Visits to the exhibit halls at 2003 conferences featured a wide variety of ways to improve therapy

By ADVANCE Staff

PTs, PTAs and rehabilitation managers are always searching for innovative ways to improve therapy. This product wrap-up focuses on new and interesting methods of therapy, from massage to application of hand-held modalities, and computerized, "high-tech"—yet drastically simple and cost-cutting–products for muscle testing, gait assessment, shoulder, elbow and knee rotation testing, and more. Interesting and fun exercise equipment designed for therapists to help patients get back on track are also featured.

Analysis and Assessment

Performance Health Technologies (Boulder, CO) announces the new SportsRAC™ Multi-Joint Rehabilitation System, an integrated technology to enhance fine motor control and joint kinesthesia in postoperative shoulders, knees and forearms, resulting in more efficient rehabilitation. SportsRAC allows patients to begin a safe, active, nonresistive exercise of injured shoulder, knee or forearm joints as early as 48 hours after surgery. The computer-based SportsRAC evaluation and exercise technology was first used successfully to help Major League Baseball pitchers recover from shoulder injuries. The knee module treats the knee and lower extremity, and the forearm modulte helps rehab muscles that cross the wrist and elbow joints. SportsRAC lets patients exercise joints actively and safely. Patients are positioned with the limb supported in a sling-like device that protects the injured joint. Within a limited range, patients move their limbs to manipulate a pointer that moves across a graphic display. This game-like interactive approach helps patients challenge themselves within safe limits. Patients become more involved in their own therapy and more compliant to the prescribed regimen. Early intervention SportsRAC therapy is nonresistive so patients receive safe, nearly painless joint exercise, and by beginning joint mobility and fine motor control training earlier, patients can recover normal joint function more efficiently and with fewer setbacks. SportsRAC also produces written reports to help clinicians assess, track and document patient progress.

Simex USA, LLC (Hanover, MA) introduces SIMIMotion, new to the United States. This portable, motion-capture analysis system software enables clinicians to use 2-dimentional and 3-dimentional motion analysis software to analyze all types of motion of dynamic subjects. 3D data can be acquired quickly and easily and presented using a variety of features. Objective results can accellerate and simplify decision-making processes in sport science and performance, biomechanics, ergonomics, gait and spine rehabilitation. "While motion teaching isn't entirely new, this type of software is very new in the United States," said zFlow Motion Capture Analysis CEO Stuart Watson. "This helps physical therapists with patients during gait analysis, orthopedic restrictions, podiatry studies and many kinds of rehabilitation." The advantages of the system include an easy-to-use intuitive user interface for operating comfort, a variety of analysis features, simple digitization of movement data using either manual or automatic color tracking, and the ability to use any camera system. Users can customize SIMIMotion printouts and presentations, transfer data to and from statistics applications, and export diagrams and graphs of analysis for later use.

S.A.M.^® Company (Henderson, NV) introduces RPI™, Rapid Posture Imaging with a portable, computerized postural evaluation system for both public events and in-office exams. Through the revolutionary RPI process, the SAM (spinal analysis machine) is a powerful documentation system for PTs and other health care professionals. The RPI software was designed for both speed and efficiency, taking the user from simultaneous PA/AP and lateral capture to hard copy (a printed report) in 60 seconds, which makes RPI ideal for any setting.

The Courageous Pacers Program (Framingham, MA) enables children of all abilities to walk 100 miles (or complete 100 miles of aerobic activity) and lift 10,000 pounds in a school year. Developed by Tim Erson, MS, PT, Courageous Pacers is a goal-oriented teaching and intervention strategy that seeks to improve physical activity levels for children and adults with special needs. Teachers and therapists in school settings use the program to improve academic readiness, combat obesity and improve gross motor skill development. Therapists can introduce the program within a classroom, and work separately with children with special needs with adaptations to the program. "One of the reasons this program is so important is that children with special needs tend to have lower fitness levels, less opportunity for vigorous play, and a higher prevalence of overweight and obesity," said Erson. "Through a classroom program, they are taught skills that will improve their health habits for life." The program is also cost effective. Instead of spending a lot of money to buy exercise equipment, participants make their own weights from recycled materials and spend about 20 minutes per day, three to five days per week, engaged in simple flexibility, strengthening and endurance exercises. Individual progress is documented on a wall chart that includes line drawings, which teach a formula for activity that is fun and easy to follow. The Courageous Pacers Program is detailed in the book Gross Motor Activities for the Inclusive and Special Needs Classroom (published by Therapro). It is adaptable and benefits able-bodied children as well as individuals with moderate to severe physical or cognitive disabilities, including autism.

Aquatics

Spectrum Aquatics® (Missoula, MT) has recently improved upon the quality of its heavy-duty ABS injection molded ladder treads, which are included with all of the company's diving towers and lifeguard platforms. The 22-inch and 26-inch, 15-degree ladder treads have been modified to facilitate ease of installation, service and maintenance. The modification consists of enlargement of the tread's underside box sections. This modification makes it easier to install and tighten the tread's attachment hardware. The appearance of the tread has also been altered, and is now more attractive and streamlined. Spectrum has increased the tread's non-slip surface area, ensuring secure footing in all environments, wet or dry. These heavy-duty ladder treads are now available to fit tubing with ADA compliant outside dimensions of 1.50-inch, or non-ADA compliant 1.90-inch.

Biomechanics

Seattle Systems (Poulsbo, WA) has launched Digital Flash Scan, an easy-to-use custom knee brace ordering tool for health care professionals. The tool consists of a digital camera, tripod and a proprietary visual scale, enabling practitioners to take detailed anterior and lateral images of the limb aligned with the scale. The two images, along with designated limb measurements, then are e-mailed to Seattle Systems, where the manufacturer's state of-the-art CAD-CAM technology utilizes them for immediate fabrication of custom-fit knee braces.

Digital Flash Scan works using a proprietary scale that provides all the accurate measurements and the visual landmarks required to build custom-fit knee braces. By aligning the limb with the visual scale's markers, Seattle Systems is able to manufacture custom braces without the mess and hassle of creating and shipping plaster impressions—the current industry-standard process for creating custom-fit knee braces. By enabling electronic ordering, Seattle Systems also reduces fulfilment times by 50 percent versus traditional ordering methods. With its portable design, Digital Flash Scan allows health care professionals to capture images at their facility. The system also improves upon the traditional methods of obtaining accurate measurements and physical features of the lower extremity, and this accuracy is pivotal for the optimum recovery of patients suffering from ligament tears and various soft-tissue injuries of the knee. Digital Flash Scan is now available to practitioners. A digital camera is included in the kit, or practitioners can use any consumer digital camera meeting the following specifications:

• Ability to take one megapixel or higher for clarity;

• Flash mode to enhance detail and prevent shadows;

• File format compatibility with Microsoft Windows98 or greater.

Long respected as a manufacturer of custom, functional knee orthoses, Seattle Systems' entire line of custom and off-the-shelf knee braces are recommended as aids for ACL/PCL and MCL/LCL instabilities.

Exercise

Balanced Body® Inc. (Sacramento, CA) introduces its new and improved Clincal Reformer®, with a 128-position padded footbar for optimum Pilates-based rehabilitation. The new model accommodates patients of all heights, including children. The footbar moves vertically in four positions, and horizontally in 32 positions all the way to the head of the machine. The padded headrest also moves vertically in four positions. Removable, sculpted shoulder rests swivel and adjust forward and backward to facilitate accurate alignment. Swivel pulleys allow variable angles of resistance; the ropes can be pulled in any direction. The Clinical Reformer also features a proprioception T-bar, a Balanced Body innovation. The T-bar is a unique tool allowing therapists to assess asymmetries in patients. The patient lies on the Reformer, placing the feet on the T-bar in a weight bearing position. The T-bar swivels on both the horizontal and vertical axes, so therapists can observe weight bearing tendencies. The T-bar also facilitates proprioception, trunk and pelvic stabilization and hip alignment.

Orthometrix Inc. (White Plains, NY) has developed the Galileo™ 2000, a powered exercise device that mechanically stimulates muscles at a specific frequency, typically 25 Hz to 30 Hz or impulses per second. This causes muscles to contract and relax by natural reflex, 25 to 30 times per second. It consists of a special oscillating platform with a 0 mm to 5 mm amplitude. When a patient stands on the Galileo platform, the oscillations help exercise the muscles, tendons and joints, as a result of the natural, reflexive response or stretch reflex. The Galileo™ 2000 has been tested in sports and fitness centers throughout Europe and by professional baseball, cycling, soccer and Olympic ski teams. Clinical studies are also in progress at the Rusk Institute of Rehabilitative Medicine in New York. Benefits to patients using the Galileo™ 2000 can include increased overall muscle performance, improved muscle strength and tone, improved postural reflexes, improved balance and coordination leading to fewer falls, and stronger bones.

Med-Fit's (San Diego) HUR line of air resistance machines are ideal for rehabilitation and senior fitness application. The HUR line features 30 machines, all designed in conjunction with leading experts in the rehabilitation and senior fitness arena. The HUR mechanism is completely enclosed, offering a level of safety and appearance not seen in prior machines. Two-tone upholstery with built-in lumbar supports cradles clients in the exercise position. Strategically placed easy access hand grips allow easy ingress and egress into the exercise position. True, zero pound starting weights, independent reciprocal function, small footprint, and infinitely adjustable resistance make HUR the logical solution for seniors and patients in rehab. Push button adjustment of resistance is standard on all machines, and foot pedal resistance adjustment may be added to all upper body stations. HUR offers many of its machines in either dual or single function. The dual function machines facilitate agonist/antagonist muscle groups to be exercised with proper anatomical alignment on one machine. This design is ideal for smaller facilities and budgets, and is not offered by the competition. The newest addition to the HUR line is the Easy Access, or EA. Eight machines are specifically designed for use by patients using wheelchairs. A CD ROM catalogue, featuring video presentation on the HUR and other Med-Fit rehabilitation and senior training stations, is available free of charge.

Modalities

Rich Mar® (Inola, OK), is making new waves in therapy with its AutoSound 5.6™, an automatic hands-free ultrasound. A new product on the market, the innovative design of the AutoSound 5.6 allows treatment without manual application. The AutoSound offers the freedom of completely safe, hands-free ultrasound at normal therapeutic levels. The design actually mimics human application with the ultrasonic output always moving via the patented AutoSound applicator. Rather than using a topical ultrasound gel, the therapist can strap the AutoSound 5.6 in place to treat patients, allowing for smoother ultrasound treatment in less time. Other advantages include a unique gel well to assure coupling, a patient control safety switch and perpendicular treatment angles. The AutoSound also offers constant movement of the output at the ideal rate of 4 cm/per second. While manual ultrasound treatments can be applied either too quickly or too slowly, the AutoSound applicator moves the field at a rate of 3.7 cm per second. This results in a more predictable and steady increase in both temperature and the amont of energy applied to the treatment area.

BlueWave™ Medical Products LLC (Vancouver, WA) introduces pain relief on the go for patients with back pain. Therapists can help patients return to an active life with the BlueWave™ Lower Back Pain Relief System, the the only combo TENS device and back support that meets FDA requirements for sale without a prescription. The system provides targeted pain relief specifically aimed at the lower back. The combination provides both pain relief and compression support. The BlueWave Lower Back Pain Relief System supports therapy care by helping patients handle back pain between therapy appointments. The durable support belt makes it easier for patients to correctly position the pads. The adhesive pads stick to the skin and the belt holds them in place, allowing the patient to take treatments during a wide range of daily activities. Lower back support fits patients with waists of 25 inches or larger. Patients can wear the BlueWave System under clothing for pain relief throughout the day, either while resting or while active.

GelZone Inc. (Venutra, CA) is a new technology company that offers paradigm shifting products that provide musculoskeletal support while stimulating the body's natural healing process. The company's first product introduction was the Gelzone Wrap^®, which combines silicone gel sheeting with stretchable fabric to achieve one-step compression. Originally designed for scar management, the wrap offers superb compression and support in a comfortable, non-slip fashion. Another distinctive benefit of the Gelzone Wrap^® is that by placing the product in a freezer for a few hours, it can then be applied in the same non-slip fashion for 10 to 15 minutes of cold therapy. Thanks to the product's six different sizes, its uses range from post-ACL compression to compression of groin pulls. Some patients have even used the largest size wrap after liposuction. The possibility of use after Caesarean section is currently being investigated. "With the introduction of silicone gel sheeting, the pad will not move, migrate or slip," assured Curt Hanson, vice president of sales for Gelzone. The Gelzone Wrap^® is just the first product the company has in store for the physical therapy community. Imminent new product offerings include an adjustable J-loop for patella bracing and pressure pads for lateral epicondylitis. The resulting effect will be to improve clinical outcomes while decreasing patients' pain and suffering and reducing overall health care costs.

Game Ready (Berkeley, CA) Accelerated Recovery System provides cold and compression therapy for athletes and active people to promote comfort and faster recovery times. Athletic trainers and physical therapists for more than 55 collegiate and 45 professional sports teams who utilize the devices report that expected recovery times have, in some cases, been cut in half by using the devices. The effectiveness of such therapy has been long recognized for treatment of soft tissue injuries. Made of flexible fabric, Game Ready wraps are attached to a control unit and plugged into a wall outlet or a portable battery pack. Cooled water then circulates through the wraps to provide controlled therapy as needed. Game Ready Technology simultaneously delivers cold therapy and compression to speed the body's healing process. The devices are easily portable, and with the battery pack, Game Ready is accessible in a car or at work. More than 120 world-class athletes have even purchased their own units for personal home usage. The effectiveness of Game Ready products helps physical therapists to not only better treat their patients, but even leads to better compliance, as Game Ready CEO Tom Oliver explained. "When patients see better results, they stick with physical therapy," said Oliver. "Using this device, a patient who might typically only show up for one or two appointments will stay with PT all the way through." Game Ready wraps are available in numerous sizes to accommodate the ankle, knee and shoulder as well as various other joints.

Pain Relief

J.T. Enterprises (Lockport, NY) helps therapists look at treating patients with plantar fasciitis in a different way. A recent study has found a simple, nonsurgical, highly effective way to relieve plantar fasciitis heel pain. The key is use of the comfortable night splint called the Strassburg Sock. The study, published in the July/August 2003 issue of the Journal of Foot and Ankle Surgery, evaluated the effect of the Strassburg Sock (without stretching exercises) versus a traditional gastrocnemius-soleus stretching regimen. The Strassburg Sock was found to be more effective than stretching, helping patients recover in an average of 18.5 days versus 58.6 days for the stretching regimen. "When other injuries occur, standard medical practice is to immobilize and maintain the damaged tissue in an anatomically correct position for the duration of the healing period," said head researcher Lance D. Barry, DPM, a board-certified podiatrist. "Treatments for plantar fasciitis should be focused toward addressing the abnormal pronation and placing the damaged ligament at anatomical length, without uncontrolled stretching."

IMAK (San Diego) introduces the IMAK Smart Glove^® with Thumb Support, an addition to the popular Smart Glove^® to protect against painful thumb injuries. For computer users who have thumb pain, the Smart Glove is now available with Thumb Support, adding a comfortable thumb extension that contains two semi-rigid stays. The two stays are located on both sides of the thumb for maximum support. This ensures proper support of the thumb while allowing the freedom of movement to continue working. Like the original Smart Glove, this new version features the same flexible, removable dorsal stay that helps keep wrists in a neutral position. The dorsal stay prevents excessive bending and flexing of the wrist but allows full mobility of the hand. In addition, a pad filled with smooth plastic beads protects the underside of the wrist from hard surfaces and sharp edges. Because it is made of durable cotton Lycra, the Smart Glove keeps hands comfortable, providing good circulation. The Smart Glove with Thumb Support is machine washable.

Swede-O Inc. (North Branch, MN) has introduced four new Thermoskin^® pain relief products. Swede-O Inc. is the national distributor for Thermoskin heat therapy products in the United States. Thermoskin^® products are found in DMEs, pharmacies and catalogs.

The Arthritic Glove provides gentle heat and support to the hand region and utilizes a warming effect to provide natural therapeutic relief. A special fabric layer combined with the perspiration wicking control of Trioxon^®, the Thermoskin system allows the wearer to comfortably use the glove for long periods and still maintain normal activities. Based on focus group studies in Australia, participants reported a 53 percent pain reduction while wearing the Thermoskin Glove. Other participants commented that the wearability and durability of the glove was excellent. The Glove is available in XS-XXL sizes, packaged in pairs.

Thermoskin will also introduce a new Ankle/Foot Gauntlet designed for increased circulation and pain relief associated with diabetes, arthritis and Raynaud's disease. The gauntlet uses natural heat therapy to gently warm trouble areas on the ankle and foot. Combining the breath ability and warming nature of Trioxon with a comfortable design ensures long-term comfort and support.

Mobility, Lift and Assist

Permobil Inc., (Lebanon, TN) introduces the C2K Aeron with "S" package, integrating the most technically advanced power wheelchair base with the most ergonomically advanced and celebrated seating design—setting a new reference point in power wheelchair performance, seating system fit and ergonomic comfort.

"The combination of both the new C2K power wheelchair base and the comfort and fit of the Aeron^® seat makes the C2K Aeron with "S" package one of the most technically advanced power wheelchairs available," said Larry Jackson, president of Permobil.

The Chairman 2K (C2K) was introduced in 2000, and it is Permobil's most versatile full-size adult power wheelchair base. The new "S" package provides increased power and speed, allowing users to travel at 7.5 mph. The C2K with "S" package incorporates the reliability and versatility that consumers appreciate and makes the C2K the world's most powerful and reliable wheelchair base available.

The C2K Aeron with "S" package features Aeron chair components from Herman Miller Inc. Herman Miller^® pioneered modern ergonomic seating in the 1970s. They are globally recognized for their problem-solving research and industry-leading designs that have brought "seating equity" to millions. The Aeron enhanced that record of innovation, receiving numerous prestigious international design awards, including the Industrial Designers Society of America (IDSA) "Design of the Decade" in furniture. The Aeron is also found in the permanent collections of many design museums. "Aeron has revolutionized materials, performance, and comfort in seating design," said Randy Brown, Herman Miller senior product manager for seating.

Among its advances, the Aeron's unique Pellicle^® suspension material conforms to the body and provides dynamic pressure relief over the seat and back for truly customized support. Air also freely circulates through the Pellicle material, preventing heat and moisture build-up and contributing to the user's long-term comfort. The C2K Aeron with "S" package also offers tool-free adjustability, giving users greater control over their comfort and support.

The C2K Aeron with "S" package comes standard with suspension in the power base and seating system, which provides users with an extremely smooth ride. Additionally, users and caregivers will find the tool-free adjustments for manual recline, manual elevating leg rest, armrest, lower leg length, and lower back support convenient and easy to use.

The standard multi-positional, tool-free armrest offers not only height adjustment, angle adjustment and flip back capabilities, it also offers users the ability to pivot the armrest laterally 17.5 degrees inward to 15 degrees outward, to achieve greater comfort and provide stability. Standard options also include power tilt and an 8-inch seat elevator.

Quickie, a division of Sunrise Medical (Longmont, CO), introduces the new Quickie IRIS (Intelligent Rotation in Space), which uses a newly designed rotational tilt system in which movement of the user's center of gravity is dramatically reduced or eliminated. As the desired tilt angle is achieved, the IRIS's rotation-in-space system ensures both the wheelbase and the tilt carriage maintain a symmetrical balance. By eliminating significant movement during tilting, the user remains stable and more comfortable. This revolutionary design also provides the shortest possible wheelbase on the wheelchair without compromising stability.

With three effective tilt ranges of -5º to 50º, 0º to 55º, and 5º to 60º, the Quickie IRIS offers significant pressure relief. The Quickie IRIS features full seat-depth adjustability, seat-width adjustability, front-hanger adjustability, tilt-carriage adjustability, and wheelbase adjustability. Without having to change the frame, the chair can expand from 14 inches by 22 inches in width and to 15 inches by 22 inches in depth. With this range of adjustability, the IRIS easily accommodates differing seating systems and body types.

With the ability to freeze the center-of-rotation, the Quickie IRIS eliminates the necessity to place users' center-of-gravity toward the front casters, therefore preserving the maneuverability of the chair. Today's products shift users' center of gravity forward while they are in an upright position to compensate for rearward center-of-gravity movement. The unique design of the Quickie IRIS eliminates the need of spring mechanisms or gas cylinders, and enables the center of rotation to be isolated and consistent, therefore requiring less effort to initiate and recover the consumer from the tilted position. Using special aluminum alloys in its design, the Quickie IRIS is light, which makes it easier to lift and transfer.

Most tilt users have difficulty making transfers and many are required to remain in their chairs in order to prevent triggering a spastic reaction. To accommodate such users, the Quickie IRIS is offered with a transit option with weight limits of 250 pounds and 350 pounds. The seating interface on the IRIS has been designed to be more adaptable for today's complex seating systems by using a 2-inch adjustment instead of the traditional 1 inch. With the new back post adjustment plates, featuring a patent pending placeholder, adjustments can be made without removing the hardware, which will significantly minimize service times. The IRIS also features a special push-button release angle-adjustable stroller handle, allowing the caregiver to easily reposition the handle to a variety of tilt positions and heights.

HUGO^® (Atlanta, GA) introduces a new state-of-the-art rollator, the HUGO, which was launched at a recent national AARP convention. HUGO, a stylish and ergonomically designed rolling walker with a seat lets users go anywhere, anytime.

The aluminum HUGO weighs only 16.5 pounds and is designed for a quick and smooth set-up and easy transport. Its extra large, 8-inch non-skid wheels makes traveling sidewalks, paths or off-trail terrain a cinch. Hand brakes lock HUGO for stability when sitting, and the grips are the perfect blend of comfort and control. HUGO features a fully padded seat and backrest with all weather covering, and includes a Velcroed compartment under the seat for valuables. The handlebar height is adjustable and can accommodate weight up to 250 pounds. A removable nylon basket allows unencumbered travel without compromising balance or stability. Reflective patches guarantee users will be seen during evening jaunts. Lightweight and easy to fold into the trunk of a car or closet, this sturdy device is popular with seniors. HUGO was designed in partnership with the nonprofit Georgia Tech Research Institute, experts in ergonomics of the elderly, to be the most user-friendly rollator on the market. HUGOs, which can be Medicare reimbursable, are being donated to all chapters of the National Multiple Sclerosis Society and to many senior centers. HUGO helps patients and the elderly maintain independence while keeping up a level of activity, both indoors and out. HUGO is available in bright and bold colors, including Pacific Blue and Titanium Silver.

Software

MediGraph Software (Philadelphia) is the most comprehensive PT documentation program of its kind. Requested by more than 70 PT curriculums, it is the new standard in documentation. The software package is the most affordable package available, and is suitable for inpatient, outpatient, and private practice environments. At 63 cents per visit, MediGraph provides multiple procedures that test and demonstrate patient status, including scored outcome questionnaires, ROM, manual muscle testing, a peer reviewed FCE, evals, daily notes, re-evals, discharge summaries, gait analysis, strength testing, customization that you can perform, and seamless integration into billing. MediGraph Software includes unlimited telephone instruction and consultation to its subscribers. Automating the documentation process allows the therapist to become more efficient. Consider that if the improved efficiency that automated software provides allows a PT to treat two extra patients per day, someone who works 50 weeks per year can increase their visit total by 500 extra visits per year, per therapist. MediGraph Software makes it easy for the non-PT to understand the outcome of treatment, thereby eliminating questions regarding the reasonableness and necessity of treatment. This layman-friendly approach will assist with payment and recertification, and it also helps referring physicians, attorneys and administrators understand what therapists accomplish with patients. MediGraph photos, bar graphs, and tables are unique in their ability to deliver of clinically relevant but layman friendly information.