PT and Med-X; Conditioning the Atrophied Back

Sunday, April 28, 2002 | 0

By Steven Danchik, MA, RPT

Physical Therapy occupies a unique position in the medical management of patients with industrial injuries. The therapist does not prescribe medication or perform surgery, but his interaction with the patient is critical for a successful result. Proper physical therapy is necessary both pre and post operatively to insure effective results of the surgeon's efforts. Many orthopedists believe that a trial of physical therapy is important before surgery is considered. Effective therapy may help a patient avoid the risks of surgery, and the insurance companies are happy to have a reduced cost of care.

The physical therapy clinic has many procedures and techniques available to help patients. An upsurge of interest in non-surgical treatment is now causing many to take a more serious look at alternative treatments. Therapists have observed for many years how weak and deconditioned, atrophied muscles contribute to injuries. Quite often we see patients in the clinic with severe muscular inadequacy. Is this muscle atrophy a result of the injury, or was it pre-existing?

The answer is both. Weak or deconditioned muscles provide poor support for the joints resulting in a greater potential for injury. An injured body part, because of pain and immobility will result in atrophied muscles.

Strengthening is obviously one of the most important goals the physical therapist stresses. Re-strengthening an injured body is critical. Pre-strengthening is an even more important goal as this may help in injury prevention. The post injury strengthening program now becomes the pre-injury deterrent to future problems. This is why I tell my patients that I want them to be stronger when they finish physical therapy than they were before their injury.

In past articles I have discussed the MedX computer assisted exercise equipment. Treatment of the lumbar spine has been discussed in detail. The same principles apply to other MedX equipment which is designed for the treatment of cervical spine and knee injuries. There are two primary factors which make the MedX equipment valuable. The first is that it is designed to isolate the body part which needs to be strengthened. It is natural for an injured person to compensate for weakness by incorporating other body parts. MedX provides the ability to isolate the body part to be worked.

The second unique feature of the MedX equipment is that it allows a true objective measurement of a patient's abilities. Once the injured body part is isolated, it can be tested for power through the arc of motion. These statistics are then compared to norms accumulated from thousands of tests. With the creation of a baseline, we can now track our patient's progress. Every therapy exercise session is now recorded, so that his performance can be evaluated. Most often, an increase in range of motion and strength is accompanied by a decrease in pain and other symptoms. This objective quantification of a patient's status is valuable to those managing his case. The MedX test is often used as a component of the Functional Capacity Evaluation.

In order to obtain the best results, a MedX program must be implemented with a comprehensive physical therapy program. Some patients require therapy to prepare them to participate in the MedX program. All patients must have proper posture instruction and a home exercise program to reinforce their MedX exercises. It is often necessary for the therapist to implement pain management to help support the patient in the performance of his rehabilitation program.

Steven Danchik, MA, RPT, is a registered physical therapist who has been providing physical therapy to injured workers for over 20 years with offices in Los Angeles, Beverly Hills, Valencia and Van Nuys. Search for him under Find Physicians or call 213-384-5502. He invites anyone interested in this program to contact his office. Tours of his facility and testing can also be arranged.