Types of rehabilitation simulators. Exercise machines for rehabilitation: types of rehabilitation, classification of equipment, special exercises, a set of classes and doctor’s recommendations

This specific section of physical culture emerged on the basis of the specifically targeted use of physical exercise as a means of restoring lost body functions.

The rehabilitation direction consists in the use of physical exercises, hardening factors and hygienic measures in a system of therapeutic measures to restore health or individual body functions reduced or lost as a result of diseases or injuries. The use of simulators for treatment and rehabilitation purposes should be accompanied by systematic medical supervision and strict consideration of the individual characteristics of those involved.

Rehabilitation physical education is intended for persons who have deviations in their health status and are therefore assigned to a special medical group. These people are physically weakened, their body's resistance to adverse environmental factors is reduced. In this regard, the main goal of rehabilitation physical culture is recovery. This goal is decisive, in relation to which the tasks of improving the health of the body of those involved are formed.

Active modern rehabilitation necessarily includes classes in the gym using specialized programs, joint gymnastics, and myocorrections with specialists using modern techniques. The emphasis in treatment is on thoughtful selection of individual loads, on drawing up, after visual diagnosis, correctional programs aimed at treating pathological movement patterns, strengthening the muscular corset - the main stabilizer of the musculoskeletal system, increasing the elasticity and flexibility of the spine, increasing the range of motion in the joints , on the load of the cardiorespiratory apparatus during gymnastics.

Treatment with the help of correct movement is the basis of one of the sections of exercise therapy - mechanotherapy, i.e. treatment with the help of properly selected exercise equipment.

Why simulators? It is exercise machines that are a completely safe form of movement, since they do not create pain with a properly designed treatment program.

Exercise machines make it possible to locally work on sore areas or, conversely, to avoid stress on certain areas.

The exercise machines do not create dangerous axial loads on the spine and do not cause “twisting” elements during movement.

Exercise machines are the best choice for non-athletic people, the elderly and children, because even people who are far from sports can predict movements, since each exercise machine is designed for a certain type of load and a certain range of motion

Of course, not all simulators are suitable for treatment and rehabilitation programs. The trajectories of movement on the simulator must accurately reproduce the amplitude of the joint. Some simulators must have restrictive devices that allow instructors to select appropriate angles for joints in case of pain or contractures. Exercise machines should have devices to make it easier to start and finish during exercise - an additional safety factor.

The method by which rehabilitation simulators work is based on an integrated approach to the treatment of diseases of the musculoskeletal system.

The main causes of back pain are muscle blockade and atrophy of the muscular corset. For various reasons, the muscle-connective tissue loses its elasticity, becomes ischemic, and at the same time the mobility of bones and discs sharply decreases, and pain occurs. Decrepit muscles are not able to hold the spinal column, which causes discogenic radiculitis, curvature of the spine, etc. It is necessary to restore blood circulation in the ischemic area by involving muscles and ligaments in the work. This is achieved through the use of individually selected loads in the rehabilitation room, in which the body is forced to include even the “affected” areas in the work. Normal circulation of blood and nutrients in these areas leads to the restoration of muscle potential, and therefore to the normalization of the entire spine and the musculoskeletal system as a whole. The optimal conditions for such recovery are threshold loads, which are possible only with the use of special therapeutic simulators. It is their use that leads to stimulation of peripheral blood circulation and nerve ending receptors in the muscles. This is carried out as a result of individually selected complex treatment, which is based on exercises using rehabilitation equipment.

An example of rehabilitation equipment is a universal multifunctional simulator with a MC for performing 500 developmental and corrective exercises against the background of variable vibration, which reduces the threshold of muscle relaxation and unloads the spine, affecting most active points.

This is a rehabilitation line that includes 7 simulators.

The anatomical backrest, thanks to its contour following the curve of the spine, removes most of the load from the spinal column.

The height-adjustable seat allows a patient of any height to sit comfortably and perform the movement technically correctly, ensuring that the necessary muscles are worked.

The fixing safety belt prevents the back from lifting off and dangerous overexertion of the lower back.

The limiting mechanism allows you to set the maximum range of motion and conduct training for patients with injuries or diseases of the musculoskeletal system who have limited mobility.

The locking mechanism allows detrained patients and those undergoing rehabilitation to install the exercise machine in the “easy start” position and perform the exercise without passing the initial phase of movement.

The isometric strength test device allows you to objectify muscle strength, analyze the results and, if necessary, adjust the treatment program.

The system of using a Smart Card with software allows you to monitor the rehabilitation and training process, analyze and, if necessary, adjust the training plan.

Thanks to its dual function, the machine allows you to train muscle groups responsible for flexion and extension of the legs. When training patients with injuries, diseases or restrictions in the knee joints, a special mechanism is used - a motion limiter, which allows the therapist to set the required amplitude and eliminate dangerous movements.

Conclusion

Based on the results of the study, the following conclusions can be drawn.

The specific functions of physical culture are recreational and health-rehabilitation functions, which are expressed mainly when using physical culture in the leisure process or in a system of special rehabilitation means.

Simulators are educational and training devices for developing motor qualities (strength, speed, endurance, flexibility, agility), improving sports technique and analytical functions of the body. The task of all types of simulators ultimately comes down to one thing - they all must create the most complete simulation of the loads that a person experiences when playing sports.

Thus, training on exercise machines is an opportunity to stay fit and improve your health at any convenient time of the day and regardless of weather conditions.

Exercise machines are divided into two main types: cardio equipment and strength equipment.

Strength training equipment is necessary if you need to shape your figure or if you like serious physical activity or working with weights.

An exercise bike is a universal tool for keeping your body in perfect condition. Regular cycling is beneficial at any age; it has a complex effect on the body.

Rowing machines are called complex because they equally contribute to the development of both endurance, which means they improve the functioning of the cardiovascular and respiratory systems, and strength.

Elliptical trainers were created by combining a stepper, an exercise bike and a treadmill. The principle of training on it is called cross-training: you need to stand on the platform, grab the handle and walk, pedaling along an elliptical path.

It has been proven that running and walking accelerate metabolic processes in the body as much as possible, thereby releasing energy and strengthening the body as a whole. A treadmill provides an opportunity to run every day without leaving your apartment and regardless of the weather.

The experience of using simulators for rehabilitation purposes and with elderly people has shown that their effectiveness increases with the directed work of teachers, trainers and instructors on the intellectualization of the training process. This means that each student must be convinced of the need and be able to ensure compliance with their individual standards at the highest possible level, and, if possible, independently organize their classes, i.e. your physical self-improvement, in the structure of your lifestyle.

In other words, when working out on simulators, everyone should become (figuratively speaking) to some extent “a trainer, a doctor, a rehabilitator, and a psychologist.” It should be taken into account that even a small shift in this direction, for example, only the patient’s awareness that his positive attitude towards exercise on exercise machines is already a prerequisite for the success of the rehabilitation process. Naturally, in this case, the instructor must be guided by the principle of individualization, in every possible way and constantly. The simulators are new and interesting, they significantly intellectualize the rehabilitation process, create a positive psychological mood, improve the emotional state of those involved, which optimizes the functioning of the principles of activity and consciousness, increasing the density of classes.

Bibliography

1. Federal Law “On Physical Culture and Sports in the Russian Federation” dated April 29, 1999 N 80-FZ

2. Vodlozerov, V.E. Locally targeted simulators / V.E. Vodlozerov. – Kyiv: Publishing center of KSMU, 2003. – 102 p.

3. Evseev, S.P. Simulators in gymnastics / S.P. Evseev. – M.: Physical culture and sport, 2003. – 254 p.

4. Evseev, S.P. Formation of motor actions using simulators / S.P. Evseev. – M.: Physical culture and sport, 2001. – 90 p.

5. Zatsiorsky, V.M. Physical qualities of an athlete / V.M. Zatsiorsky. – M.: Physical culture and sport, 1970. – 200 p.

6. On the problem of training support for student sports / M.G. Leikin [et al.] // Problems and prospects for the development of sports games and martial arts in higher educational institutions: collection of articles. articles of the Second electronic scientific conference. – Kharkov, 2006.

7. Leikin, M.G. Biomechanical aspects of strength development in the process of education and training / M.G. Leukin. – Kyiv: Publishing House of the Ministry of Education of Ukraine, 2001. – 152 p.

8. Leikin, M.G. Methodological features of the use of simulators in physical education of schoolchildren / M.G. Leikin, Yu.K. Makurin // School and pedagogy. – M.: APN USSR, 2000. – P. 230-249.

9. Leikin, M.G. Scientific substantiation and creation of sports and fitness equipment: dis. ... Dr. ped. sciences in the form of a scientific report / M. G. Leikin. – M., 1999. – 120 p.

10. Matveev L.P. Theory and methodology of physical culture.-M.: FiS, 1991

11. Nifontova L.N., Pavlova G.V. Physical education for people engaged in sedentary work. - M.: Soviet sport, 1993

12. Popov, G.I. Biomechanical foundations of creating a subject environment for the formation and improvement of sports movements / G.I. Popov: dis. ... Dr. ped. Sci. – M., 1992. – 327 p.

13. Rehabilitation of the health of students by means of physical culture: Textbook / Volkov V.Yu., Volkova L.M., St. Petersburg State Technical University, St. Petersburg, 1998. - 97 p.

14. Training systems / V.E. Shukshunov [and others]. – M.: Mashinostroenie, 2001. – 256 p.

Any serious illness for a person, especially when he is bedridden, is a difficult ordeal. Even a short stay in an immobilized state (3-5 days) reduces muscle strength and joint mobility, impairs blood circulation, and reduces intestinal motility. Exercise machines for bedridden patients are used to restore motor activity, strengthen muscles, and improve the general condition of the patient.

Functions of rehabilitation simulators

Many reasons can contribute to a lying state: spinal injuries, joint pathologies, Parkinson's disease, stroke, paralysis, chronic diseases, side effects of medications. Prolonged static body position causes dystrophic changes in muscle and joint tissues, so at the first opportunity you need to start restorative gymnastics and use exercise equipment for bedridden patients.

Devices that provide stress to individual muscles and joints for therapeutic purposes are called rehabilitation simulators. They help restore a person’s lost abilities after illness and injury. Depending on the functional disorders, each model is designed for a specific muscle group and has its own design features.

According to GOST, rehabilitation devices are divided into several types:

• to restore the functions of the spinal column;
• restoring the functionality of the hands;
• restoring the performance of the lower extremities;
• universal series models.

The first ones were developed for patients with intervertebral disc diseases and various articular deformities. Products of the second group provide measured loads on the muscles of the upper torso. Leg exercisers strengthen the smooth muscles of the limbs and develop joints. Universal devices simultaneously act on the upper and lower body.

Exercise machines for bedridden patients have a gentle effect on the muscles, taking into account the weakened state of the body. In most cases, they are equipped with electric motors and hydraulics. They can be divided into 2 groups: mechanotherapeutic devices and robotic technology.

Mechanotherapeutic devices

This group includes special devices that locally act on a specific muscle group, through the physical efforts of the patient himself, inertia or due to a mechanical engine.

To increase the effect of mechanotherapy, it is necessary to systematically perform exercises. The duration of the action and the level of load are determined by the attending physician depending on the nature of the injury and disease.

Exercise machines for bedridden patients, aimed at restoring lost functions, strengthening joints and smooth muscles, differ from conventional sports equipment by the presence of special sensors, control panels and monitors that allow them to adapt to the patient’s condition, read and remember information. Mechanotherapeutic devices work on joints, lower and upper limbs, and fine motor skills of the hands.

Professional therapeutic simulators include devices from the following manufacturers:

• Artromot;
• Kinetec;
• Ortorent et al.

Thanks to the action of the devices, lost functions are restored, muscle tone increases, and the musculoskeletal system is strengthened for further rehabilitation.

Leg exercisers

The exercise bike for bedridden patients is designed for cyclic rotations of the lower limbs. The device is equipped with a remote control that controls special programs. The monitor allows you to monitor the progress of your training. The mobile function and clamps allow you to install the model on the headboard.

Indications for use:

• post-operative rehabilitation;
• paralysis;
• recovery after coma;
• complications after stroke;
• long-term immobilization of limbs.

A leg trainer for bedridden patients improves blood circulation in soft tissues, maintains the elasticity of joints, and prevents the formation of blood clots, bedsores, and congestion in tissues.

Note. The rehabilitation device simplifies the care of bedridden patients, since its use does not require changing body position.

Joint devices provide control of flexion and extension movements, adduction, abduction and rotation. Using the control panel, the angle of the hip and knee position is adjusted. Such procedures prevent stiffness of the joint and contribute to early rehabilitation of the patient.

Indications for use:

• hip fractures;
• osteotomy of the knee joint;
• installation of a hip prosthesis;
• excision of the articular membrane.

Manufacturers produce exercise equipment for bedridden patients after a stroke that simulate walking. This helps prevent muscle and tendon atrophy and maintain motor abilities until the connection between the brain and the limb is restored.

Hand devices

Rehabilitation exercise equipment for the shoulder girdle can be used by both bedridden and sedentary patients. The remote control allows you to set the range of motion, angle of adduction, abduction and rotation.Indications for use include shoulder replacement, injuries and dislocations with complications.

Universal models

Manufacturers produce active-passive simulators for simultaneous development of the upper and lower extremities. The combined device is equipped with special devices, clamps, the ability to control heart rate, analyze and display the results on the monitor. Thanks to this, rehabilitation after various diseases is faster and more effective.

The device is used for patients with the following pathologies:

• traumatic brain injuries;
• stroke;
• rehabilitation period after prosthetics and amputation;
• decreased movement in elderly patients;
• spinal injuries.

Mechanotherapeutic rehabilitation is prescribed by the attending physician after a complete diagnosis. The exercise machine for bedridden patients is selected taking into account the area of ​​immobility and the physical condition of the patient.

The latest innovative developments for the rehabilitation of bedridden patients are robotics that affect all problem areas. The use of such systems allows the patient to get to his feet faster, prevent complications associated with immobility, and adapt the heart to future loads.

The essence of the system is mechanical movement, identical to a healthy body. A person is attached to a robot, the patient looks at the screen and the pictures encourage him to take action, which the technology performs for him. During the manipulation process, atrophied muscles “remember” lost movements.

Contraindications to the use of exercise equipment

In many cases, simulators are of great benefit, helping a person in rehabilitation and making it easier to care for a bedridden patient. However, there are conditions when the use of a hardware method can cause complications. These include:

• Ankylosis (joint immobility due to fusion of articular surfaces);
• Infectious diseases;
• Thrombophlebitis;
• Cholelithiasis;
• Tumors and hernias in the area that will be subject to stress during training.

Devices for bedridden patients can improve a person’s general condition, restore muscle tone, maintain joint elasticity, and restore lost abilities. When combined with medications, physiotherapy and massages, they contribute to high rehabilitation of the body. You can buy an exercise machine for bedridden patients in orthopedic centers, online stores, and from manufacturers of specialized equipment. Every small victory moves the bedridden patient to a new stage of the rehabilitation path, leaving the negative consequences of the disease behind.

Video

Ischemic (coronary) stroke is a pathology that entails not only physical (paralysis, paresis of the limbs), but also psychological consequences (depression, apathy, loss of interest in life, problems with attention and other mental functions). Exercise machines after a stroke are necessary not only to restore the motor functions of the legs and arms, but also to improve the general condition of the patient’s body.

Indications for use

Why do patients who have had a stroke need exercise equipment?

• help improve coordination, develop joints of the upper and lower extremities;
• tone the muscles and prevent them from atrophying;
• “force” the brain to work, actually re-forming lost neuromuscular connections;
• help improve the patient’s general condition (including moral and psychological).

Types of exercise equipment after a stroke

Mechanotherapeutic

These simulators after a stroke to improve the functioning of the “affected” limbs are designed to work out striated muscles. So, there are several varieties of them:

• sitting The main task is to learn to rise from a chair again;
• playground - helps restore walking skills;
• exercise bikes. They work the muscles of the arms and legs; in addition, they have a good effect on the functions of the heart and blood vessels.

Important: there are also devices aimed at actively-passively working exclusively the muscles of the paralyzed limb.

Thanks to them, a bedridden patient can imitate movements with his arms, legs or walking. The list of such exercise equipment after a stroke includes functional beds and exercise bikes.

Devices for joints

Of course, the musculoskeletal system of the human body includes not only muscles, but also the joint and ligamentous apparatus. To restore the functions of the latter, there are also special devices - each of them has its own “specialization”:

• for legs (knee, ankle, hip);
• upper limbs (shoulder, hand, elbow).

Myostimulators

Thanks to electrical impulses of a certain power, such simulators after a stroke “force” the muscles to contract and bring them into “working condition.” Their advantages:

• fight pain syndrome;
• tone not only the superficial, but also the deep muscle layers.

Robotic technology

These are programmed structures that imitate the movements of human limbs. Moreover, each machine “adjusts” to the needs of a particular patient and performs movements with the appropriate amplitude and speed.

Advantages:

• robotics may well replace a physical therapist at home;
• looking at the operation of the machine, a person again learns to walk, move his arms and perform other actions independently (the eyes are the main sensor of the body).

How to restore finger function

Exercise machines after a stroke must be used to improve motor activity of the fingers. Without “healthy” hand functions, a patient who has previously suffered a stroke will not be able to independently care for himself or perform basic manipulations.

The range of such devices includes:

1. retainers. Their task is to hold the fingers, which have been bent as a result of ischemic changes, in an anatomically correct position;
2. designs for developing grasping movements and improving coordination;
3. devices whose work is aimed directly at strengthening muscles, increasing strength and endurance;
4. devices for developing fine motor skills of the fingers.

Exercise machines after stroke: review of the most popular

Shagonog

A walking simulator is designed for bedridden patients who have suffered a stroke. The principle of operation is that it slowly affects the receptors of the lower extremities, forcing the muscles to work in the same way as during full walking. The main task of the device is to prevent atrophy of the leg muscles.

Equipment:

• power unit;
• foot carriage;
• stand.

The simulator is fixed on the patient’s lower limb using 3 fasteners. It is made to order according to individual patient measurements.

Important: in order to minimize the risk of injury as much as possible, during exercise it is necessary to prevent the leg in the simulator from “falling over” to the side. It is better for the patient to be under the supervision of loved ones during this period.

MOTOmed VIVA2

A simulator for working out the muscles of the upper and lower extremities. Thanks to it, people who have suffered a stroke perform passive training, due to the operation of an electric motor (it powers the pedals of the device). It is also suitable for active exercises (in later periods of rehabilitation, when the muscles have already partially recovered and become toned).

At its core, MOTOmed VIVA2 is similar to robotics - the simulator is equipped with a large, convenient display, an electronic control system, and is sensitive to even the slightest muscle spasms. According to rehabilitation doctors, this device is ideal for patients who have suffered a stroke to improve muscle function at home.

Affordable Alternative

Do not forget that in addition to expensive devices, even improvised means can be used to effectively restore the functioning of the limbs. For example, tying shoelaces, grasping small parts with your fingers, and laying out cards are excellent exercises that do not require additional financial costs.

Rehabilitation doctors recommend that stroke patients get a stepper or an exercise bike. These devices allow you to develop knee joints, help get rid of muscle weakness, and have a good effect on the condition of the cardiovascular system. At later stages of rehabilitation, you can train on the wall bars, take dumbbells (with light weight), hoops, jump rope and other well-known sports equipment.

Gymnastic balls help improve muscle tone and coordination of movements. The Rubik's Cube is ideal for developing fine motor skills and developing the upper limbs. Modeling from plasticine also solves the same medical problems.

The special post-stroke simulator “Bud” is popular among rehabilitation specialists - it is individually programmed, adjusted to each patient, and allows you to effectively develop the hands, individual fingers, and joints of the upper extremities. Thanks to this device, according to reviews from patients and doctors, already from 2-4 weeks of rehabilitation, lost sensitivity returns to the fingers, they become more mobile and dexterous.

Important: during the recovery period, do not forget about therapeutic massage - it can be hardware or manual (in this case, the procedure should only be performed by an experienced doctor).

Features of rehabilitation training

The duration of classes, the set of exercises, and the dynamics of recovery should be monitored by a specialist. The organization of the training process after a stroke is influenced by the following factors:

• the extent to which the hemorrhage affected brain functions;
• characteristics of the body, the health of a particular patient;
• effectiveness of medication and physiotherapeutic treatment.

For almost all patients, the first six months after a stroke are the most difficult. If the patient does not fall into a coma, then on the third day after the incident you can already perform simple breathing exercises (to avoid congestion in the lungs). Approximately on the 5th day, they begin simple gymnastics, which is supplemented with effective physiotherapeutic procedures:

• oxygen baths;
• massage;
• myostimulation;
• acupuncture, etc.

It happens that after a stroke (depending on how severely the brain cells were damaged), patients literally have to relearn how to walk, talk and perform normal everyday activities. In addition to traditional drug treatment and physiotherapy, the rehabilitation course involves performing special gymnastics (physical therapy) and working on exercise machines. In the situation with the latter, if you have the funds, you can acquire expensive multifunctional devices that imitate finger movements, walking, develop joints and solve a lot of other useful problems.

Alternative and no less effective may be more accessible equipment and methods - gymnastic sticks, balls, horizontal bars, plasticine modeling, etc. Even basic exercises performed in the “lying”, “sitting”, “standing” position in combination with massage , demonstrate excellent results in the later stages of rehabilitation.

Only an integrated approach to solving the problem of quick and successful recovery after a stroke will lead to the desired goal - a healthy, fulfilling life.

In a narrow sense, a rehabilitation simulator is a device for passive or active performance of special exercises that provide stress to the muscles, joints and skeletal system of the body, i.e. This is a training device.

When are rehabilitation simulators used?

Rehabilitation simulators are used:

To restore the functions of the musculoskeletal system after injuries and diseases
- for the rehabilitation of a patient after myocardial infarction
- to restore lost muscle tone
- to improve joint mobility
- for the prevention of pathologies of the respiratory system and cardiovascular diseases if a person is bedridden

How does a rehabilitation simulator work?

The principle of operation of a particular model of a simulator is determined, of course, by its design, but any rehabilitation simulator accurately follows the natural trajectory of a joint, does not create dangerous loads on the spine, and has a precise system for adjusting the intensity and level of load.

Even if the training on the simulator is passive (i.e. the patient himself does not make any effort), the body is forced to include the muscular corset and ligaments in the work. As a result, blood circulation and tissue nutrition improves, muscle tone increases, which, in turn, better maintain the skeletal system.

Types of rehabilitation simulators

The state standard of the Russian Federation divides rehabilitation simulators into 4 groups.

Exercise machines and vibration chairs for rehabilitation of spinal functions and strengthening the body as a whole using massage, stretching, dosed load on the body and thermotherapy. They are used for diseases of the intervertebral discs, contractures and other joint deformities, as well as for passive standing sessions to improve the functioning of all body systems. Rehabilitation simulators of this type include vibrating massage chairs, verticalizers and parapodiums of all types, and wall bars.

Examples of exercise equipment for the spine and general strengthening effect (restoring the normal functioning of the respiratory, digestive, urinary, skeletal and other systems of the body due to the vertical position): wall bars, parapodiums, walking machines, verticalizers.

This group of rehabilitation simulators also includes simulators for the restoration and development of basic household skills (opening a lock (chain, latch), fastening a zipper, turning on the light, etc.). They are used mainly during the recovery period after myocardial infarction, as well as to maintain the tone of the muscles of the upper extremities if a person is confined to a wheelchair.

Examples of rehabilitation exercise equipment for the upper limbs: a table for mechanotherapy, a developmental complex “Don”, a panel with pegs, a panel for ergotherapy, an exercise bike with an electric motor and an attachment for hands, a flexion-extension exercise machine, an expander.

They are used during the recovery period after a serious injury to the lower extremities, as well as for preventive purposes after spinal cord injuries, when a person is confined to a wheelchair and restoration of motor function is impossible.

To rehabilitation exercise equipment for legs include all kinds of exercise bikes, treadmills and knee flexion/extension machines. They work both from the patient’s physical effort (if he is able to exert effort) and from an electric drive.

In the latter case, the person remains passive, and the exercise equipment is driven by an electric motor - a training simulation occurs, during which the muscles and joints receive the load necessary to maintain tone and improve blood circulation.

Examples of rehabilitation exercise equipment for legs: simple pedal exerciser, exercise bike with electric motor.

Examples of universal rehabilitation simulators: pedal trainer.

According to the principle of operation, rehabilitation simulators for both adults and children are divided into:

Electromechanical (combination of an electric motor and human effort)
- mechanical (only human efforts)
- automatic (only electric motor without human intervention, passive training)
- semi-automatic (partial human participation)
- hydraulic (hydraulic drive to facilitate movements)
- pneumatic (gas spring to facilitate movements)
- inertial (load elastic elements - springs, harnesses)

The recovery period after a stroke can take many months and even years. But regardless of the degree of neurological deficit, concomitant disorders and how motivated the patient himself is to recover, controlled physical activity is extremely necessary. In specialized rehabilitation centers, exercise therapy and mechanotherapy programs are being developed for patients, which significantly reduce recovery time and have a general health-improving effect. Those used for this make it possible to create loads on those muscle groups that are practically not used during active or passive gymnastics or are not worked well enough to eliminate contractures, prevent muscle atrophy and improve coordination of movements.

Purpose of rehabilitation simulators

To understand the need for simulators in post-stroke rehabilitation, it is enough to consider the most important problems that accompany this period.

Muscle tone disorders. Muscle hypertonicity that develops after a stroke makes it extremely difficult to carry out both passive and active exercises necessary to restore motor activity and coordinate the patient’s movements. With the help of exercise therapy, massage and physiotherapy, it is not always possible to achieve the correct sequence of movements, the desired level of load and other aspects that determine the correct implementation of rehabilitation measures. In addition, the patient is often bothered by pain in the muscles and joints, which can completely exclude the possibility of carrying out exercise therapy with him - he reflexively resists the instructor’s movements in fear of pain. The machines allow you to reduce stress on muscles and joints through additional suspension points and shock-absorbing systems and increase neuromuscular control through biofeedback training. Thanks to this, the degree of pain is significantly reduced and the exercise becomes more comfortable.

Circulatory and trophic disorders. Disturbances of innervation and deficiency of motor activity inevitably lead to a decrease in the supply of nutrients and oxygen to tissues, which leads to negative consequences for tissue metabolism. As a result, stagnant, atrophic, necrotic and other processes may develop, which entail dysfunction of all systems and organs. This further complicates an already difficult situation, and the consequences of a stroke can be accompanied by bedsores, muscle atrophy, intestinal atony, respiratory and heart failure, etc.

Psychological barrier. It is very difficult for a person who has been on bed rest for a long time and has difficulty maintaining balance to overcome himself and try to return to his normal life. The main role in this is played by the psychological barrier: “I won’t be able to”, “It will hurt me”, “I will fall and hurt myself”, etc. In such cases, the patient may experience irrational mistrust even of close people offering their support and accompaniment. It is important for him to feel reliable support for his legs and to be able to independently control the strength of his hand grip, which saves him from falling.

With the help of working on simulators, the listed problems become less acute. The patient is provided with optimal physical activity for his condition and psychological stress is reduced. He is able to independently carry out various actions (for example, hold tightly to the handrail), which relieves him of fear.

Requirements for simulators for rehabilitation

A stroke rehabilitation simulator must meet the following minimum requirements:

• have permits for its use in the field of medical rehabilitation;
• the design of the simulator must be developed in accordance with the requirements for ergonomics and technical aesthetics;
• the technical parameters of the simulator should provide for the possibility of adjusting the height/amplitude/load/frequency and other indicators within the framework of the exercises for which this simulator is designed;
• The base of the simulator must be firmly fixed to the floor/wall/ceiling and not move in any plane while working on it.

Rehabilitation simulators of the Madin Group of Companies

Madin Group of Companies develops exercise equipment for rehabilitation after stroke, which is used to restore and maintain motor abilities, coordination of movements, normalization of muscle tone and other aspects of physical health.

Exercise machine "Balance-Master". This allows you to work out the muscles responsible for the stable position of the lumbar region and the torso as a whole. It provides a training function with biofeedback, which provides the necessary degree of exercise without overexertion. With regular exercises on the “Balance-Master”, a decrease in muscle tone and normalization of muscle reactions are observed. Movements made with the help of the simulator help restore intestinal functions, which in most cases are impaired due to improper innervation and prolonged bed rest. "Balance-Master" also provides physiological stress on the joints, which helps prevent their stiffness and increase the range of motion. Stimulation of blood circulation through active movements improves tissue trophism and prevents osteoporosis. The patient learns to safely transfer the general center of gravity of the body to the paralyzed leg and thus prepares himself for the first step.

Alter Step. This simulator is a rehabilitation complex consisting of stairs and parallel bars. The adjustable position of the simulator allows you to adjust the height of the elements individually, for each patient. An important feature of Alter Step is its motivational ability. It provides a reliable support for your hands when moving, and the steps are equipped with an anti-slip coating, which makes the position of your feet stable. Taken together, this allows one to overcome the psychological barrier that is often found in stroke survivors and those on long-term bed rest. In addition, on this simulator the patient can conduct independent exercises, developing the muscles and joints of the lower and upper extremities and the shoulder girdle. Alter Step can be customized to suit the patient's needs - the steps vary in height up to 15 cm and can be transformed into a platform. The angle of inclination of the handrails changes in accordance with the angle of inclination of the steps, the height and width of the handrails are adjusted individually. A wheelchair ramp makes it easier to use the machine. The patient can independently climb onto the simulator and there, using the handrails, get up from it and start exercising. Using Alter Step, it is convenient to monitor the dynamics of recovery, increase or decrease the level of difficulty of exercises depending on the objective indicators of a given patient. In addition to restoring muscle tone and mobility of the joints of the arms and legs, the exercise machine provides an optimal level of cardio exercise, which generally contributes to the saturation of tissues with oxygen, restores blood circulation and improves overall health indicators.

"Exarta Mini". This simulator is designed for exercise therapy in patients with limited mobility who are unable to independently engage in physical therapy due to contracture of joints and muscles, severe pain, muscle atrophy and other conditions that often accompany the rehabilitation period after a stroke. The main advantage of Exart Mini is the ability to use it in almost any conditions, including restoration at home. The design of the simulator provides for facilitation of active and passive movements of the patient due to additional suspension points. This simultaneously reduces discomfort and pain and reduces the load on underdeveloped muscles and joints, which prevents their injury. Training can be carried out both in two planes (movements left-right, up-down), and in 3D format. In the latter case, a physiological load is provided on the hinge-type joints, the amplitude of movements increases and an additional load is created necessary for progress. Also, exercises in the so-called closed kinematic chains teach the muscles to work cooperatively as they do in life, for example, when standing up and walking.

"Imitron". This simulator is designed for mechanotherapy and performs movements that simulate walking. The “Imitron” design provides for the possibility of exercise even for patients with adynamic lower limbs - the mechanism is driven by moving the levers with the hands (or even one lever with one hand). Thanks to exercises on the simulator, congestive pulmonary and cardiac events are prevented, which is especially important for patients who remain immobile for a long time. Exercising in a vertical position eliminates constipation and also prevents urinary tract infections. By stimulating blood circulation, the risk of developing osteoporosis and trophic disorders is reduced, and passive movements help maintain mobility of the joints of the arms and legs, prevent their contracture and prevent degenerative changes. In addition, the simulator allows you to gently and gradually eliminate already developed joint stiffness, and regular exercises on it have a positive effect on the psycho-emotional state of the patient.

"Equos". This simulator is designed to restore the functions of the vestibular system, develop correct walking skills, improve the ability to maintain a stable body position and to treat other disorders caused by vestibular dysfunction (ataxia). Its feature is biofeedback, which creates an additional channel informing the patient about the position of his body in space. The effectiveness of Equos is based on physiological, non-traumatic stimulation of the vestibular nuclei of the brain. After a 20-minute session with the simulator, the improvement in the ability to maintain body balance lasts for 4–5 hours. After working with Equos, other rehabilitation measures may be carried out, which are difficult or unsafe for a patient who is unable to maintain balance. As a result, a wider range of therapeutic and restorative procedures becomes available to patients with vestibular dysfunction and ataxia. According to studies, 100% of patients who underwent rehabilitation with the help of this simulator significantly improved coordination of movements and the ability to maintain body position, and there was a partial improvement in speech and cognitive abilities.

Rehabilitation glove "Anika". It is designed to improve fine motor skills, one of the key abilities that make self-care possible that are lost, in whole or in part, after a stroke. This is a unique design that uses biofeedback and allows you to adjust the rehabilitation program based on the individual characteristics of the clinical situation and the patient’s objective capabilities.

All simulators developed by the Madin Group of Companies are included in the equipment standards for medical rehabilitation centers and have appropriate documentation allowing their use in rehabilitation departments and specialized institutions.