Exertools, Novato, Calif, has been a manufacturer and distributor of training, conditioning, and rehabilitation equipment since the early 1990s. The company originated the medicine ball rebounding concept, along with other low-tech training devices. Rehab Management spoke with Eric Parsells, president, about functional equipment and the role of PTs. Q: What are some of the changes you have seen in the industry in the past decade? A: First of all, sports medicine really took off, and then the growth of outpatient physical therapy was another big change. Of course, isokinetics gradually became the thing for a long time. And finally, functional equipment became the major trend, and that continues today, along with the rising popularity of aquatics. The real challenge for therapists now is understanding the science of their art well enough that they know when to correctly apply all of the exercise modalities that are available to them, to get the correct effect for the patient. Q: What are your thoughts on functional training equipment and its place in physical therapy? A: In reality, the word functional is a misnomer. If you want to know if someone can walk up and down the stairs, or get in and out of a chair, or raise his arm over his head, you just ask him to do those tasks. It is similar to practicing your basketball game to improve your actual playing. It is not truly functional, but instead you are working on parameters of fitness and motor control. From that, you put those together and have some semblance of function, but not actual function. Our company was originally called Functionally Integrated Technologies, so we were in on it, too. However, with our rebounder, the only task you are working on functionally is somebody being able to throw a ball against a rebounder. Yet physiologically, you are working on overriding the stretch reflex, elongating the muscle. Basically, you are working on a neurological patterning that improves power. To me, that is very different from being a functional exercise or piece of equipment. Q: What are some of the challenges facing physical therapists today? A: I attend a lot of trade shows, and the only one I go to where the number one question is always about reimbursement is the physical therapy show. That is a huge challenge, and will continue to be for some time. And all you have to do is look at recent history. Managed care said, basically, "You have to get people better faster." Which, in a way, is a good thing, because it allows therapists to get people better and not just rely on equipment alone. It makes the PT's job more important. Still, I think it would be great for the industry if there was less coding and more fee-for-service being done. For example, why can't PTs become more like personal trainers, and charge for individual service and by the hour? It is so common now for someone to go to a personal trainer and pay upward of $50 an hour. If PTs would be allowed to do more of that, it would probably create many new opportunities for people in the field to expand their careers, for example. Q: What do you see happening in the future, as far as equipment trends go? A: As I mentioned earlier, the field of aquatics has just really taken off, and I would guess that this would keep getting more and more popular in the coming years, since it has been very effective in treating patients. Also, I know technology is expanding, but I still think low-tech equipment will continue to be effective and popular. ® -Ben Van Houton, Associate Editor
