Jan 29, 2015Research Shows Total Gym® Most Reliable Measure of Post-Rehab Functional Performance
By Dan Cipriani, Ph.D., P.T., manuscript reviewer for the Journal of Athletic Training
Previously, few options existed for rehabilitation and athletic training specialists to precisely measure lower extremity performance in individuals with restricted weight bearing ability. In the past, these specialists had to rely on conducting manual muscle tests, often an inaccurate measure, to determine strength and functional performance in a patient recovering from a lower extremity injury. 
We saw the need for a useful partial weight bearing (PWB) test to track patient progress earlier in the rehabilitation process. In a joint effort between San Diego State University (School of Exercise and Nutritional Sciences) and the University of Toledo (Health Science), we engaged in a study to measure the reliability and validity of the Total Gym® incline trainer as a consistent tool for measuring leg strength. The results of the study were published in the North American Journal of Sports Physical Therapy in May 2009.
Thirty-seven adult patients recovering from an injury and/or surgery to the ankle, knee or hip were studied. They were recruited from orthopaedic surgery and physical therapy clinics in San Diego, Calif. and Toledo, Ohio. All patients were tested using two Total Gym PWB performance tests: 1) the number of one-legged squat repetitions a patient could do in 30 seconds; and 2) the time needed to complete 20 squat repetitions on one leg – all at an incline level that used 55 percent of the individual’s body weight as resistance. Patients also went through timed ascending and descending stair tests, walking speed and single-leg hop tests.
Our research found that measuring leg performance on Total Gym provides meaningful information about the current functional status of a patient earlier in the rehabilitation and recovery process. The Total Gym tests provided reliable data to detect change in patient status, such as functional improvement, or whether a patient exhibited no change or loss of performance.
Additionally, the research found a significant connection between how many repetitions a patient could do on the Total Gym and how fast that patient could walk and climb stairs. After four to six weeks, patients returned for follow-up testing and those who showed improvement in the Total Gym performance tests also showed improvement in their stair climbing ability and walking speed. The correlation between the Total Gym tests and the walking and stair climbing measures were significant.
Total Gym has evolved from solely an exercise apparatus for rehabilitating patients to a measurement tool to provide valid information about a patient’s progress toward full weight bearing function. Our research provides evidence that the partial weight bearing tests on Total Gym were responsive to the positive changes in patients’ progress, making these tests a useful adjunct to measuring patient improvement, particularly in the early stages of rehabilitation. Based on subjective feedback, patients felt they could really give their best effort on the Total Gym because they did not have fear of falling or injury.
To view an abstract of the original research, please visit: http://efisportsmedicine.com/assets/026/31546.pdf.
Dan Cipriani is an associate professor in the Schmid College of Science Department of Physical Therapy at Chapman University. He sits on the International Editorial Review Board for the Journal of Orthopaedic and Sports Physical Therapy and is a manuscript reviewer for the Journal of Athletic Training and the Physical Therapy Journal. Cipriani holds a Ph.D. from the University of Toledo and a B.S. from The Ohio State University.
