works is an application designed to be used on Apple's iPhone, that enables patients to view their exercises literally whenever and wherever it's most convenient for them. He's also at work expanding the exercise library. "We just continue to update and add to our exercise library based on the needs and requests of the users and the PTs that are creating them," he says.

For some practices, however, technology-based exercise programs that are fully accessible to all patients are still far off in the future. As BioEx Systems founder Doug Feick, PT, explains, "there's still a whole generation out there who feel most comfortable with a paper-based system." BioEx Systems provides users with a library of hundreds of exercises that can either be printed or e-mailed to patients for at-home use. The program is easy to learn as it keeps patients and their routines well organized.

The PhysioTools system features an easy-to-use process for creating handouts.

BioEx Systems features hundreds of exercises that can be either printed or e-mailed to patients.

"Every time a program is created it is automatically saved under the patient's name," Feick notes. "PTs can also pull up reviews that show all the different programs they've been given," he says. The user-friendliness also extends to the exercises themselves, which were created by Feick and from input from clients, and include a written explanation of the exercise as well as a detailed drawing, which show the patient exactly how it should be performed.

According to Feick, the most popular feature about BioEx Systems is that there are never any extras to buy. "We don't require you to buy a hardware key or keep buying extra libraries. It's very affordable in that way," Feick says.

BioEx recently improved its program's search function to make it faster and less time consuming for users to find the exact exercise they're looking for. The company also plans to expand its library to include orthopedic, wheelchair, and other exercises, as well as a number of wellness and personal training routines to assist patients in their transition from physical therapy to more general wellness therapy.

The PhysioTools system also allows PTs to create high-quality handouts for their patients using software that is easy to install and use. The system was developed in Finland in 1987. Since then it has grown to include a library of more than 15,000 exercises in more than 60 different modules, and it is available in 21 languages. The exercises can be printed or e-mailed to patients and feature color photographs, detailed drawings, or videos.

In the past few years PhysioTools has introduced a Web-based version of its program, which provides access to all its features from any computer with Internet access. "PhysioTools Online still offers the many features available in PhysioTools for Windows with additional benefits including e-mailing handouts and the ease of adding and categorizing your own pictures," says Gail Milne, the company's sales and marketing director.

In addition, the program has added new modules on everything from respiratory care to cardio. Currently in the works is a feature that will make sharing exercises with other PTs a snap. "We will be adding the ability to import and export templates and user pictures so customers can share their own exercises with other users," Milne says.

PhysioTools provides customers with a wealth of different pricing options depending on their needs and budget. "PTs can choose to purchase individual modules, professional collections, or a standard subscription," Milne explains.

ESSENTIAL QUESTIONS

Certainly other options exist, and a little bit of research can pay off in a big way. Factors such as a practice's location, patient demographics, time available to create the routines, and, of course, the price of the program will most likely play a role in selecting the most suitable software program for a practice, and will be among the most commonly asked questions PTs will have. The following questions, recommended by the manufacturers themselves, should provide a good place to start:

• What are the pricing options? Some systems may require users to buy a base module first; others allow users to buy the software or pay on a subscription basis.
• What upgrades are users entitled to? Some systems let users upgrade their products to a newer version for free, but only for a certain amount of time.
• Is there a trial or demo available? Always look for a trial period before making a full commitment. Trials are a great way to test out software features and even to compare across several systems. PhysioTools, for example, offers potential users a demo CD; Homeprograms.net lets users try the system out for 1 month free; while BioEx Systems offers users a choice between a demo CD and a downloadable working version.
• How many exercises are available? No doubt, most systems boast an impressive number of available exercises, but not all may suit the needs of every practice.
• How secure is patient information? According to Milne: "As health care moves more toward electronic records and increases its reliance on IT, software will need to ensure it meets demands such as security and protection of patient records."
• What customization options are available? All systems offer unique customization options. Some will let users go in and edit the exercises at will. Others let users brand their materials with the practice's name, logo, or showcase additional information.
• Who developed the exercises? As Ed Chung points out: "There is a difference between exercises made by personal trainers, PTs, and athletic trainers. Among [these three groups] they can develop three totally different exercise routines."

FINDING THE RIGHT FIT

On at least one point the manufacturers all agree: A good software platform should give users the option to create customizable, individualized workouts that suit patients' needs. This may mean having access to a range of exercises that suit a variety of different skill and therapy levels that will adjust to the patient over the course of their treatment. The growing selection of exercise software options will ensure that every practice should be able to find an affordable program, which will improve both patient outcomes and confidence. Certainly, the industry has come far from humble beginnings.

Stephen Noonoo is the associate editor for Physical Therapy Products. For more information, contact .