Todd Ginkel, D.C., CEO of PDR Clinics, explains that exercising and strengthening the spine musculature to resolve back and/or neck pain can be difficult because larger and stronger muscles in the back may activate before the cervical or lumbar muscles are isolated. MedX machines, however, like those used at PDR Clinics, addresses this obstacle by directly isolating a patient’s muscles, eliminating interference by other muscle groups that are not directly involved in the patient’s back or neck pain.
“MedX machines, which include the Lumbar Extension, Rotary Torso, Cervical Extension and the Cervical Rotation, isolate spinal muscles so effective rehabilitation may occur,” Dr. Ginkel explains. “Without proper isolation, compensatory muscles are activated with little to no effect on the muscles that need to be targeted, such as the multifidus in the lower spine.”
Software resides in the MedX equipment and allows clinicians to collect data throughout all phases of rehabilitation, Dr. Ginkel says. Initially, therapists conduct a physical test and compare the results to age-, gender- and weight-based norms. These scores and comparisons enable therapists to tailor a rehabilitation plan to each patient. Because the software gathers data throughout the exercise process, therapists compile empirical evidence quantifying how each patient responds to therapy, which enables them to determine if and when patients meet their rehabilitation goals.
“We don’t take our patients beyond their ability levels,” Dr. Ginkel says. “We bring them back to where they should be to perform the activities of daily living, and then their home maintenance program maintains that. It’s not like strenuously working out your biceps so they get huge, and then when you stop, those muscles return to normal. We try to return our patients to their normal ability levels.”
After completing an eight- to 12-week rehabilitation program using the MedX machines at PDR, patients maintain progress through the practice’s Maintenance Program, which allows patients to use the MedX machines once a month. Dr. Ginkel notes that an internal study of PDR patients showed that 97% of those who used the MedX maintenance program successfully maintained their strength gains or had gained additional strength at one-year follow-up.
Stabilization is the Key
To help a patient achieve proper lumbar isolation during exercise, the MedX lumbar extension machine, for instance, keeps the pelvis and legs fixed in place through a system of padded restraints. Therapists may adjust the machine to fit each patient, preventing disc herniation or further injury. Dr. Ginkel explains the motion of the exercise actually reduces disc bulging and helps direct blood flow to the injured area, loosening ligaments, muscles and connective tissue.
Jennifer Missling, M.S.P.T., Director of Rehabilitation at PDR, says limiting patients’ range of motion also helps allay fears of movement that may have been reinforced by constant pain.
“The MedX machine is a great tool because only therapists can get someone who is guarded in their range of motion in the machine, which only allows them to move in an isolated way,” Missling says. “Patients feel safe, work one on one with their therapists, and objectively see their range of motion improve every week, which gives them confidence and spinal strength to be more successful when we move them into more functional movements and activities.”
Reducing Downstream Costs
Thomas Kraemer, M.D., Medical Director of PDR, explains that back pain is complex because as the pain essentially shuts painful muscles down, other muscles activate to carry the burden. Therapists at PDR use the MedX machines to reactivate the muscles that have been dormant and inhibit those muscles that were never supposed to activate to begin with. Doing so renormalizes movement, prevents further exacerbation and, by encouraging blood flow to the weakened musculature, encourages the reduction of myofacial adheasions and restoration of muscle mass.
Ultimately, PDR teaches its patients the techniques and exercises that enable them to take control of their therapy.
“From their first consultations with physicians on day one of the program through the rest of therapy, we teach patients how to be their own therapists,” Dr. Kraemer says. “We want them to be independent, self-sufficient and maintain their health on their own. We’re trying to build independence so they don’t have to keep utilizing health care.”
Patient education does not stop at the proper training regimen, Missling says. Patients also learn self-management techniques for addressing painful muscle flare-ups and receive training in proper functional movement that prevents patients from suffering additional strain caused by improper lifting, standing or sitting.
Things Have Changed
Over the years, approaches to treating back pain have changed, Dr. Kraemer remarks. Whereas the old approach was marked by timidity, he says the new method is predicated upon aggressive treatment, depending on patient comfort. At PDR, the MedX machines play a significant role in providing effective and aggressive treatment, enabling therapists to more quickly move patients with chronic or recurrent back pain to standard exercises.
“If patients are weak in isolated areas, such as the back, then it will be difficult to be successful with normal exercises,” Missling says. “By using MedX equipment to bring them up to a normal level of strength and range of motion, those exercises become much more effective.”
Pre- and Postsurgical Utility
Dr. Kraemer notes that some patients respond well to standard exercise, and for these patients, therapists at PDR provide comprehensive therapeutic services to facilitate their recovery. For those who have not responded well to standard exercise or are recovering from surgery, a therapy that includes exercises using the MedX machine may present the best therapeutic option.
Dr. Ginkel emphasizes that patients considering surgical intervention for back pain may experience relief through therapy using the MedX machine, thus eliminating the need for surgery.