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.
© Exermend, Inc. 2002
