Movement therapy device
Therapeutic, motor-driven and software- controlled movement therapy devices are increasingly used in rehabilitation and work with disabled people to support physiotherapy and drug therapy. They are mainly used in patients with neurological (e.g. stroke or multiple sclerosis ) or neuromuscular (e.g. muscular dystrophies ) diseases or physical disabilities. Movement therapy devices can be used in institutions as well as in private homes. Most movement trainers now have a built-in motor, which enables not only active, but also passive training.
Indications
Movement therapy devices are used in cases of paralysis or neuromuscular diseases with extensive loss of function in leg and / or arm mobility. As a result of the disease, these movement deficits mainly occur in patients with multiple sclerosis , apoplexy ( stroke ), paraplegia , spastic paralysis, muscle diseases , traumatic brain injury , cerebral palsy , hemi- , para- or tetraplegia , Parkinson's disease , spina bifida , polyneuropathy , Guillain-Barré syndrome , poliomyelitis , muscular dystrophy, amyotrophic lateral sclerosis (ALS) etc. or in the case of immobility due to orthopedic diseases and general lack of exercise. In addition, movement therapy devices are increasingly used in cardiology, dialysis and in intensive care units. The movement trainers are now also used in orthopedic , rheumatic , cardiological and geriatric patients.
Special power-driven movement therapy devices are recognized by the health insurance resources and thus listed in the aid list of statutory health insurance. The use of therapy robots to save costs in physiotherapy can also be a movement therapy device.
Therapeutic benefits
The benefits of exercise therapy devices are to alleviate the consequences of a lack of exercise (e.g. circulatory disorders , stiff joints, muscle breakdown and digestive problems, etc.), to maintain or improve the ability to walk, to lure the muscles and also to reduce spasms, to discover and strengthen residual muscle strength promote and strengthen the psyche and well-being.
Active training
During active training, which is similar to an ergometer , the person steps on the device with their own muscle power against a finely adjustable braking resistor. During active training, various forms of biofeedback are possible with some movement trainers . This can be shown, for example, in the form of distance, performance, energy expenditure or symmetry (simultaneous display of active performance separately for the right and left side) of the legs or arms. These biofeedbacks serve both the motivation and the checking of the training values (e.g. the symmetry of the leg movement to compensate for right-left deficits). This is e.g. B. has been tested for the arms with the support of robots .
Assistive training (motor-assisted active training)
With the help of assistive training (motor-assisted active training), even users with little physical strength can actively train themselves (with motor assistance). The users bring in their existing muscle power and with the help of the motor and special software, the pedals can be accelerated in many cases. Patients in the rehabilitation process can start early to use and promote even the slightest muscle strength themselves. Assistive training plays a major role, especially for people with a stroke . In order to guarantee a smooth run even when pedaling on one side, the motor replaces the weak limbs, so to speak. This prevents the trainee from adopting incorrect movement patterns.
Passive training
To warm up or if you lack muscle strength, you can train in passive mode. The motor moves the legs or arms of the user. This passive gymnastics has a very positive effect, especially in the case of spastic paralysis and as preparation for physiotherapy. The legs (or arms) can be loosened, the muscle tone can regulate and decrease. If the spasticity is shooting in, the movement trainer recognizes the blockage and releases it by gently changing the direction of rotation. Even in passive mode, the movement trainer can display biofeedback, which provides information about muscle tone. Of course, the trainee can switch from passive to active training at any time. No further presettings are necessary for this.
Differences to bicycle ergometers
Movement trainers can be used both passively - with motor assistance - and actively - with your own muscle power. This means that training with a movement trainer is possible even with the slightest residual muscle strength. With the right equipment, you can train your arms as well as your legs. The symmetry training integrated in the movement trainer enables the trainee a targeted coordination training to build muscle. It is also used to prevent and avoid relieving postures . In contrast to bicycle ergometers , the movement with a movement trainer is supported by an electronic flywheel, which guarantees a smooth run regardless of the degree of disability . The performance range of the movement trainer starts at 0 watts. Bicycle ergometers usually only start at 20 watts, which means for people with little muscle strength that they cannot train on an ergometer. In addition, the trainee can remain seated on a chair or in a wheelchair while exercising with an exercise machine.
Individual evidence
- ↑ A. Kamps: Cyclical movement training of the lower extremities in stroke rehabilitation. In: Neurological Rehabilitation. 11 (5), 2005, pp. 259-269. (online) ( Memento from October 29, 2007 in the Internet Archive )
- ↑ Arnd Krüger : History of movement therapy. In: Preventive Medicine. Springer, Heidelberg Loseblatt Collection 1999, 07.06, pp. 1–22.
- ↑ JC González, JC Pulido, F. Fernández et al .: Planning, execution and monitoring of physical rehabilitation therapies with a robotic architecture. In: Stud Health Technol Inform. 210, 2015, pp. 339–343.
- ↑ R. Morales, FJ Badesa, N. García-Aracil include: Pneumatic robotic system for upper limb rehabilitation. In: Med Biol Eng Comput. 49 (10), 2011, pp. 1145-1156.