MECHANOTHERAPY: rehabilitation using “Artromot” devices (Germany)

Mechanotherapy devices “Artromot” (“ARTROMOT”, Germany)- These are modern specialized passive impact devices designed to develop a particular joint. They are an excellent addition to the main therapy for injuries of various kinds, arthroscopy, capsulotomy, arthromia, etc. “Artromot” devices operate on the principle of mechanotherapy and allow you to begin rehabilitation after injuries to damaged joints already in the early stages of recovery.

The principle of operation is the passive treatment of the damaged joint with electromechanical painless effects: the patient places the injured limb in the apparatus, which begins to perform flexion-extension movements. The devices are designed so that the patient can perform natural, physiological movements in the joints without additional stress. The angle of flexion and extension is set for each patient individually by the doctor. There is a separate device design for each joint. Our center has devices for the hip, knee, ankle, shoulder, elbow, wrist joints, as well as for the hand joints. The devices of the Artromot line allow for rehabilitation after injuries and orthopedic operations in the comfortable conditions of our Center. More information about mechanotherapy:

Mechanism of operation

To get rid of back pain and restore joint mobility, tablets and ointments alone are not enough. The complex treatment includes robotic therapy devices for the upper and lower extremities and spine. The technique is most in demand in traumatology and orthopedics due to a number of effects:

• Stimulating effect. While working on active-passive mechanotherapy simulators, metabolic processes in tissues are accelerated and the vital potential of cells increases. Blood circulation is activated and the functioning of the respiratory system is improved. For diseases of the spine and joints, the result of therapy depends on the quality of the exercises and the amount of work done.
• Trophic impact. Thanks to the saturation of tissues with oxygen and nutrients, the process of healing and restoration is accelerated. The basis of the trophic effect is biochemical and physiological changes, due to which the energy potential of muscle fibers is restored. For example, in case of paralysis and paresis, mechanical massage prevents the development of muscle atrophy.
• Compensatory effect. Helps restore lost function of limb joints or adapt to new conditions in cases of severe biomechanical disorders.
• Normalizing mechanism. Expands the functional indicators of the affected areas of the body. This occurs due to regularly performed physical activity on the muscles. Mechanotherapy helps restore not only the function of the joints and spine, but also other systems in the body.
• General impact. It is known that mechanotherapy of joints improves blood circulation and lymph flow of the limb, metabolism in articular cartilage and muscles. Exercises on simulators increase stroke and minute blood volume, activate coronary blood supply, and increase physical endurance.

The entire set of exercises is carried out in a certain sequence, under the supervision of a doctor or exercise therapy instructor. The initial stage includes simple traditional loads: dynamic and cyclic exercises for 15-20 minutes. The training is completed with specific exercises lasting up to 30-60 minutes.

Advantages

Doctors choose mechanotherapy for their patients for the following advantages:

• Versatility

Mechanotherapy is allowed for spinal decompression and other complex conditions when it is necessary to restore the mobility of joints and muscles.

• Safety

When performed correctly, the exercises relieve axial load from the joints and prevent them from rubbing against each other, which eliminates any injuries. This is especially important after injuries, as well as in cases of damage resulting from arthrosis or ankylosis.

• Individual loads

The degree of load is selected individually, in accordance with the anthropometric data of the patient.

Passive therapy

With passive mechanotherapy, movements in the joints occur due to the smooth and gradual operation of the device’s levers. The therapy is aimed at developing movements and restoring joint function through dosed stretching of the ligaments and joint capsule. At the same time, the muscles relax. The effectiveness of passive exposure lies in the fact that the joint moves with an individually selected amplitude and speed. There is no active contraction of the periarticular muscles. The technique is recommended to be carried out during early rehabilitation.

How exactly does mechanotherapy help restore the body?

The therapeutic effect of mechanotherapy is:

• tonic effect;
• improving tissue trophism, blood and lymph circulation;
• formation of functional compensations;
• improving pulmonary ventilation and coronary blood supply;
• increasing proprioceptive sensitivity;
• normalization of the functions and integrity of the body.

Restoring the body with the help of mechanotherapy is one of the auxiliary means of rehabilitation and should be used in combination with other methods, such as the use of hygienic and therapeutic exercises, walking, and dieting.

Types of simulators

Modern mechanotherapeutic simulators, depending on their design, are designed to perform a number of tasks:

• Block. In block simulators, a cable is passed through the blocks, at the end of which a load is attached. To regulate the force, a change in the mass of the load is provided. Training can be carried out in a standing, sitting, or lying position. Mechanotherapy using block devices is carried out in order to improve mobility, strength and endurance, and strengthen weakened muscles.
• Pendulum. The exercises are performed thanks to the force of inertia that occurs when the pendulum mechanism oscillates during loads performed by the patient himself. Muscles are strengthened and joint mobility increases. The load is adjusted by changing the angle, weight of the load or the location of its attachment.
• Isokinetic. They are represented by electromechanical devices with the ability to regulate the speed of load execution and resistance force. The greater the force, the greater the resistance and load on the limb. Isokinetic exercise machines are used exclusively to increase strength.
• Combined or general strengthening mechanotherapeutic devices - roller, rowing machine, treadmill, exercise bike, etc. Exercises on them involve several muscle groups at the same time. Such devices are indispensable for compensating for insufficient physical activity.

Commented by orthopedic doctor Ph.D. Litvinenko Andrey Sergeevich:

In the rehabilitation of diseases of the joints and spine, active-passive mechanotherapy devices from Ormed have proven themselves to be excellent. The equipment is universal, computer controlled, allows you to individually configure all parameters, suitable for both adults and children. Thanks to the introduction of mechanotherapeutic simulators into complex treatment programs, we were able to double the rate of restoration of function of the knee and hip joints in degenerative diseases.

Spine surgery: types, indications, rehabilitation

Spinal surgery is a serious surgical procedure that requires the highest skill of the surgeon and proper preparation of the patient. Well planned and carried out according to the protocol, it gives a high chance of cure, relieves pain, restores motor activity and improves a person’s quality of life.

Surgical treatment, due to its complexity and responsibility, is resorted to in the most severe cases - with rapid progression of the disease, the presence of complications and a severe course, for example, if there was a compression fracture.

The operation is carried out:

• As planned.
  After a thorough diagnosis, in the absence of contraindications
• Urgently
  . For health reasons, after minimal preparation

Types of spine surgeries

Surgical treatment of the spine is performed using a variety of methods that differ in volume, access and other characteristics. For each pathology there is a list of the most commonly used ones, including both open and endoscopic techniques:

• Radiofrequency thermal ablation
• Nucleoplasty (laser, plasma, hydro-, mechanical)
• Laser vaporization
• Endoscopic removal of disc herniation
• Microdiscectomy

Decompressive-stabilizing operations involve decompression (interlaminectomy, foraminotomy, hemilaminectomy, laminectomy) followed by stabilization:

• Interspinous fixation
• PLIF (rear)
• ALIF (front)
• XLIF (lateral)
• TLIF (transforaminal)

Separately, operations are performed for weakness of the bone structure of the vertebrae (osteoporotic pathological fracture, vertebral hemangoma, metastasis to the vertebral body:

• Vertebroplasty
• Kyphoplasty

These interventions consist of introducing bone cement (methacrylate) into the affected area of ​​the vertebral body through a needle percutaneously under the control of an image intensifier.

There are other types of operations used in modern surgery to treat problems of the cervical, thoracic, sacral and lumbar spine. Most of them are minimally invasive endoscopic, allowing you to quickly and safely eliminate the existing defect.

Indications for surgery

The cervical region is the most mobile and richly innervated in the spine. The muscular frame here is anatomically not strong enough. Therefore, pathology in the cervical spine (intervertebral hernia, spondylolisthesis) is widespread and in a short time leads to complications - impaired blood circulation, tinnitus, dizziness, fainting, pain, paresis and paralysis of the upper limbs. In the severe stage, loss of vision and hearing, and respiratory failure are possible.

The lumbar region experiences the greatest load. Damage to it leads to radiating pain in the legs, paresis, paralysis of the lower extremities, and disruption of the pelvic organs. Severe lower back pain also often accompanies lumbar pathology. Without timely treatment, changes can be irreversible.

Treatment at the Mirt Medical Center

The Mirt multidisciplinary medical center offers a wide range of medical services - diagnostics, denervation for pain relief, surgical surgery, rehabilitation.

People come to us with questions: Is the operation dangerous? Does it hurt a lot afterwards? Will cartilage grow? An operating surgeon with 10 years of experience will be happy to answer all the patient’s questions:

• Surgical treatment is effective in 90% of cases
• The restoration potential of cartilage and bone tissue is different for everyone
• Pain occurs after any surgical procedure. It can be successfully managed with the help of analgesics prescribed for 10-14 days

For our part, we can guarantee that we will make every effort and operate quickly and accurately. Read the reviews on the website and come see us in person!

Advantages of surgical treatment at the Mirt medical center:

• Efficiency, safety
• Maintaining scope of functions
• Inpatient treatment 4-7 days
• Pain relief
• Minimal complication rate
• Minimal tissue trauma
• Short recovery period

How is the operation performed?

This is a clearly planned and streamlined process. The course of the surgical intervention is carried out according to a pre-drawn protocol under x-ray and video control. Initially, the patient undergoes diagnostics to identify contraindications. If they are not available, a surgery date is set.

• Before the intervention, light premedication is given to relieve anxiety.
• Anesthesia is performed. This is a modern combined sevoflurane anesthesia. An anesthesiologist monitors the patient's condition
• The surgical field is accessed. With endoscopic methods, the incision size is 2 cm. With decompressive and stabilizing interventions, the incision size is larger
• Treatment of bone areas, decompression of compressed nerve roots, and removal of the nucleus pulposus are carried out
• The final stage is stabilization, depends on the type of operation
• Carry out control diagnostics. If the goal of the operation is achieved, then stitches are applied

On average, the work of the operating team takes 1.5-4 hours. How long it lasts depends on the volume, degree of complexity, access and what metal structure is chosen for the intervention. High-tech endoscopic techniques can reduce the duration of the treatment process.

From the operating room the patient is admitted to the intensive care unit or hospital. Observation from 4 to 7 days. You can't sit. Need a corset. A sick leave certificate is issued for the duration of treatment.

Is it possible to treat a herniated disc without surgery?

Patients of our multifunctional center “Myrt” often wonder if it is possible to get rid of the disease without surgery? Of course, but not in every case. With significant stenosis or sequestered hernia, conservative treatment will not be possible.

Many come to us when time has already passed - degenerative processes or injuries have caused severe pain, paralysis and immobility. Disability lies ahead. In this case, conservative treatment such as pills or injections will not be effective and surgery is recommended.

Modern operative surgery tends towards minimally invasive procedures. They have good recovery statistics. Therefore, there is no need to be afraid of surgery.

Postoperative period

Depending on the degree of complexity and extent of the surgical intervention, the hospital stay will take from 4 to 7 days. During microsurgical or endoscopic removal of a hernia, the patient can get up on the first day. In more complex cases - only on the 2-3rd day.

You cannot keep your back bent or make large-amplitude movements. In the first two weeks, all movements should be calm and measured, so as not to provoke suture separation or rejection of the implanted endoprostheses.

Recovery in the postoperative period takes from 2 to 12 months. It is necessary to take medications recommended by your doctor. Follow a special diet.

Working capacity is restored after 2 months. For some, light work and shorter working hours may be recommended. Any heavy physical activity, including sports, is strictly prohibited for up to a year.

Rehabilitation after spinal surgery

This is a set of procedures aimed at restoring the full range of motion in the spine. Thanks to the operation, the defect that interfered with his functioning was removed; now it is important to remove the consequences, restore endurance and motor activity. Rehabilitation and restoration of the spine helps with this.

The success of treatment largely depends on these procedures—the absence of complications, relapses, and the speed of tissue recovery. Rehabilitation is necessary even after minimally invasive surgical interventions, therefore, when visiting our center, it is so important to listen to and follow all the instructions of the rehabilitation doctor.

Everyone has their own goals during the rehabilitation period. To summarize, they come down to:

• Reduce pain
• Stimulate wound healing
• Prevention of possible complications
• Restoring range of motion and endurance

A rehabilitation plan for each patient is created individually. Some need to restore the range of functions, while others literally learn to walk again. You cannot sit for several weeks, so many procedures are performed lying down or standing.

After surgery, sensation is restored and pain may increase. Feeling as if legs are on fire. It is imperative to tell your doctor and rehabilitator about your symptoms. Using different subtypes of rehabilitation therapy, you can get rid of discomfort!

Physiotherapy

Stimulates regenerative processes, accelerates wound healing, promotes pain relief, improves microcirculation and osteosynthesis. Our clinic uses shock wave therapy, laser and ultrasound therapy, halo and pressure therapy, ozone and electrotherapy, quantum and shock wave techniques, magnetic therapy and computerized spinal traction.

Medical massage

Allows you to restore lost sensitivity, stimulates blood circulation, and allows you to develop muscles.

Passive mechanotherapy

With the help of special medical robots, immobile limbs are developed gently and painlessly. Recommended after paralysis.

Kinesitherapy

Our center operates in two areas at once - work on multifunctional simulators and neuromuscular activation. With their help, the spine is stabilized by activating the muscle chain - a group of deep and superficial muscles (transverse abdominal muscle, multifidus muscle), performing correct movements, forming a motor stereotype and pain relief.

Classes are painless, comprehensive and with constant progress - increasing the dosed therapeutic effect. This allows you to achieve your goals in a short time.

The specialists of our center know and love their work, helping hundreds of people every day return to their normal lifestyle. Thanks to the help of the professionals at Mirt MC, the period of rehabilitation treatment is minimal, and soon you will be able to enjoy all the colors of life!

Exercise therapy after spinal surgery

This is an important part of rehabilitation after surgery. Exercises improve tone and blood circulation. Classes are held in the hall of the Mirt MC using simulators and special equipment.

Patients also need home exercises. Strong therapeutic exercises, exercises, adherence to an activity regimen, a diet rich in nutrients and vitamins. Psychotherapy sessions may be required, especially after serious spinal injuries.

A complex of all available methods and active cooperation between the doctor and the patient at all stages after surgery is the key to a quick and complete recovery.

To make an appointment and learn more about surgical spine surgery in our multifunctional center, please call +7 (4942) 334-911. Call us, we will be happy to help!

What effects does the technique produce?

The maximum effect is observed when classes begin in the early rehabilitation period. Long-term use of the method is possible. Exercises on a device for robotic mechanotherapy of the upper limb, legs and spine can be performed for a long time for both therapeutic and preventive purposes.

Effects of the technique:

• strengthening muscle fibers;
• improving blood flow and lymph outflow;
• pain relief;
• improvement of synovial fluid synthesis;
• acceleration of regeneration of damaged tissues;
• increasing performance and endurance;
• stabilization of the condition of periarticular structures;
• restoration and improvement of joint mobility;
• acceleration of rehabilitation and recovery.

Therapeutic exercise and mechanical massage affect the entire body. Muscular activity improves the functioning of the central nervous system (eliminates neurological symptoms of diseases), normalizes the functioning of internal organs, and improves immunity.

Indications

The rehabilitation period of patients who have lost the ability to move, associated with the use of progressive methods of mechanotherapy. The procedure is carried out for each individual patient personally. The patient does not need to leave the room to exercise. This method is especially important for patients with stroke, spinal injury or paralysis. People with damage to the upper extremities are prescribed group classes, which are conducted under the strict supervision of a rehabilitation physician. Mechanotherapy is effective not only for injuries; procedures are prescribed for patients with arthrosis, arthritis, curvature of the spine, paresis, adhesions in joints and tendons, for recovery after implantation or after replacement of a damaged joint.

Mechanotherapy is prescribed for damage to various organs. The high effectiveness of passive training for people who have lost physical activity for a long time has long been proven.

Contraindications

• Joint contractures;
• Arthritis and arthrosis of the joints;
• Scoliosis of the spine;
• Posture defects (kyphosis, lordosis);
• Ankylosing spondylitis;
• Myalgia and myositis;
• Scar changes in soft tissues;
• Paresis and paralysis;
• Injuries of the spine and joints;
• Postoperative period;
• Prolonged bed rest;
• Restricted mobility in elderly patients;
• Long-term immobilization (after plaster casts, Ilizarov apparatus).

• Ankylosis (complete closure) of the joint;
• Severe joint deformities;
• Complete muscle atrophy;
• Thrombosis and varicose veins in advanced form;
• Increased body temperature, chills;
• Presence of tumors in the affected area;
• Some forms of cerebral palsy;
• Severe heart disease;
• Mental disorders;
• Alcohol intoxication;
• Pregnancy.

Mechanotherapy for curvature of the spine and poor posture helps stop the progression of the deformity and strengthen the muscle corset.

Patients with unhealed fractures are recommended to refrain from sessions on mechanotherapeutic devices. After the procedures, mild muscle pain is possible, since the muscles have not been stressed for a long time. Intense pain indicates incorrect dosage of exercises or non-compliance with implementation tactics.

Dynamic parallel bars simulator Alterstep

Alterstep is a multifunctional, highly effective dynamic gait rehabilitation simulator that combines two devices for training the musculoskeletal system and early rehabilitation after injuries, strokes and other diseases of the nervous system: parallel bars and a ladder with electronic step height adjustment. Ease of control, comfort and accessibility for difficult-to-mobile patients allow this simulator to be used in rehabilitation departments and centers, clinics, nursing homes, neuro- and cardiac rehabilitation departments.

The Alterstep dynamic parallel bars simulator is approved by the Ministry of Health of the Russian Federation and is recognized as having all the necessary standards for medical rehabilitation.

Alterstep combines two high-quality devices (ladders and bars), which allow you to:

• safely train the musculoskeletal system;
• carry out early rehabilitation after diseases of the nervous system, strokes and other injuries.

Advantages

• The presence of electronic adjustment of the height of the steps (from 0 to 15 centimeters), which allows you to choose the best option for each patient.
• Safety in operation. The device is equipped with an anti-slip coating for the feet, which makes it impossible to get new injuries.
• Ease of operation. In order to start training on the ladder bars, you do not need to have deep technical knowledge; just read the attached instructions.
• Accessibility for patients with difficult mobilization.
• Possibility of independent use of the device. Each patient can instantly change the settings and make them as comfortable as possible.

Indications

• cerebral palsy;
• flaccid paresis;
• plegia;
• arthrosis of the lower extremities (except grade 4);
• back pain (radiculopathy in remission, instability in the lumbar spine);
• cardiovascular failure without any significant disorders;
• impaired blood and lymph circulation in the pelvis;
• contractures;
• post-traumatic arthrosis.

Contraindications

• acute infectious and inflammatory diseases with high body temperature and general intoxication;
• acute period of the disease and its progressive course;
• malignant neoplasms before their radical treatment, malignant neoplasms with metastases;
• severe mental retardation (dementia) and mental illness with severely impaired intelligence;
• the presence of a foreign body near large vessels and nerve trunks;
• acute disorders of coronary and cerebral circulation;
• acute thrombosis and embolism;
• increase in cardiovascular failure with decompensation of blood circulation and breathing;
• bleeding;
• general serious condition of the patient;
• significantly pronounced pain syndrome;
• negative ECG dynamics, indicating deterioration of coronary circulation;
• atrioventricular block.

Temporary contraindications for use

• exacerbation of chronic diseases;
• complication during the course of the disease;
• intercurrent diseases of an infectious or inflammatory nature;
• acute injuries;
• the appearance of signs indicating progression of the disease and deterioration of the patient’s condition;
• vascular crisis (hypertensive, hypotonic or with normal blood pressure (BP));
• heart rhythm disturbance: sinus tachycardia (over 100 beats per minute), bradycardia (less than 50 beats per minute), attack of paroxysmal or atrial fibrillation, extrasystoles with a frequency of more than 1:10.

Risk factors that may cause damage to the osteoarticular apparatus include:

• severe osteoporosis in older people, especially women;
• significant effort on the part of the patient with fragile callus, after fractures of the bones of the extremities in patients with spastic paralysis and impaired pain sensitivity. Caution should be observed after fractures to prevent the occurrence of pseudarthrosis and arthrosis.

Patient preparation

The effectiveness of the technique depends on the quality of preparation. It is aimed at the effectiveness of therapy and safety. Before mechanotherapy, it is recommended to carry out simple preparatory measures:

• exclusion of contraindications;
• refusal of heavy meals 1.5-2 hours before training;
• clarification with a doctor about the technique of performing exercises.

During sessions, medical professionals monitor how correctly the patient performs the exercises.