Catherine M. Horst, PT, Cert. MDT
Physical therapy clinicians are routinely presented with the challenge of how to provide the necessary external forces during patient self-treatment to achieve effective end range exercises. Over the years, we’ve used sheets, belts, ironing boards, posts, and countertops. Clients need to get to end range for effective reduction of their derangement and to return to function. As the McKenzie Institute’s Dana Greene explains it, “End range is where the magic happens!”
The Oakford Group has designed a patient self-treatment tool that, under complete control of the patient, provides the extra overpressure sometimes required for full reduction. The Invertabelt provides a simple solution for patients who need progression of forces to achieve end range. With a physical therapist’s instruction, the client can easily control tension on the belt, making their directional exercise more effective.
For example, during extension in standing exercises, it can be difficult to achieve end range due the need to maintain balance while extending the hips and spine as the center of mass shifts over the base of support. Furthermore, many patients don’t have the mobility in their upper extremities necessary to position their hands at the lumbosacral spine to elicit optimal overpressure.
With the Invertabelt, the client stands on the vertical strap attached to a band around the waist. While the hips and lumbar spine extend and progress forward, the tension on the belt provides a gentle but effective force both caudally and anteriorly at the desired level, while the segments above the belt extend posteriorly during movement. Using the Invertabelt, the movement feels more effective, and end range is easier to achieve than with other strategies such as pulling on a sheet, belt, or pole across the lumbar spine. Many patients have difficulty grasping a sheet strong enough to provide the necessary force, and the pole is just uncomfortable on the back.
Also in standing, when a relevant lateral component requires repeated sideglide in standing, I’ve instructed patients to strap themselves to a pole and push themselves away, or to use the wall and shove their hips as far as they can toward the wall. Without any wall or pole, the Invertablelt, when positioned at the opposite hip, can provide a lateral and caudal force during sideglide, making this exercise more effective as well.
Finally, adding overpressure in repeated extension in lying is also easily achieved with the Invertabelt by placing the toes in the foot strap and plantar flexing the ankle to adjust the tension, thus adjusting the overpressure and traction force applied to the lumbar spine. In prone lying or prone on elbows, simply plantar flexing the ankle intermittently may provide the client relief in the way of a gentle self-traction force.
In our profession, we eagerly seek new strategies to empower our patients and help them achieve autonomy for managing their own symptoms. The Invertabelt is a creative tool we can recommend our clients use to complement the skilled interventions we provide and even facilitate effectiveness and compliance with our directional treatments.
Heather Roeder, MPT
"This is a great device to capture overpressure and stabilization at individual spinal levels for patients with a variety of complicated diagnosis of "Low Back Pain." This little tool allows patients to stabilize spinal segments, correct postural alignments and stretch muscle imbalances. As a therapist, treating low back pain on a daily basis, I strongly recommend this product for patients to continue with their necessary daily exercises for optimal results."
Melissa White PT, MPT, PRPC
"5 out of 5 Stars!! I am a pelvic floor physical therapist and with my patients there is many times a lumbar or thoracic component involved. The invertabelt has been an excellent adjunct to my treatment program for this reason. There is often a need to mobilize the spine secondary to the nerve involvement from the thoracic, lumbar, and sacral segments that innervate the bowel and bladder. This has been a great product for my patients to take this important treatment approach into their own home. The invertabelt is so nice because it offers many other treatment strategies that can be utilized with one small handy piece of equipment. My patients love to use this product for strengthening exercises as well. It has great a great asset to my practice and can add great value to anyone suffering from low back pain!"
Dan Barclay DPT