As a Manual Therapist, I’ve learned to accelerate patients through their programs to accommodate managed care. But even therapy with time constraints requires an individualized and careful approach. That’s why it’s important to have a single device that’s versatile and achieves outcomes. I had been especially frustrated when I tried to find a device that would work on lateral motion, focusing on strength, coordination, balance and timing for my spine and extremity populations.

     The Dynamic Edge, by The Skier's Edge Co. of Park City, Utah, is a rehab tool that has met all my requirements. I usually use the Dynamic Edge with people who have ankle, knee, hip and low back injuries. Once I mobilize the injured body part with soft tissue and joint techniques, I transfer them to the gym to integrate functional activity. Most patients who strain their joint or tissue will feel pain, thus losing rotation. But by using the Dynamic Edge, patients can work in a three-dimensional manner. Standing on the Dynamic Edge footpads that move laterally, patients control the movement of the platform. In doing so, they work their muscles in an integrated pattern.

     This integration is particularly useful when trying to promote muscle balance. As Janda explains, muscles that tighten are the triceps, hamstrings, short thigh abductors, hip flexors (illiopsoas, rectus femoris, TFL), piriformis, quadratus, lumboum, spinal erectors, pectoralis, upper trapezius, levator scapula and short neck extensors.1 While these muscles tighten, others develop weakness or inhibition, Janda explains. These muscles are the tibialis anterior, vastus medialis, rectus abdominal and lower stabilizers of the scapula.1 This imbalance can lead to an abnormal distribution of forces on joint structures, loss of range of motion, altered proprioceptive feedback and compensated hypermobility. In addition, muscle imbalance affects muscle timing, or how muscles work synergistically in a particular firing pattern to create motion.1

     Coupled with a stretching program of the tight myofascial unit, the Dynamic Edge’s lateral motion attacks imbalance injury by taking a three-dimensional approach-working the medial, lateral and interior posterior musculature in an integrated pattern. The musculature works synergistically in a steady flow. Because the motion is repetitive, tight muscles tend to contract rather than lengthen. This contraction inhibits the muscles. In turn, the weak muscles complement the motion, which helps strengthen those specific muscles. Thus the outcome–clinical functional balance between short or tight muscles and long and weak muscles-is more easily achieved using the Dynamic Edge. In addition, the Dynamic Edge adds a degree of challenge for patients, thus increasing compliance.

     Because of these aspects, patients with patellofemoral problems, ACL repair and meniscectomies do well on this machine. In addition, the Dynamic Edge has helped post-surgical low back patients progress after they become proficient with a gym ball.
Since I began using the Dynamic Edge in my clinic six months ago, I have been
very impressed.

     In fact, I’m in the process of incorporating EMG studies to further prove the Dynamic Edge’s success with patients. The equipment’s versatility and “fun” aspect make rehabilitation much more effective for patients. And when dealing with time constraints of managed care, I can rest easy knowing there’s equipment that can rehab my patients in record time without compromising outcomes.

Reference
1. Janda, V. (1996). Evaluation of muscular imbalance. In Liebenson, C. (Ed.),
Rehabilitation of the Spine. (pp. 97-112) Baltimore: Williams & Wilkins.

Alan Grondin, PT, MTC, is regional director of Physiotherapy Associates in Altanta. He also is a distance faculty member at the University of St. Augustine, Fla.