Passive/Active Exercise

By Errol Gray

Passive/active exercise is becoming widely accepted as a means of providing range of motion and overall movement for those whose ability to walk has been chronically compromised.

Active exercise occurs when nerve impulses cause individual muscle cells to contract against a load. Such exercise will maintain and even increase the strength of available muscles, with profound implications for quality of life and independence.

Passive exercise occurs when a motorized device, or manual manipulation, provides movement to the limbs and trunk. Such daily motion has proved extremely beneficial for retaining flexibility in muscles, joints and tendons, and for stimulating bowel and bladder control. The advantage of using a motorized device is that the amount of exercise each day is at the pleasure of the user.

When muscle power in the legs is limited as in, for example, people recovering from stroke, the reduced ability to walk often results in inadequate stretching of the achilles tendon, causing foot drop -- which in turn further reduces the ability to walk or manoeuvre without the use of an ankle brace. Passive exercise provided by the Ex N’ Flex 250 has proved to be extremely useful in correcting this condition. When used in the reverse direction, the achilles tendons in both legs are subject to rhythmic stretching, which can be exaggerated if some muscle power is available. In many cases this has resulted in a reduction of foot drop and an improved ability to walk.

Passive exercise also provides a patterned input from the limbs back towards the brain. Repatterning is important when there is excessive tone in a particular muscle grouping which causes, for example, a foot to turn inwards or outwards, making it difficult to place on a foot rest. Patterned movement with the foot held in its correct position may help restore the foot to its correct position.

Marlene Allan, a physiotherapist at Hillside Manor, Oshawa, wrote that a woman 22 years post stroke presented such increased tone in her left arm and leg that she could not sit in a wheelchair for independent mobility. After a few weeks of using the Ex N’ Flex EF 250 Leg Exerciser, her tone was reduced to the point where she could sit comfortably and safely on a wheelchair, and lift her foot off the floor and onto the foot rest. A similar reduction in tone has been achieved for her arm by using the Ex N’ Flex EF 100 Arm, Trunk and Shoulder Exerciser. She no longer needs extra fastening straps to secure her arm to the arm cradle or position her trunk.

Many of our nursing home clients report that regular use of the Ex N’ Flex has a calming effect on people with Alzheimer’s, and enables people with Parkinson’s disease to walk with an improved gait. In a recent letter from East Dennis, Massachussetts, Jeff Woodburn describes some of the remarkable things happening to his father, who has both Parkinson’s and Alzheimer’s. For the past year, he had been unable to walk unless assisted by two aides. After seven days on the Ex N’ Flex, he was able to regain sufficient flexibility and muscle strength to walk on his own. If he shows any signs of agitation, he will go on the machine and immediately calm down. He is now able to go home on day trips and enjoy walking around his own yard with minimal assistance.

The combination of active and passive exercise in one machine, along with the ability to flip easily back and forth between the two modes, provides an extremely useful device for people with long-term disabilities. Passive exercise overcomes the problems of immobility by providing as much rhythmic, patterned movement to the limbs as desired, while the active mode maintains and increases any available muscle power. Rediscover the pleasure of movement!

(Dr. R. Errol Gray is President of Tecogics Scientific Ltd.)