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Interest in intensive exercises (FES bike, treadmill locomotor training)

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    #16
    Adrian, I too have heard that access to exercise equipment is limited in England although I think that somebody with sufficient financial resources should be able to import such devices from Europe. At the present, there are very few large companies involved in marketing of such devices. Wise.

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      #17
      Meeker, good points, good post.

      Curtis, good points, good post.

      As I'm delving deeper and deeper into this, I call, Exercise Induced Recovery concept / application I have come to the following conclusions:

      1. It works for all the reasons stated by Meeker.

      2. It doesn't mean a guarantee of motor function return but it does have significant health benefits for everyone that outweigh the reasons not to engage in one (exercise program). Everyone should do something. Even chair exercises.

      3. Data providing the insurance cos. reasons to reimburse is coming but should be more concrete within a year - I hope.

      4. The equipment is absurdly expensive for most. And it doesn't have to be.

      5. Exercise / intense pt will be a part of any "cure" therapy.

      6. The future (3-5yrs), imo, is not in rehab designed centers (unless attached to a hospital or sci model center) but in home based equipment.

      7. Every doctor associated with CNS medicine should prescribe exercise as part of every rehabilitation program regardless of whether or not he/she believes it will promote recovery or not. Imo, they really don't know what is/isn't possible.

      8. The earlier a program is started the better. Same whether ab'd or da'd.

      9. This concept is catching on - big time.

      10. We are all responsible for going after this whether we have 'money' or not.


      Go get'em!

      Onward and Upward!

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        #18
        British spinal units always seemed to be of the opinion that you should accept your condition and get used to life in a wheelchair,this may change now that a study carried out at Glasgow Southern General has shown that in some cases patients regained function using treadmills. The last I heard they were seeking for additional funding to carry out a larger study, so maybe things are looking up at last for sci victims in the UK.

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          #19
          ~

          [This message was edited by Jan on Nov 18, 2002 at 10:56 AM.]

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            #20
            FES bike and it's benefits

            I just got off the phone with Mr.Petrofsky. He, the inventor of this bike, and FES technology, said the price was $25,000. not ($25.) Thus, the reason not much interest; because of the high cost. The price of these bikes have come way down since. For pages and pages of absracts about the benefits of exercise and FES bikes look up Electrologic.com

            As a side note, 80% to 90% of these bikes have been covered by insurance and the majority of them are in homes as opposed to clinics. I have to say again how nice it was riding the newest model the "Galaxy"; very user friendly, easy to operate, and comfortable.

            Meeker

            jrm design art studio

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              #21
              Meeker, I meant $25, not $25,000. This was what Seneca and I were told the people were requested to pay to have access to an FES bike... Despite this trivial price, apparently not many people were willing to take the time to use the device. I was very surprised by this because I would have thought that there would be more interest. In any case, our poll here is suggesting that a large majority of people are interested in trying an ambulatory training device even if they have to pay $1000, $10,000, or even more for the device. This should be good news for Steven Petrofsky and Electrologic. Wise.

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                #22
                We have the Stimaster and the 4000 unit.

                Steve's done a yomen job with these devices. A few issues to consider are: you need to be consistant. It works do build back atrophying muscles as long as you stay with it.As soon as you stop for any period of time your body will go back to the way it was.Also you should have 2 man transfers or use the lift device. It takes some time to get set up, hooked up and running and then you take everything off and do the transfer back to your Chair(Plan on an hour to an hour and a half.You've also got to unplug it when your not using it for a while because the computers are very sensitive to power surges, although homeowners insurance will cover any breakage less deductable. We are thinking in order to be more consistant we need to find a Physical Therapy school where Justin would be a good research project, or hire 2 persons to come to your house 3 times a week.If you can do these things and remain consistant you will definitly see some good results.Heymaybe if Steve got enough business he'd be able to lower the price. Hey maybe if enough people were interested on this board you could get a bulk rate.Happy to ans. any questions from our experience.

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                  #23
                  I think that before anyone of any means writes off $1,000 or even $10,000 as too much for their family's budget they need to do a bit of homework. First and fore most is how much do you and will you be paying in deductibles, co-pays and lost wages (for those working) for each medical treatment you need that exercise would have prevented.

                  I went from inpatient rehab to an outpatient 5 day a week program at my local county hospital (no SCI equipment but a PT more than willing to work with me). I did that for 2 years and after working passively with HKAFO braces and then blocked knee standing I had enough return to go back for 4 months of inpatient rehab again. Yes, I have private insurance but while my doc at the time was a PPO at the PPO rehab I still had to call my congressman. When I left there it was back to 3 days a week PT no OT. In the 8 years I did this I was in the ER twice, once immediately after rehab 2 when an aide let me fall during a practice transfer because she was watching me and not my board as instructed and once for possible meningitis. I went from constant UTIs to maybe twice a year by the 3rd year with no change in routines, no pnuemonia or bronchitis or flu (even before I had the Pnuemovax and years I skipped the flu shot), NO skin break down! A sore boil for a bit that I babied but no decubiti anywhere. I did break an arm but that was studpidity on my part. DO NOT use an arm as a wedge and then stir Wheaties cookie dough by hand. [img]/forum/images/smilies/biggrin.gif[/img]

                  Two years of no PT and I have had bronchitis, UTIs galore again, a nice touch of cellulitis and to top it all off IBS (irritable bowel syndrome). Oh, and one trip to the ER for a recheck of a badly sprained ankle and torn muscles that were causing AD (which had never been a problem for me before).

                  In sum, with all my wonderful insurance coverage (and I know I am blessed) they were getting off cheaper paying the hospital and later the hospital's freestanding clinic for PT, and at times OT, then letting me sit. My costs for prescriptions alone could cover that $1,000 bike. Add just 25% of the cost of, say, a broken leg what with husband's time off work for doc visits, pain meds, co-pays for repeated trips to doc for skin checks, etc and that would cover maybe $3,000 of that higher price bike. If you can itemize your taxes then get a doctor's order to include in your records and write that bike off as a medical expense or ask insurance to go 50-50 with you.

                  Where there's a will, there's a way. I'm working on picking out a non-FES bike because I can now pedal backwards on my own. [img]/forum/images/smilies/cool.gif[/img]

                  Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I will try again tomorrow."
                  Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I will try again tomorrow."

                  Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied and are based solely on my experiences as a SCI patient. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

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                    #24
                    Dr. Young:

                    I would definitely use a home unit for gait training or biking. But unfortunately cost is a limiting factor. If I had the money, I'd spend whatever it took.

                    However, your relating the experiences of this clinician in the eighties is intersting. I think there would be much more of a positive response if such a device were available today, especially for a price affordable to limited personal budgets. In my opinion this is due to two things; the Internet and Wise Young.

                    I say "the Internet" because through it the market for such a device can sit in their homes and read all about it, watching videos of the device in use, reading testimonials, and discussing the device's merits online. I say "Wise Young" because through the information he's either directly provided, or given us access to, many with SCI now understand that neural retraining, nerve repair, and functional gains may continue for years and may be effected by repetitive rehab.

                    James Kelly

                    [This message was edited by James Kelly on Nov 19, 2002 at 11:13 AM.]
                    James Kelly

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                      #25
                      Jim, you give me too much credit. Christopher Reeve probably did more to push the idea of exercise for the disabled than anybody else. Even people in the MS community have become real advocates of exercise. I spoke recently to a group of people with MS and told them that learned non-use may be a significant part of their continuing neurological deficits. I anticipated that there might be some opposition or skepticism about that idea but I think most of the people in the audience was quite enthusiastic. I also learned that people in the MS community have a very difficult time getting insurance coverage for physical therapy if they are in a wheelchair. Wise.

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                        #26
                        If the people involved in FES were smart, they would figure out a way to get their product into more homes. Say, lease the bikes. Have the client pay the freight and pay for insurance (loss or damage). Then find a way to set up a monthly charge. Or maybe a dealer could set up something like this. I don't know much about the bikes. I am just throwing an idea out there. The FES manufacturer or dealer could probably write down the lease loss against the profit on sales. Maybe a lease with the option to purchase. There are ways around every problem.

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                          #27
                          I just "bought" an Ergys2 bike from Therapeutic Alliance. It hasn't arrived yet... can't wait. My insurance company opted to go for a 24 month lease with the option to buyout anytime. I think this is smart because if it doesn't work well for me, it's a lot cheaper than buying the thing outright and being stuck with a very expensive machine with a very limited market to sell it.

                          80% of lease payments go towards reducing the buyout price.

                          This can be done with insurance companies and third party players. If I was an FES company I would probably not want to do this with individuals... although teaming up with a finance company would be a good way to go. You sell to them at a lower price and let them deal with the credit risk, payments, etc. Although you sell at a lower price, you'd sell more units and more SCI victims could benefit.

                          For the buyer it could mean a payment of maybe $300/month for a 5 year lease-to-own program.

                          I know that $1/month is too much for many people with SCI and it's very unfortunate. However, for those with jobs and/or some income it may be more doable than paying $14K all at once.

                          I'll mention this to Therapeutic Alliance next time I speak to them.
                          "Oh yeah life goes on
                          Long after the thrill of livin is gone"

                          John Cougar Mellencamp

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