ATM2 device (Full Version)

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hmgross -> ATM2 device (May 31, 2005 12:03:00 PM)

Is anyone familiar with this? I got an email from someone at BackProject (www.backproject.com) who will be demonstrating the use of this device at some of the upcoming Mulligan courses. I will not be able to attend but was curious if anyone out there has experience with this particular device. Thanks.



Sebastian Asselbergs -> Re: ATM2 device (June 1, 2005 2:13:00 AM)

ATM2? A newer version of the ATM. IHaving an ATM in the clinic allows the clinic owner to smoothly deplete the bank account of any ATM user - the patient. The newer version is even better - it makes the patient believe that their money is well spent on their health!

Holly, I have no idea, obviously - but I am groggy after a lot of meetings ....



hmgross -> Re: ATM2 device (June 1, 2005 5:24:00 AM)

Hey, that's OK Sebastian! I have been to the Mulligan course and part of the treatment is getting the patient to move in a pain-free motion and it looks like this machine is designed to help support the patient with straps into a painfree weight bearing position so they can get more ROM in the trunk, hip, whatever. If anyone has used this, please let me know. I have a hard time with "mobilization with movement" on larger people and this may help. I don't know. I think they should have called it something other than ATM--- :)



Shill -> Re: ATM2 device (June 1, 2005 8:13:00 AM)

Holly,
I have seen the device on video only, not in person. I have the CD demo they give out, and it is an interesting concept. Of course, with any piece of equipment, cost is an issue. Have you seen any demos videos of how it works? Im sure they wouldnt mind if I sent you one, after all, it would basically be free advertising for them.
Let me know.

Steve
sf.hill@hosp.wisc.edu



hmgross -> Re: ATM2 device (June 1, 2005 9:07:00 AM)

Thanks Steve--I appreciate it!



JLS_PT_OCS -> Re: ATM2 device (June 1, 2005 9:36:00 AM)

I tried it out at CSM.
Seemed like quite a contraption, with straps and all sorts of stuff, designed to "stabilize" certain segments while others moved, especially to get extension motions.
I think Sebastian's summary was appropriate.

I would think some sort of good treatment effect sizes would need to be seen before this is placed in every PT clinic. My usual high amount of skepticism is obviously in effect here... while trying it, my wife was laughing because I rolled my eyes at the well-meaning instructor who was strapping me in, as he detailed it's miraculous wonders and healing powers.

Seems yet another overpriced overhyped device to me.
But I did get to sign up for a free ipod if I tried it...so there you go.
J



hmgross -> Re: ATM2 device (June 1, 2005 10:24:00 AM)

I know, I'm not for gadgets, but there is one technique I use for people that helps with mid-thoracic pain, involves a bit of a bear hug and lift from behind while the person actively rotates (a Mulligan mobe with movement type of thing), and I just can't do that on some people. I am on a limited budget and like to really research things before I buy. I spent a fair amt of $$ on my Nustep crosstrainer (recumbent stepper) but I use it alot so it has been worth it (my e-stim/US machine on the other hand...)



srcase -> Re: ATM2 device (June 1, 2005 1:32:00 PM)

Holly,
There are many other ways to mobilize the thoracic, or better yet have the patient self-mobilize (foam roll or mobilization wedge under the patient). I know it's difficult being a "smaller" therapist. :) If you were going to invest in one piece of equipment to increase mobility in larger people or geriatric clients, I would recommend Gary Gray's True Stretch because it allow the person to stay upright and move in triplanar dynamic stretches, giving lots of good proprioceptive input because they are standing up against gravity but also supported where needed. Just my 2 cents!
Sarah



wesselpt2 -> Re: ATM2 device (June 8, 2005 11:02:00 AM)

Back to the topic at hand. We have an ATM2 in our facility and is used regularly for the spinal stab individuals. At first I was reluctant to attach folks into the device but now have come to appreciate it. The concept is neuromuscular re-education in the weight bearing position. Using flexion, extension or rotation, patients move first through painfree range then isometrically hold in mid range, against resistance, thereby facilitating the stabilizing system. It's the hold time that is the main event for re-education. Commonly I perform Mulligan techniques prior to administration of the ATM. Key point: patients must be relatively in control of their symptoms and not acute, in my experience with the ATM. Draw back: time consumming (takes 20 minutes for a treatment) and must be operated by a technician. I see primarily spines and in my opinion is worth the investment. As a manual therapist I find it an excellent adjunct. But you must have the case load I suppose.



hmgross -> Re: ATM2 device (June 8, 2005 11:15:00 AM)

Thanks wesselpt2- I would like to hear more from others who attend the Mulligan courses where the ATM2 will be demonstrated. It helps to get people's experiences and opinions, especially since my budget (and space) is limited.



Shill -> Re: ATM2 device (June 9, 2005 3:16:00 AM)

Wesselpt2,
After using this, does the patient need to remember exactly how he or she moved during the painfree movemement on the ATM2, and then try to move this way during daily activities? How does it carry over?

Thanks,
Steve



Randy Dixon -> Re: ATM2 device (June 9, 2005 6:22:00 AM)

I haven't actually seen one used but I would be interested in what the theory behind it's use is. It looks like it is based on a structuralists theory. For the LB it seems that it's main purpose is to position and stabilize the pelvis, which makes me wonder what that tells us about other treatments to stabilize and position the pelvis.

Isn't it's basic mechanism that of positioning in an "anatomically correct" position with the belief that if the body moves in that position it will "neurologically reset" to that?



hmgross -> Re: ATM2 device (June 9, 2005 10:45:00 AM)

Randy, that was my understanding, much like the Mulligan techniques. It is not something that usually needs to be repeated after the motion is restored. However, I saw "home units" advertised on the BackProject web site, so I am not sure.



wesselpt2 -> Re: ATM2 device (July 2, 2005 8:19:00 PM)

Shill,
The patient does not need to consciously remember or dublicate the movement of the ATM device. The benefit is received automatically during the resisted hold time due to the facilitation of the stabilizing system. The theory is similiar to the PNF concepts that re-education takes place inherently within the body when it is capable of the moving properly. Of course this implies that a structural defect has been corrected either at the time of ATM application due to positioning or prior to. The carry over is in the nervous system as the phasic muscles shift into tonic capability. It seems, though, that this process has to be repeated throughout treatment in order to see structural change. I think it works well for facet syndrome type pain but have not had great success with spondylogenic or radicular type pain. Hope this helps. ----Brian Wessel, MPT, OCS



goodlooks58 -> Re: ATM2 device (July 4, 2005 10:38:00 PM)

Can't the PT do the same what the ATM-2 does manually? i.e. put the pt in a pain-free position and have the pt hold him/herself isometrically with/wihout eyes closed? just a thought...



Randy Dixon -> Re: ATM2 device (July 5, 2005 9:11:00 AM)

They could probably rig something pretty easily if they understood what was being done. I thought about using a standing table and some straps to try it out. But then again if you find that you like it, it is probably worth getting the machine rather than constantly trying to improvise.

I think that if the principles of it hold true, then that does offer some interesting treatment possibilities beyond what the machine does.



Shill -> Re: ATM2 device (July 6, 2005 3:46:00 AM)

Brian,
Thanks, that does help.
What structural defects are you correcting prior to treatment on the ATM? (typically). I assume through manual techniques, but just thought I would ask.
Thanks again,
Steve Hill PT



dosrinc -> Re: ATM2 device (July 7, 2005 10:26:00 AM)

Anybody have a cost estimate, i have seen it in use at conferences and always thought you could duplicate the same with some foam blocks and a gait belt.
Rick



JLS_PT_OCS -> Re: ATM2 device (July 8, 2005 3:34:00 AM)

Rick, I think you just summarized the whole thing right there...
j



srcase -> Re: ATM2 device (July 9, 2005 2:18:00 PM)

I think it's interesting that Brian Mulligan states that he doesn't really know how it works, but it does....Hmmmm. I think it would be a costly piece of equipment to buy just for those few patients that are too "large" to perform Mulligan's on. I find most of the Mulligan techniques too physically awkward and difficult for me to put into daily practice anyway. But that's just my opinion of course.
Sarah



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