Hanley Pain &
Rehabilitation Center of Orlando
The Science Behind the Treatment
Adapted from Spineworks.com
- If pain does not resolve 8 to 10 weeks after an injury, a clinical phenomenon takes place. The muscles in the injured area will begin to suffer from 'disuse atrophy.' Following an injury, the patient begins to protect that area by bracing themselves and moving differently. The lack of use further weakens the muscles in the lumbar and cervical spine, often times resulting in an increase in pain.
- The Med-X rehabilitation equipment is designed to isolate the injured muscles, and safely increase strength and range of motion. The result is a decrease in pain and functional restoration of normal mobility. There is no other equipment currently available that can safely and effectively isolate and rehabilitate the lumbar and cervical muscles.
- Treatment Based on Knowledge of Tissue Repair: The key components of any rehabilitation program designed to address weakness, deconditioning and substitution is overload, progression, and isolation. An overload stimulus demands that the involved segment work at greater than normal levels. An overload stimulus improves neural control and increases the muscle contractile protein size. Strength and structural integrity will improve through a facilitation of neural control and muscular hypertrophy. Isolation is the key to targeting the specific area of dysfunction (weak link). Isolating a movement makes it possible to provide a progressive overload stimulus to the weakened segment. In the lumbar spine the glueteal and hamstring muscles can substitute for a weak back by producing movement through pelvic rotation. By stabilizing the pelvis in the Med-X machine during the movement of extension, the spinal erectors and lumbar spine can be isolated for an overload stimulus. This environment also allows for neuromuscular re-education of alienated muscle tissue. Without isolation the exercise stimulus will not target the muscle group and specific movement in question, and the efficacy of the rehabilitation program will be compromised. Isolating a movement prevents substitution and provides the safest environment in which to provide a therapeutic overload stimulus.
- Isolated mechanical loading helps align new collagen or connective tissue. If random alignment of collagenous tissue occurs during the healing process then cross fibers and adhesions develop. When movement is finally initiated these cross fibers are disrupted and the collagen repair process must start all over. By providing mechanical loading during the repair process the fibers are aligned along lines of mechanical stress, adhesions do not develop and collagenous repair will be optimized. Providing frequent movement of the lumbar spine and facet joints in an isolated manner will increase the production of synovial fluid, which acts as a lubricant and assists in the smooth gliding operation within a joint capsule. Loading and unloading the disc increases the rate of diffusion through an otherwise avascular area. This increased diffusion can help regulate inter discal pi-I which may be a source of pain. Specific exercise also increases localized blood flow which facilitates healing through the removal of metabolic waste products and the delivery of nutrients. Wolfe's Law states that bone mass and density will be increased in areas of stress. The detrimental effect of immobilization and non-weight bearing environments is the significant reduction in bone density. Specific exercise that provides an overload stimulus will increase calcification and bone density of the spine. Rational care must be based on physiological principles and knowledge of the repair processes. Exercise should be precisely prescribed and given in dosages that elicit a specific response.
- The Med-X equipment has been available since 1988. It takes years to complete research and publish results. There is now a rapidly growing body of published research documenting the efficacy of specific intensive exercise for chronic back pain patients.
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