One of the primary goals during patient care should be to phase treatment protocols from passive therapy to active therapy and ultimately fitness-based exercise.
The objective is to educate, teach, train and empower your patients to take an active role in maintaining their health. Implementing an on-site active therapeutic fitness program combined with a doctor-guided at-home program will add new dimension to your treatment programs.
It all makes sense, but how do you go about assessing therapy and fitness equipment best suited for your office? Legendary martial artist Bruce Lee once said, "Simplicity is the key to brilliance."
Stay Simple
The wonderful part about keeping it simple is that you don't need a lot of space to implement a successful fitness program. There is no need for large pieces of equipment with dozens of bells and whistles. "Simple" typically means inexpensive, so your initial startup investment can be more cost-effective. And patients like simple. The key principle with simple is that your patient may also use the equipment at home after your on-site, doctor-guided program. If patients feel better from what they use in your clinic and they have the opportunity to purchase one for home-use, they usually do.
Implementation Guidelines
Now let's get into some guidelines for implementing programs and action steps for assessing the right equipment for your office environment.
What should you look for in clinic rehab/fitness equipment?
The Tools
Remember the concept of simple? These are what I like to call "bang for your buck" products; simple, powerful, effective, and easy to integrate.
Kettlebells have been around for ages. Made out of cast iron, they're cannonball-shaped weights with a single handle on top. Kettlebells offer movement-based training, otherwise known as functional training. They offer full-body conditioning and rehabilitation benefits.
The body learns to work as one synergistic unit linked strongly together. Kettlebell training involves multiple muscle groups and energy systems at once thus increasing resistance to injury. Improved mobility and range of motion can be obtained by teaching basic patterns of hip joint hinging, gaining increased strength without increase of mass. Kettlebell exercisers are lean, toned and functional, not bulky—a benefit that helps prevent injury.
Indian Club swinging can be described as circular weight training but can exercise the shoulder, wrist and elbow in ways not possible with traditional linear weight training. Indian clubs are basically bowling pin shaped devices weighing 1-2 pounds used to perform circular movement patterns. Clubs will not only strengthen muscles and ligaments, maintain joint flexibility and improve range of motion but will greatly reduce risk of injury. You will also notice improved rhythm and eye-hand coordination due to the concentration and high neural demands necessary to perform the movements. Club training is one of the best tools you will find for shoulder and neural rehabilitation.
[pb]Suspension Training refers to unique training movements with bodyweight exercises allowing you to manipulate body position and stability to provide multi-planar resistive and neuromuscular exercises in a proprioceptively enriched state or to unload the body. With the versatility in manipulating load stability, and force vectors, suspension training can be a functional training tool used in the treatment and prevention of musculoskeletal injuries or disabilities and used to improve fitness and performance.
Thick Ropes. During most thick rope exercises, the muscles in the hands and forearms are engaged to a great extent, which is an area where many people lack sufficient strength. Grip strength is a key component of neuromuscular conditioning and linked to rotator cuff stabilization. In addition to stronger hands and forearms, ropes can be used for a variety of climbing and pulling exercises to increase relative body strength. Rope training is extremely effective for core stability and rotational training. Postural muscles may be highly stimulated when you do a rope wave training program on your knees while actively preventing hip flexion.
Resistance Bands offer variable resistance, which is the key feature of this equipment. The exercise is more difficult the further you step away from the center focal point and you must control the movement in both eccentric and concentric directions. Using a band requires coordination and balance so you end up utilizing more muscle groups to stabilize your body. You can target specific muscle groups or smaller muscles more easily than with weights. Bands offer more variety because you can create resistance in all directions, which helps you strengthen neglected muscle groups. Also, since there are different tension levels based on the color band you use, you can easily alter the difficulty level. You can also mimic real-life situations by using the band for movements you would make in activities of daily living, such as bending, twisting and rotating.
Medicine Balls are weighted leather or rubber balls, between 1 to 25 pounds, that you throw and perform various full-body exercises. The ball requires coordination, strength, and stamina to keep it under control during exercise. It is one of the most effective tools to train all of the muscle groups in your body, especially your stabilizer muscles for functional strength. This is a rehabilitative advantage that isolation lifting does not provide. Over time, your body will learn to become more efficient with full-body exercises. Medicine ball throws challenge different body load vectors as you use different muscle groups to balance your body and maintain control of the ball. This trains your body to react faster and be in command of the load.
Stability Balls. The use of stability balls originated in the world of rehabilitation. Inexpensive, portable, lightweight and highly effective, they are a primary asset to any fitness program. The exercise ball is a great tool to improve the strength of the abs and the lower back. Because it is a little unstable and you must constantly adjust to remain balanced, use of the stability ball improves the functional strength, balance and flexibility of the body. Using the ball during training will utilize many additional muscles to maintain stability and balance. The dynamic movements will improve the natural motor reflexes of the body as different muscles are utilized during movement, especially the ones that are not routinely used with linear exercise patterns.
Document
Document patient progress with written doctor-guided programs and protocols. Note time, reps, rest, sets, and patient response during each session by using standardized outcome measures. Use appropriate reimbursement codes for in-clinic programs (e.g. 97110, 97112, 97150). Maintain an active inventory of your training equipment for direct client purchases if you choose to offer cash-based, doctor-guided home exercise products.
Invest in just a few select pieces of equipment listed above to start seeing the benefits in patient outcomes and retention.
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Some doctors thrive in a personality-based clinic and have a loyal following no matter what services or equipment they offer, but for most chiropractic offices who are trying to grow and expand, new equipment purchases help us stay relevant and continue to service our client base in the best, most up-to-date manner possible. So, regarding equipment purchasing: should you lease, get a bank loan, or pay cash?
