THE BIODEX SYSTEM

By Harold Zwart, MS, PT

WHY A BIODEX

In a managed care environment, clinicians must return patients to definable levels of function as quickly as possible.
The best way to deliver efficient and cost effective treatment, and provide quality care is to evaluate the patient, define the level of impairment, and confirm the impairment cause. This evaluation must include the objective assessment of all parameters that affect function, including the Musculoskeletal and neuromuscular systems.
Once the components have been assessed, a specific target outcome such as return to ADL, work, or sport can be defined. A critical pathway or treatment plan can then be created to maximize the rehabilitation process.
Without clearly defining impairment and cause, rehabilitation is little more than a guessing game based on assumption rather than objective facts. While passive treatments (such as hot packs) may relieve symptoms, only active interventions (such as therapeutic exercise) quickly progress the patient along a treatment plan to the desired outcome.1 The Biodex Multi-Joint System is the only testing and rehabilitation device exclusively designed for both assessment and treatment of the parameters that define function.

MUSCULOSKELETAL EVALUATION AND EXERCISE
The Biodex System is designed to progress patients through the rehabilitation process in the safest, quickest, and most efficient manner possible.
Only the Biodex System provides uncompromised biomechanical positioning that increases the effectiveness of the activity and encourages proper arthokinematics. This ensures that harmful patterns of compensation do not develop when the patient is returned to function. The Passive Mode allows development of the patient's passive and active range of motion (ROM), followed by the development of strength in the isolated joints and surrounding musculature.
The basis of the strengthening component is Isokinetic Muscle Loading, the only safe method of maximally loading a dynamically contacting muscle throughout a joint's entire range of motion.
Biodex exclusive torque-based ramp allows the patient to achieve Isokinetic speed sooner in the range of motion and to maintain the speed longer. This promotes greater benefits from the accommodating resistance as well as more reliable evaluations.

NEUROMUSCULAR ASSESSMENT AND FUNCTIONAL TRAINING
Utilizing physical, auditory and visual biofeedback to train patients to perform sub maximal eccentric muscle loading at preselected resistance levels develops the neuromuscular control which necessitates restoration of normal joint arthokinematics.
The ability to accelerate to, maintain and decelerate from the pre-selected Isokinetic speed, reciprocally, is the same contraction sequence performed in functional activities. Studies have consistently found a high correlation between Biodex test scores and functional tests.2, 3 Biodex torque-based acceleration is directly comparable to the ability to produce power necessary for functional activities. The ability to decelerate (the lever arm) and reaccelerate in the opposite direction develops the dynamic joint stability necessary to maintain joint integrity during functional activity. In effect, the reciprocal contractions (changing the agonist to the antagonist and the antagonist to the agonist) train the muscles to stabilize the joints instead of the ligaments, reducing the risk of injury during dynamic activity.
The majority of connective tissue injuries occur at the end range of motion, during the reciprocal transition. For this reason, assessment and training of patients' capabilities is vitally important. This valuable assessment is only possible on a Biodex Multi-Joint System.
Biodex also provides the clinician with accurate, clear documentation of acceleration and deceleration to statistically demonstrate the significant correlation of the patient's functional activity.

NEUROPHYSIOLOGICAL EVALUATION AND TRAINING
Proprioception, the complex series of afferent messages from the periphery to the Central Nervous System (CNS), and the CNS's efferent response to the muscles, is known as neuromuscular coordination. Without efficient neuromuscular coordination, the muscles will not be able to stabilize joints or even allow for the simplest of joint motions to be performed in an effective manner, hindering the patient's function.
Among the components essential to the development of neuromuscular coordination are Kinesthesia and Proprioception.
The Biodex Multi-Joint System allows for evaluation and training of Kinesthesia through:
• Limb and Joint Motion Detection Testing and Training
• Joint Motion Response Testing and Training
The Biodex Multi-Joint System allows for evaluation and training of Proprioception through:
• Passive Joint Reposition Testing and Training
• Active Joint Reposition Testing and Training
Only the Biodex Multi-Joint System allows the objective evaluation and challenging treatment of these essential components of function. The ability to clearly define and address them during the rehabilitation process is paramount in effectively and efficiently returning a patient to the level of function desired by the employer, or prescribed by the payer, in the shortest time possible.

ADVANTAGES OF BIODEX ISOKINETICS

NOTHING CAN DUPLICATE THE PERFORMANCE OF THE BIODEX ISOKINETIC SYSTEM

• EFFICIENCY
Biodex lsokinetics is the only safe way to load a dynamically contracting muscle to its maximum capability throughout the entire range in a continuous reciprocal motion using either functional positions or isolated in proper biomechanical positions. A Biodex lsokinetic contraction recruits a larger number of muscle fibers than any other method of exercise.

• SAFETY
Biodex Isokinetic resistance accommodates to: Pain, Fatigue and Musculoskeletal Leverage. The resistance a patient encounters is in direct proportion to the effort. Patients will never encounter more resistance than they are capable of applying.

• DECREASED JOINT COMPRESSIVE FORCES
High speed Isokinetics minimizes joint compression and translational forces while it strengthens musculature. Biodex lsokinetics allows high speeds even in short arc patterns.

• FUNCTIONAL TRAINING AND EVALUATION
Biodex lsokinetic performance has been consistently shown to demonstrate a positive correlation to function. Only Biodex lsokinetics allows patients to test and train with the isolated joints and surrounding musculature in biomechanically correct positions and at speeds that approximate function. All the parameters (including force generated during acceleration and deceleration) that define muscle Functional performance can be measured.

• REPRODUCIBILITY
With the highest level of accuracy, reliability and repeatability of any evaluation dynamic procedure, only Biodex Isokinetics allows for the objective documentation of
• NEED (functional disability),
• PROGRESS (response to therapy), and
• OUTCOME (return to function).

• EFFICACY
There have been more than 2,000 studies published utilizing Isokinetics as an evaluation and rehabilitation method. An estimated 60 million patient treatments.

• VERSATILE AND COST EFFECTIVE
The versatility and adaptability of the Biodex lsokinetic System allows treatment of the widest variety of patients through every phase of rehabilitation. The Biodex lsokinetic System increases clinic efficiency and treats more patients more effectively.