A Closer Look at Advanced Physical Therapy at LMH Health
When managing a patient’s recovery from an injury or surgery, a physician may recommend physical therapy to help improve mobility, movement, and overall function. While traditionally focused on hands-on treatment, advances in technology are now playing a key role in enhancing patient outcomes.
LMH Health, 325 Maine St., is pictured in May 2021.
“Advanced physical therapy technology allows us to create more precise and personalized treatment plans,” explained Justin Rohrberg, physical therapist at LMH Health’s West Campus. “These tools enhance therapy by providing objective data, improving decision-making, and offering a comprehensive approach to patient care.”
Let’s examine some of the innovative technologies available at LMH Health.
Assessing Strength, One Movement at a Time
Isokinetic dynamometers are frequently used in scientific studies to assess strength. LMH Health employs this technology to evaluate patient strength, especially for those with knee or shoulder injuries.
“We use the isokinetic machine to isolate a certain body part and really key in on how strong the patient is and the strongest part of their range of motion,” Rohrberg noted.
The dynamometer measures torque – the force a muscle produces at a specific speed – and its output throughout the patient’s range of motion. Rohrberg further explained, “It measures how quickly the muscle turns on and off, and just how strong it is. We can simulate various exercises and adjust the weight, aiding in rehabilitation.”
During testing with the machine, the monitor displays the power and torque exerted. “You start here with your knee at 90 degrees and by the time you kick it out, your knee is straight and pretty close to zero. Based on the research that’s been done, we know that you should exert most of your force at between 40 and 70 degrees, ideally around 60,” he said. “We can use this data to determine where the greatest force production is and where we need to work in order to ensure the safest possible return to running, jumping, or sport participation.”
Testing Newton’s Third Law
Force plate technology from VALD Performance is another tool used at LMH Health, which directly relates to Isaac Newton’s third law of motion during evaluations.
Patients stand on a sensor plate that detects variations in force output. During a squat, the sensors determine the force exerted on each phase of the movement. It also works in a similar way during jumps. The plates sense how much force is used in the push-off and how much is used trying to break momentum on the way down. This helps show the symmetry between the right and left sides, helping to determine where you’re loading as you land.
This provides far more information than a therapist can observe with the naked eye. “The force plates help identify asymmetry during movements including squats and jumps,” Rohrberg said. “We can put someone who has had a knee replacement on the machine and show them that they’re loading more on one side, generally the one that was healthy and had to compensate, and that we need to work more on strengthening the other one.”
Physical therapists at the West Campus recently completed a study on loading patterns over time for patients undergoing knee replacement, both pre- and post-surgery, to help improve patient outcomes.
Integrating Technology for Enhanced Recovery
Incorporating technology into patient rehab is a common practice at LMH Health. Runners seeking more information about their running mechanics can utilize the RunStrong program.
Through this program, therapists can perform an exam to make objective assessments and use state-of-the-art video analysis at the motion analysis lab at the West Campus. The video running analysis is used to measure cadence, foot strike, and any gaps in a runner’s form and technique. It allows the team to understand strengths and weaknesses to help them retrain.
Runners start by answering detailed questions about their history, including injuries, training schedules, gear, and their goals. They undergo a short exam to allow the team to make objective assessments about strength and flexibility, and then proceed to the treadmill.
“Video analysis allows us to look at foot placement and running efficiencies,” stated Nami Stone, LMH Health physical therapy director. “We use cameras and a specialized treadmill with sensors that allows us to take measurements and hone in on the areas that a runner needs to work on. If there’s some hip weakness showing up, I can hone in on hip and core work. If the knee bend is too great, we can work on quad strengthening.”
Stone also assesses a runner’s cadence, which is the number of steps per minute, to understand how it affects ground contact time. Longer ground times mean lower cadence, or a longer time that pressure is exerted on joints and muscles, potentially increasing the risk of injury.
“I have found that by simply increasing cadence, some of the increased bounce and/or increased knee bend significantly improves,” Stone said. “That’s something we can easily look at with these analyses.”
Recovery Without Weight
For patients recovering from surgery, therapists at LMH Health use additional technology to assist with the return to weight-bearing activities.
Therapists may use a blood flow restriction device for patients recovering from ACL construction, which simulates heavy weight lifting without actual weights. This is especially beneficial in post-surgical recovery.
“We basically cut off most of the blood flow to your arm or leg to simulate what it would be like if you’re lifting a really heavy weight,” Rohrberg explained. “We’re able to do the same thing by restricting your blood flow with this machine as we may not want to lift heavy weights if you’ve just had surgery, in order to allow tissue to heal properly.”
For patients with injuries where weight-bearing activities are limited, the Hydroworx 2000 pool can play an important role in their recovery. The pool’s warm water, adjustable depth, jets, and treadmill allow patients to perform exercises in the water, using buoyancy to their advantage. The West Campus is the only location in Lawrence to offer this advanced pool treatment.
“Having all this technology under one roof gives LMH Health a competitive edge,” Rohrberg noted. “We can use all these different tools and we’re able to get a well-rounded picture of where patients are and need to be, both from a testing and recovery standpoint. The technology helps us to make better decisions for our patients.”
