NW Spine - Library
Key Elements of Effective Spine Rehabilitation Equipment
By Peter W. Teaney, MPT & Greg E. Bradley-Popovich, DPT, MSEP, MS, CSCS
The following is the unedited version of a commentary by physical therapists at NW Spine Management, Rehabilitation and Sports Conditioning featured as a sidebar on spine rehab in the trade journal Club Business International. The full article by Stephen Wallenfels, which describes several successful facilities that utilize MedX medical technology, is available in CBI 2001;22(11):54-57.
Lumbar Extension
Strengthens the muscles of the lower back.
"Needs to stabilize the pelvis to discern what force contribution the spinal extension musculature is producing. Stabilization precludes the hamstrings and gluteus muscles from confusing the test results. Additionally, this type of machine should have an adjustable counterweight to neutralize the misleading effect of bodyweight."
Rotary Torso
Trains the rotary muscles of the torso, the internal and external obliques. Significant for patients with twisting or turning motions in their job.
"Very diagnosis specific. Should be careful because in some cases the rotary torso application will be contraindicated."
Abdominal Crunch
Exercises the primary abdominal muscles.
"Quality varies from brand to brand. Must be biomechanically correct. It’s important to isolate the abdominal muscles, otherwise the hip flexors are recruited. Select a machine that does not restrain the feet. Lumbar extension, torso rotation, and abdominal crunch combine to create a protective ‘steel cage’ around a problematic low back."
Cervical Extension
Strengthens the postural muscles in the back of the neck, which are important in continually supporting the head.
"It’s important to be able to subtract the weight of the head when accurately testing for muscle strength. As with lumbar extension, a counterweight actually allows a patient to begin gently exercising with less resistance than the weight of the moving body segment "
Cervical Rotation
Strengthens the muscles in the front of the neck.
"Similar to torso rotation, this exercise must be used judiciously. But, it can selectively test and train the often neglected front neck musculature."
General Comments:
"In a medical application there needs to be reliable strength and range of motion testing capability and supporting research. In all applications, the machines need to be able to limit the range of motion, and effectively isolate the targeted muscles to minimize muscle substitution."