The Clinical Advantage CATALOG 54 LEADER IN NEUROMUSCULAR EVALUATION & THERAPEUTIC EXERCISE DISTINGUISH YOURSELF

Transcription

1 The Clinical Advantage CATALOG Edition BIODEX LEADER IN NEUROMUSCULAR EVALUATION & THERAPEUTIC EXERCISE DISTINGUISH YOURSELF SPORTS MEDICINE ORTHOPEDIC OLDER ADULT NEUROREHAbILITATION WELLNESS INJURY PREVENTION MEDICAL FITNESS CARDIOPULMONARY REHAbILITATION NEUROMUSCULAR RESEARCH I S O : I S O : C E R T I F I E D BIODEX Int l

2 Increase efficiency and productivity through use of automated G-code and Impairment Level Reporting Improve documentation of rehab effectiveness Objective measures manage patients efficiently and effectively Enhances objectivity, repeatability and reliability of functional limitation reporting Justifies clinical decision making Balance System and BioSway Sample CTSIB Report with G-Code Gait Trainer 3 Sample Training Exercise Summary Report with G-Code For Full Size Sample Reports Enhanced reporting includes: Impairment percent with associated modifier code Functional Limitation G-Code categories Patient status: (current and discharge) BIODEX Int l

3 what S NEw Software Enhancements for Balance System SD, BioSway and Gait Trainer 3 (see product pages for updates specific to each device) Automated G-code Calculation and Impairment Level Reporting Important for Medicare reimbursement and fostering continuity of care. Enhanced Sensory Integration Balance Testing Capabilities Including ability to perform Balance Error Scoring System (BESS) test of postural stability and create Custom Testing protocols for CTSIB and BESS tests. Enhanced Normative Data Increased normative databases targeting athletic and older adult populations for a leading edge with Balance Assessment for Concussion Management and Fall Risk Screening and Conditioning programs. Patient Data Collection Software Utility Easily export patient data as a.csv file and import into Excel for statistical analysis to create custom normative data. elearning In an effort to improve product utilization and advance clinical value, Biodex provides a series of elearning tutorials. We offer the following courses in the Biodex elearning Center: Alternative positioning for Selected Exercises in the System 3 and System 4 Balance SD BioSway FreeStep SAS Gait Trainer 3 Unweighing System Using Balance Measurements in Concussion Management Enhanced Marketing Support to build Concussion Program For those seeking to offer a best practices concussion management program, Biodex offers the Balance Assessment solution along with the marketing support to help attract athletes, parents, community sports teams, school coaches and athletic directors, as well as referring pediatricians. This service is offered exclusively to owners of the Balance System SD and BioSway. See pages for details Biodex has recently introduced our new Floor Planner, a click-and-drag program that enables you to layout Biodex Physical Medicine products to your exact room specifications. It s easy to use and great for planning! Create an account to save your drawings for future reference or to communicate with a Biodex representative at the time of purchase. Another value added service from Biodex FACILITY LETTERHEAD MARKETING SUPPORT SAMPLE LETTER TO: Local Physicians / Pediatricians Remove the guesswork enroll your patient in a Biodex Concussion Management Program Dear Give parents added assurance when managing a child s concussion! In addition to a medical diagnosis, [Facility Name Here] is excited to extend the resources of our new Concussion Management Program to support and manage head injuries in conjunction with your office protocols. [Facility Name Here] now offers a Biodex Concussion Management Program and we would like the opportunity to enroll your patients with a simple baseline test of balance and cognitive assessment. In the event of an injury, patients are retested and compared to baseline as well as compared to age- and gender-specific normative data. All data is stored per athlete with the ability to generate HIPAAcompliant reporting. The test takes only minutes but will provide valuable information in the event a patient sustains a concussion. High school athletes engaged in contact sports are experiencing concussions at an alarming rate. The Centers for Disease Control (CDC) estimate up to 3 million sports-related concussions are happening in the U.S. with school-aged children making up the majority of these cases. The rate of reoccurrence is just as concerning. When a concussion protocol is followed, kids usually recover within a week or two. Without a protocol, the risks can be great, including reoccurrence and possible lasting effects. Each concussion is different, so too is each patient s recovery. Having objective-baseline and data-driven support is essential for those difficult return-to-play decisions. We ask that when considering a Concussion Management Program for your patient athletes, you consider [Facility Name Here]. We invite you to visit our facility and understand the benefits of the program first hand. Please call to schedule an evaluation. MARKETING SUGGESTION >> offer FREE vouchers for baseline testing to the patients of local pediatricians, allowing them to distribute to thei r patients. It makes them look good, gives patients something tangible and valuable, builds an athlete base in your practice. Sincerely, P.S. - The Biodex Concussion Management Program is used by local and professional sports teams throughout the U.S. Concussion Management Program Marketing Support quick index System Balance System SD NEW Automated G-Code Calculations Fall Risk Screening and Conditioning Program Balance Assessment for Concussion Management Balance and Mobility Solutions Practical Applications BioSway NEW Automated G-Code Calculations BioStep 2 Semi-Recumbent Elliptical Upper Body Cycle RTM600 Rehabilitation Treadmill Gait Trainer NEW Automated G-Code Calculations Unweighing System Complimentary Clinical Guidelines for BWSTT Harnesses for Unweighing and FreeStep SAS...31 FreeStep SAS Supported Ambulation System BIODEX Biodex Medical Systems, Inc. 20 Ramsey Road, Shirley, New York, Tel: (Int l ), Fax: info@biodex.com,

4 4 Biodex System 4

5 The most popular and advanced dynamometer in the world. More than 25 years have passed since Biodex introduced the world s first multi-mode computerized robotic dynamometer. That event and subsequent firsts have made the Biodex dynamometer the choice of the most distinguished clinics and research facilities around the world. Sports and orthopedic medicine, pediatric medicine, neurorehabilitation, older adult medicine, industrial medicine, and researchers depend on Biodex to provide consistent, accurate objective data. Objective data that provides the best outcome for their patients... objective data that supports their research... objective data that separates their facility from the rest. Our 200 employees strive to keep Biodex at the forefront of innovation, effectiveness, efficiency and reliability. That s why so many world class facilities depend on Biodex. If you appreciate the benefits of the System 3, the System 4 offers so much more: Advanced dynamometer technology for greater performance Seat design accommodates athlete to pediatric applications Software interface, no other system is faster or easier to use Software features include: - End by % of fatigue - in Biofeedback, an exercise bout can be completed when the work for a repetition has dropped below a threshold (such as percentage of work) - Rehabilitation Progress Report that plots strength, pain, ROM and other defined measurements...and much more Touch-screen see it, select it, adjust it - it s that simple Simplified patient positioning with on-screen audio and visual aids Requires 64 sq-ft of operating space Activity-specific Work Simulation Exercises Wide Range of Normative Data Excellent after-sale support, installation and continuing education programs S4 the only choice for those who know the difference

6 Biodex System 4 ADVANCED TECHNOLOGY At Biodex we believe that true innovation in patient care starts with you, the clinician. Historically, rehabilitation professionals have viewed our clinically-driven products as technological extensions of their hands and as advancements that increased their clinical performance and improved their patients outcomes. These innovations represent a unique place in physical rehabilitation where art and science meet to inspire technology. Consider an isokinetic exercise mode that allows the limb to accelerate to a fixed speed without impact and decelerate into an electronic cushioned stop for the safest and most efficient form of exercise. Consider a CPM exercise mode that allows the patient to comfortably exert forces but not exceed specified limits, permitting the earliest possible post-operative intervention to decrease joint effusion, increase range of motion and develop strength. Consider an isotonic mode that provides resistance at a constant force while allowing velocity to vary, a mode that safely mimics functional activities while providing patients with quantitative biofeedback. Consider an isometric exercise mode for safe base line strength testing before and after surgery. Now consider our latest development: THE BIODEX SYSTEM 4, a rehabilitation tool with the simple ability to evolve both intuitively and intelligently to meet the ever-changing requirements of your patients. And your practice. From acute care, to advanced rehabilitation therapy and testing, Biodex keeps you, the clinician, in complete control. ADVANTAGE SOFTWARE 4.0 MORE RESPONSIVE, EASIER TO USE AND FASTER TO SETUP Advantage Software 4.0 is the most comprehensive, easy-to-use, featurerich software that has ever been released for human performance testing and rehabilitation. Motivate patients with on-screen charts and graphics that track performance and encourage compliance. Powerful curve analysis allows you to conduct even more complex neuromuscular evaluations. Every step of the rehabilitation plan is captured and documented. System 4 makes a point of being easy to use for all skill levels, bringing the clinical advantages of this technology to every application. Moving from treatment to analysis to report generation is just a click away. Only Advantage Software 4.0 features the Rehabilitation Progress Report. This onscreen chart and printable report tracks Pain, Range of Motion and Strength throughout the rehabilitation protocol. The Clinical Advantage BIODEX VERSATILITY AND MARKETABILITY SpoRTS/oRThopEDIc MEDIcINE Whether your orthopedic and Sports Medicine practice is allowed only limited visits or you have the luxury of managing a complete recovery, Biodex is the tool that adapts to every environment. Evidence-based clinical protocols combine science with practical application to ensure that you provide the best outcomes. Shoulder Dysfunction Knee Osteoarthritis Lateral Ankle Sprains Patellofemoral Dysfunction Anterior Cruciate Ligament Other capabilities include pre-season screening, injury prevention and athletic performance enhancement. Note: Additional Biodex based sports medicine protocols are available at 6 pediatric MEDIcINE Biodex Multi-Joint Systems have been used to test and treat children worldwide. Isokinetic muscle testing helps clinicians by providing objective data for neuromuscular control and strength. Pediatric attachments and age-based normative data are available. NEuRoREhABILITATIoN The Biodex program for neurorehabilitation helps patients build strength, endurance and coordination. Spasticity management includes objective quantification at specific contraction velocities. The passive mode is used for repetitive exercise. The eccentric mode is especially useful for controlled strengthening.

7 ...Multiple Applications and Pathologies with a Single Investment. AN INTEGRATED SYSTEM TO MAKE SET UP FASTER AND EASIER The expanded array of on-demand audio and visual aids, color-coded setup icons and full color positioning posters make setup simple. Patterns and positions possible with the System 4 are virtually unlimited. SYSTEM 4 PRO FULLY ACCOMMODATES A WIDE VARIETY OF POSITIONS AND EXERCISES The Biodex System 4 Pro fully accommodates a wide variety of positions and exercises. It features a positioning chair with 360 degrees of rotation, motorized seat height adjustment and superior stabilization. Biodex System 4 Pro requires 64 sq-ft of operating space. Attachments are provided for the ankle, knee, shoulder, elbow, wrist and hip. A linear Closed-Chain Attachment, Back Extension Flexion Attachment, and an array of Work Simulation Attachments are available options. SYSTEM 4 QUICK-SET DESIGNED FOR KNEE, ANKLE, SHOULDER, ELBOW & WRIST Set the Range of Motion - need help? Simply refer to the on-demand audio and visual aids. If space and budget are primary concerns, the Biodex System 4 Quick-Set is what you need. This system requires only 32-square feet of operating space yet still ensures maximum patient stabilization. It features a fixed-height positioning chair with 360-degree rotation and front/back travel for easy patient setups. Attachments are provided for the ankle, knee, shoulder, elbow and wrist. A optional, linear Closed-Chain Attachment is also available. Visit our website to view product video INDuSTRIAL MEDIcINE older ADuLT RESEARch The Biodex Multi-Joint System has been used in over 1,000 published studies. Unique capabilities include: Analog Signal Access Interface This optional feature provides real time analog voltage representations of torque, position and velocity from the dynamometer. Customized Motor Control The "Researcher s Tool Kit" provides the advanced investigator direct access to the embedded dynamometer system not otherwise available via the application software. The core of the Tool Kit is an extension to the System 4 firmware that exposes the motor controls to an external interface designed by the researcher. By employing the optional Work Simulation Tools and Back Attachments, the System 4 can perform: Activity-specific assessment and rehabilitation capability Functional capacity evaluation Work hardening VISIT OR CALL FOR BROCHURE AND PRICE LIST. Biodex Fall Risk Programs have been employed by leading clinics for over ten years. They are the only fall programs that incorporates a complete array of objective tests. Isokinetic testing will identify weakness; exercise will improve ankle and leg strength. Curve Analysis allows the user to conduct complete neuromuscular evaluation. Note: Learn more about the Researcher s Tool Kit and the Analog Signal Access Interface at To order, call Biodex toll free Int'l

8 Balance System SD Now with AUTOMATED G-Code CALCULATIONS Meeting multiple clinical needs with a single tool. SIx Featuring both Static and Dynamic capabilities POSTURAL STABILITY TRAINING Emphasize specific movement patterns or strategies by placing markers anywhere on the screen. Score reflects how many times a target is hit. MAzE CONTROL TRAINING This defined movement pattern encourages proprioception and motor control. Various skill levels challenge a wide variety of patients. LIMITS OF STABILITY TRAINING Challenges the patient s balance within their sway envelope. Progressively increase sway envelope over time. Helps identify functional limitations or weaknesses within a defined sway envelope. RANDOM CONTROL TRAINING Introduces a cognitive component to balance training. An undefined movement pattern where the patient is challenged to keep pace with a moving target. Target size and movement speed can be varied to match skill level. Ideal for motor control and vestibular training. WEIGHT SHIFT TRAINING - Patients are challenged to shift and control their center of gravity within two parallel lines, in the medial lateral, anterior posterior and transverse planes of movement. Changing the width of the lines controls the degree of difficulty. Score is kept to track progress. PERCENT WEIGHT-BEARING TRAINING Target zones change color when within % weight bearing targets. Helps train proper posture. INTERACTIVE CATCH GAME FOR BALANCE TRAINING The CATCH game offers various progressive skill levels to promote interaction and help Color printer included keep patients engaged. CATCH also offers the ability to create a custom protocol geared toward specific training activities. THERE IS A DIFFERENCE THE BIODEx ADVANTAGE. The only static and dynamic system that provides fast and accurate Fall Risk Assessment and Conditioning for older adults; plus closed-chain weight-bearing assessment and training for lower extremity patients. 8

9 Static and Dynamic Balance Testing and Training FEATuRES: Static and Dynamic (SD) Offers twelve levels of platform control as well as static force setting allows testing, training and rehabilitation programs for diverse populations. Balance Training Includes proprioception and stabilization exercise, range of motion and weight shift exercises. Objective Documentation Printed color reports prove need, track progress and document outcomes ideal for insurance reimbursement. NEW Automated G-code Calculations and Impairment Level Reports Increases efficiency and productivity, improves documentation of rehab effectiveness fostering continuity of care, helps with audits, efficiencies and reduces claims denial. NEW Enhanced Sensory Integration Balance Testing Capabilities Ability to perform a modified version of a Balance Error Scoring System (BESS) test of postural stability, popular for concussion management. Modify existing or create custom protocols for both the CTSIB and BESS tests. Custom Reporting Allows entry of unique comments to test results and assignment of CPT codes. Six Training Modes and Five Testing Protocols Standardized testing for true progress assessment. Standardized Fall Screening and Athlete Knee Injury Screening Tests Simple, quick and accurate. Test results are compared to age-based normative data to help identify fall candidates and athletes predisposed to knee injury. NEW Normative Databases New healthy populations stored for test comparison of older adults for fall screening and student athletes for concussion management. Audio Biofeedback Used for cueing successful target hits. Visual Biofeedback Prompts patients into proper postural and balance control. Large Display Features 12.1" touch-screen display, powered by a Windows CE operating system. Multipurpose Connectivity Allows connection to larger monitors and LCD projectors to enhance interaction for visually impaired patients. Adjustable Support Handles Lock in place for safety or swing away for an unobstructed, open environment for a variety of training activities. Locking Surface Ensures safe "on and off" patient movement. Mobility Transport wheels allow easy relocation between clinic and community for fall screening programs and health fairs. USB Compatibility Accommodates external keyboard, a mouse, printing devices for remote operation and USB memory devices for data transfer and software upgrades. For sample reports, CPT codes, testimonials, applications, bibliographies and warranty information, click in at Video and Audio Out Bolsters connectivity options to other devices. NEW Patient Data Collection Software Utility (complimentary download) Facilitates download and transfer of patient data allowing for unlimited storage capacity, reporting or exporting as a.csv file and import into Excel to run statistical analysis for normative data generation. The most popular Balance System now even better The Biodex Balance System SD has been designed to meet the needs of everyone looking to improve balance, increase agility, develop muscle tone and treat a wide variety of pathologies. Featuring easy-to-follow touchscreen operation, the Balance System SD is simple to learn and operate, leading the user step-bystep through testing protocols and training modes in both static and dynamic formats. Extremely versatile, it is the only system that provides fast, accurate Fall Risk Screening and Conditioning for older adults; closed-chain, weight-bearing assessment and training for lower extremity patients; and adds the objective balance assessment component to a concussion management program. The Balance System SD also serves as a valuable training device to enhance kinesthetic abilities that may provide some degree of compensation for impaired proprioceptive reflex mechanisms following injury. Using this unique device, clinicians can assess neuromuscular control by quantifying the ability to maintain dynamic bilateral and unilateral postural stability on a static or unstable surface. FIvE STANDARDIZED TESTING ENvIRONMENTS 1. Fall Risk Screening 2. Athletic Single-Leg Injury Screening 3. Dynamic or Static Limits of Stability 4. Postural Stability 5. Clinical Test of Sensory Integration of Balance (CTSIB) STANDARDIZED FALL RISK SCREENING TEST PROTOCOL Biodex Balance System can identify a potential problem in just two minutes. Compares balance test results to agedependent normative data. Fall Risk Assessment Protocol is consistent with American Geriatrics Guidelines. ICD-9 Code V15.88 Personal History of Fall includes patients identified as at risk of falling. AThLETE KNEE INjuRy SCREENING TEST PROTOCOL Consistent with leading sports medicine programs including Cincinnati Sports Medicine, Cincinnati Children s Hospital and University of Pittsburgh. CONCuSSION MANAGEMENT PROTOCOL Preseason baseline testing and post injury return to play management using The Clinical Test of Sensory Integration of Balance (CTSIB). CTSIB Utility Software available for download, see page 11. Prove Need. Progress. Outcome All test results and training sessions can be stored and printed. Comparison to normative data helps communicate need, progress and outcome. To order, call Biodex toll free Int'l

10 Balance System SD 12.1" High resolution color touch-screen LCD display Supports USB keyboard in all screens for entering text and numerics. Adjustable support handles Auxiliary Serial and USB Printer Ports Adjustable height display to accommodate each patient Color printer with stand - included Utilizing the CTSIB capabilities clinicians can test patients and compare results to normative data and automatically calculate G-codes and impairment modifiers. For a detailed view of the CTSIB report visit us on the web at Features both static and dynamic balance capabilities Locking surface ensures safe on-off patient movement Transport wheels allow easy relocation Ethernet connection accommodates wired and wireless printing. Progress reports document change over time and outcomes. All test results and training sessions are output on easy-to-read 8.5" x 11" reports which can be placed into the patient s file. Visit our website to view product video Safety Step Stool (optional) the non-slip surface assures stability and patient safety. CTSIB Indexed Pad (included) standardizes foot positioning for improved consistency and result comparisons. CTSIB SCREEN: The CTSIB test helps determine which sensory system (visual, somatosensory, or vestibular) the patient relies on to maintain balance. NEW Automated G-Code Calculation and Impairment Level Reporting Enhanced objective reporting produced by the Biodex Balance System SD documents impairment percent with associated modifier code, functional limitation G-code categories, and patient status (current and discharge) - important for Medicare reimbursement and fostering continuity of care. The automated data increases efficiency and productivity by allowing more time with patients and less time processing paperwork. In addition, it improves documentation of rehab effectiveness, helps with audits, and reduces claims denial. 10

11 ...Multiple Applications and Pathologies with a Single Investment. Broaden Your Applications Increase Your Clinical Value. FALL RISK SCREENING AND CONDITIONING With the Balance System SD, Biodex includes a comprehensive Fall Risk Screening and Conditioning Program and Protocol to help the clinician begin a Fall Program. This is an excellent tool in the growing field of Fall Risk. The Biodex Fall Risk Screening & Conditioning Program includes the marketing support to assist with community outreach at senior centers and other events to build awareness and expand patient base. SENIOR REhAB The Balance System SD is part of the Balance & Mobility product series for addressing age-related diseases. Tackling the needs of the older adult requires understanding of the complex physiology of this population segment. The Balance System SD increases mobility, addresses fall risk, improves balance, develops muscle tone and increases agility. Many centers routinely balance-screen all elderly admitted for any rehabilitation because the elderly suffer degradation of balance just by convalescing in a hospital bed for a few days. Biodex works with leading rehabilitation centers around the country to increase awareness as well as provide the tools necessary to address these particular challenges. NEuROREhABILITATION Referral of Parkinson s disease patients to both inpatient and outpatient rehabilitation facilities typically follows a traumatic fall. The training exercises of the Balance System SD are geared to improve strength, range of motion, gait and balance. In practice, the Balance System can capture, quantify and document a patient s relative tendency to overcompensate to one side or the other. This information can often determine a true course of treatment. WELLNESS The Balance System SD is simple to use with an intuitive touch-screen display. Wellness members require minimal supervision and can progress through the various levels at their own pace. Training exercise includes static and dynamic balance activities, weight shifting, increasing limits of stability, and improving reaction time. The system produces color reports to provide motivating feedback. SPORTS MEDICINE/ ORThOPEDIC A great resource for any clinic when addressing sports-related injuries and surgical rehabilitation. Help athletes perform better by demonstrating functional deficits. The Biodex Balance System documents weakness and challenges patients to improve. The various test modes evaluate the athlete in a static or dynamic environment, then generates objective documentation of the results. Reports include standard deviations of target performance, the percentage of time an athlete stays in a particular quadrant and then compares performance to normative data, built into the system. This allows the objective measures of the athlete to be trained, and then easily reevaluated and assessed to quantify improvement. CONCuSSION MANAGEMENT Biodex Balance Assessment for Concussion Management is used by high school, college and professional sports teams to unravel the mystery of concussion and to bring together best practices combining cognitive testing and a graded symptoms checklist in combination with balance assessment. The Balance System SD is an objective Balance Assessment tool that provides a performance baseline against which post-injury performance can be compared. The CTSIB identifies and tracks disturbances in balances and the three associated sensory systems. Complimentary Software CTSIB Utility Software allows you to store athlete baseline test results, compare to post-injury balance assessments and manage progress with documentation. Biodex provides this valueadded benefit at no charge. Download the software from Biodex website. SPECIFICATIONS: Dimensions: Base: 30" w x 44" depth x 8" h (76 x 112 x 20 cm) Platform: 21.5" diameter (55 cm) Color Touch-Screen Display: Viewing Area:12.1 (30.7 cm) diagonal screen; 9.75 w x 7.25 h (24.8 x 18.4 cm) Angle: Adjustable from vertical back to approximately 45 Display Height: Adjustable from 53" to 68" h above platform (135 x 173 cm); 76" h (193 cm) maximum from floor. Stability Levels: 12 dynamic levels, plus locked for static measurements Platform Tilt: 20 from horizontal in all directions Support Rails: Adjustable from 25" to 36.5" above platform (64 to 93 cm). Rails can swing away from platform when not in use. Printer: HP DeskJet Printer Stand: 24" x 24" (61 x 61 cm) Patient Capacity: 400 lb (136 kg) Weight: 196 lb (89 kg) Power: 115 VAC, 50/60 Hz, 15 amp line or 230 VAC, 50/60 Hz, 15 amp line Power Rating: 350 watts Certification: ETL listed to UL and CAN/CSA C22.2 No.:601-1-M90. CE conformity to EN , EMC compliance to EN Warranty: Two-years parts; one-year labor Balance System SD, 12.1" Display, 115 VAC...$12, Includes Fall Risk Screening, Biodex Balance Assessment for Concussion Management, printer, printer stand and CTSIB Indexed Pad. Export models available. Resources Included: NEW elearning Tutorials for increased product utilization. Marketing Support for Fall Risk Screening & Conditioning Program. Marketing Support for Balance Assessment for Concussion Management. Optional Step Stool, Balance System SD...$ ATTENTION Existing Balance System SD Customers: Display and Software Upgrades are available. Contact Biodex Customer Service for details. To order, call Biodex toll free Int'l

12 Fall Risk Screening & Conditioning Program Help patients thrive and attract older adult community members... with Fall Risk Screening & Balance Exercise Reduce Falls and Improve Balance Falls are one of the greatest causes of serious health problems among older adults. Biodex has established a Fall Risk Screening & Conditioning protocol that allows residents to enter a program with data-driven goals. The easy to understand feedback keeps people motivated to improve their results. The program and associated technology, will not only help reduce a patient s risk of falling, but can be used to rehabilitate total hip and knee replacement, as well as a wide array of orthopedic and neurological conditions and generally improve overall mobility. The Program Balance Assessment The Balance System SD can identify a potential problem in just two minutes. The Biodex Fall Risk protocol of balance exercise will improve an individual s ability to remain upright under challenging conditions. Lower Body Strength Strength is a critical contributor for a rapid response to a balance disturbance. Testing will identify weakness and, if necessary, exercise will significantly improve lower body strength. Gait and Endurance Independence is directly related to walking speed. Older adults typically display a slower walking speed, with shorter steps, varied in length. These are all factors related to falls. Senior safe exercise equipment, such as the Biodex BioStep, can help strengthen and build endurance of muscles; specifically those associated with ambulation. 12 Objective Documentation Objective reporting is a marked distinction with the Biodex Balance System SD necessary in this changing environment allowing you to justify need, demonstrate progress and accurately report outcome.

13 Balance System SD FACTS ON FALLS Both the incidence of falls and the severity of fall-related complications rise steadily after age 60. In the United States alone, one in three people age 65+ fall each year. The most common cause of falls includes weak muscles, unstable balance, dizziness, vision problems, side effects from medications and environmental hazards. Studies show that balance training, gait, strength and flexibility training not only help improve mobility and confidence, but help reduce the risk of falling. Real-time feedback keeps patients motivated to improve during exercise training. Marketing Support Biodex is committed to helping drive referrals to your facility by providing clinical and business support. When you invest in the Biodex Balance System SD, you gain access to a series of marketing materials and sample communications to assist you with physician and patient education as well as community outreach to increase awareness and build your Fall Risk Screening & Conditioning Program. Marketing Support Materials Protocol for Fall Risk Screening & Conditioning Community Outreach Materials including signs, advertisements and press releases Patient Recruitment Materials including posters and customizable brochure Physician Education Materials including customizable flyer and sample letters to referring physicians Glenwood Care Center Incorporates the Biodex Balance System SD into their Fall Risk Screening Program with Great Success I m thinking about getting another Balance System SD just to use out in the community. It is so worth its weight in gold. Glenwood uses the Balance System SD to educate the community about fall risk assessment. They take it to every health fair, and provide Fall Risk Screening for anyone who wants to be evaluated for specific risk factors known to contribute to falling and decreased mobility. Each person is provided with a printout of their Fall Risk Assessment. People attending David Merkley Executive Director, Glenwood Care Facility the event are so excited because they receive hard data. Our booth is the only one at the fairs that has a line from the time the doors open until the end of the day, states Merkley. It s awesome! Glenwood Care Facility located in Oxnard, CA started as a private facility in It was part of Beverly Health Care for a time and in 2003 it was acquired by the Ensign Group. It is a skilled nursing facility that provides short-term rehabilitation as well as long-term care. To order, call Biodex toll free Int'l

14 Balance Assessment for Concussion Management The Importance of Combined Assessment Biodex Balance Assessment adds the objective, neurophysical component for the management of concussion. The benefit is that clinicians are able to quantify the elements of balance - before and after an injury occurs. The objective data provided by the Biodex Balance Assessment tool provides a performance baseline against which post-injury performance can be compared. In addition, a healthy population of student-athletes is stored in the system for general normative data comparison. The Importance of Measuring Balance Research shows that athletes often demonstrate decreased stability post-concussion. 1 The postural stability deficit can best be explained by a sensory interaction problem that prevents concussed athletes from accurately using and exchanging sensory information from the visual, vestibular, and somatosensory systems. 1 Difficulty in postural sway control can persist even after signs and symptoms of concussion reside. 2 Or, more simply stated, the athlete may appear asymptomatic and even pass a computerized cognitive test, however, the lingering effects of a balance disturbance from head trauma would go otherwise undetected without a balance assessment. The value of Measuring Balance Balance Assessment, in combination with Cognitive Testing and a graded Symptoms Checklist increases overall assessment sensitivity to greater than 90% 3. Each on their own tells an incomplete story. Concussion should be approached through a multifaceted assessment, and each component of the assessment process should focus on distinct aspects of an athlete s function. 3 Measuring Postural Sway Postural stability testing is an accepted objective measure in the evaluation of athletes with acute cerebral concussion. Large negative effects in postural sway are often identified at both immediate and follow-up assessment points, demonstrating the need for assessment of postural control as part of a concussion protocol. Biodex Balance Assessment goes beyond objective balance testing for changes in postural sway. Using the Clinical Test of Sensory Integration of Balance (CTSIB), independent testing of all three sensory feedback systems can determine the individual's reliance on the visual, vestibular and somatosensory systems. Clinical Test of Sensory Integration of Balance The Clinical Test of Sensory Integration of Balance (CTSIB) is the accepted, standardized assessment that identifies and tracks disturbances in balance and the three associated sensory systems. Combined with today s technological advances, this test provides the sports medicine community with a more accurate and objective assessment tool for evaluating postural stability. mctsib On-Screen Report Guskiewicz, KM, et al, Postural Stability and Neuropsychological Deficits After Concussion in Collegiate Athletes (Journal of Athletic Training 2001;36(3): Valovich McLeod T, The Value of Various Assessment Techniques in Detecting the Effects of Concussion on Cognition, Symptoms, and Postural Control. Journal of Athletic Training 2009;44(6): Broglio SP, Macciocchi SN, Ferrara MS. Sensitivity of the concussion assessment battery. Neurosurgery. 2007;60: ; discussion Finnoff, JT, et al (2009). Intrarater and Interrater Reliability of the Balance Error Scoring System (BESS). PM&R, Volume 1, Issue 1, January Broglio SP, Guskiewicz KM, Concussion in Sport: The Sideline Assessment. Sports Health. 2009; 1:361

15 Dear Sincerely, The Importance of Biodex Balance Technology Balance System SD BioSway Biodex Balance Assessment is conducted using either the versatile Balance System SD or portable BioSway. The Biodex Balance System SD is a sophisticated measuring and training device for static and dynamic balance testing and training. The BioSway is a portable balance device limited with a static-only platform. Biodex Balance SD (Static and Dynamic) The mctsib can be performed on either Biodex balance device, designed to systematically test the sensory selection process by compromising available somatosensory, visual, and vestibular senses while measuring an athlete s ability to minimize postural sway. The Sway Index is an objective quantification of postural sway and is measured during the mctsib. The test provides a generalized assessment of how well an athlete can integrate various senses with respect to balance, and compensate when one or more of those senses are compromised. In addition to performing the CTSIB test, the NEW version of the Balance System SD and BioSway software now includes the option of conducting a modified version Biodex BioSway (Static) shown with optional Printer of a Balance Error Scoring System (BESS) test of postural stability, popular for concussion management. Both systems now feature the ability to create custom sensory integration balance testing which allows for modification of existing or the creation of entirely new protocols with both the CTSIB and BESS tests. 4 Marketing Support Available exclusively to our customers using Balance Assessment in support of a concussion management program, Biodex provides an assortment of marketing materials to attract athletes, parents, community sports teams, school coaches and athletic directors, as well as referring pediatricians. Materials can be customized to reflect your facility and used to broadcast the role of Balance Assessment in the management of concussion. FACILITY LETTERHEAD MARKETING SUPPORT SAMPLE LETTER TO: Local Physicians / Pediatricians Remove the guesswork enroll your patient in a Biodex Concussion Management Program Give parents added assurance when managing a child s concussion! In addition to a medical diagnosis, [Facility Name Here] is excited to extend the resources of our new Concussion Management Program to support and manage head injuries in conjunction with your office protocols. [Facility Name Here] now offers a Biodex Concussion Management Program and we would like the opportunity to enroll your patients with a simple baseline test of balance and cognitive assessment. In the event of an injury, patients are retested and compared to baseline as well as compared to age- and gender-specific normative data. All data is stored per athlete with the ability to generate HIPAAcompliant reporting. The test takes only minutes but will provide valuable information in the event a patient sustains a concussion. High school athletes engaged in contact sports are experiencing concussions at an alarming rate. The Centers for Disease Control (CDC) estimate up to 3 million sports-related concussions are happening in the U.S. with school-aged children making up the majority of these cases. The rate of reoccurrence is just as concerning. When a concussion protocol is followed, kids usually recover within a week or two. Without a protocol, the risks can be great, including reoccurrence and possible lasting effects. Each concussion is different, so too is each patient s recovery. Having objective-baseline and data-driven support is essential for those difficult return-to-play decisions. We ask that when considering a Concussion Management Program for your patient athletes, you consider [Facility Name Here]. We invite you to visit our facility and understand the benefits of the program first hand. Please call to schedule an evaluation. MARKETING SUGGESTION >> offer FREE vouchers for baseline testing to the patients of local pediatricians, allowing them to distribute to their patients. It makes them look good, gives patients something tangible and valuable, builds an athlete base in your practice. P.S. - The Biodex Concussion Management Program is used by local and professional sports teams throughout the U.S. Concussion Management Program Marketing Support Sample Letters Sample Press Release Sample Advertisements Educational Brochure Clinical Voucher Awareness Poster A decreased ability to maintain balance is one of the hallmark signs of concussion. 5 Objective Documentation Data from objective measures of postural stability is a critical component in determining severity of injury and post-injury recovery. Both the Balance System SD and BioSway provide postural stability/balance testing with objective documentation including detailed baseline and post-injury summary reports, progress reports with comparison to baseline or normative data. Reports are used to track recovery and can be forwarded to doctors, coaches, parents or athletes to provide quantitative data that substantiates return-to-play decisions. NEW Extensive Normative Data A healthy population of student-athletes is stored on the system for general normative data comparison. mctsib Progress Report Workshops & Education Biodex University and co-sponsored concussion management workshops are scheduled regularly. To order, call Biodex toll free Int'l

16 Balance & Mobility Demonstrate need, progress and outcomes more effectively with Biodex. Biodex physical medicine devices work seamlessly together for an integrated approach to rehabilitation. Independently, each device builds on strength towards improved mobility; together they address balance, strength, cardiovascular health and confidence. Objective reporting is a marked distinction with Biodex Balance & Mobility devices - necessary in this changing environment allowing you to justify need, demonstrate progress and accurately report outcome. Biodex Balance & Mobility will set your facility apart, making it attractive for Accountable Care Organizations, referring hospitals, doctors, and the community. Expand your rehabilitation capabilities while at the same time accelerating rehabilitation time, maximizing staff, providing objective documentation and reducing the risk of hospital readmission. BioStep 2 Semi-Recumbent Elliptical The BioStep 2 improves cardiovascular endurance and builds strength of muscles associated with gait and mobility. Incorporating the BioStep 2 Semi-Recumbent Elliptical strengthens the muscles associated with ambulation and offers cardiovascular benefit. The BioStep 2 combines lower extremity and upper body exercise with a smooth, continuous motion. Even the most debilitated patient can use and benefit from the BioStep 2. We use the BioStep with virtually everyone. The patients that I like to use it the best with are cardiovascular patients; the ones with COPD or low activity tolerance, because we can get exact measurements on how far they can go, how fast they are going at what resistance, and then they see those numbers and they try to beat them every time. We can monitor their oxygen and heart rate, and we can push them to go further and further distances. Not everyone is going to tolerate walking far distances or using the treadmill far distances, but it is surprising, as far as the people you can put on the BioStep. We have some patients who cannot even stand and we can put them on the BioStep to strengthen their legs and to stretch out their legs, as they are stuck in their wheelchair for long periods of the day. Just about anyone can tolerate it. Meghan Klein, DPT - Director of Clinical Development Odom Health & Wellness Group at the Lighthouse of Waconia, MN Unweighing System Offloaded support during assisted ambulation before a patient is fully weight bearing. The Biodex Unweighing System is our newest piece of equipment, explains Bill Broglie, New Beginnings Physical Therapist. Everyone here loves it. Before getting this equipment, I had patients whose balance and ataxia were so bad, that is was just too unsafe for them to walk and ambulate in any way. Today, I have patients that are walking because of the Unweighing System. For non-weight bearing patients, the Biodex Unweighing System allows patients the benefit of movement who couldn t achieve otherwise. Ideally used over the Gait Trainer 3 (or any treadmill), or over ground, the safety aspect increases patient confidence when they are ready to progress. The Biodex Unweighing System gives our patients the confidence they need, says Broglie. Although they cannot walk on their own, the Unweighing System gives them the sensation of walking. It gives them the hope that maybe they will walk again one day. And, when their confidence is built up, it makes them want to work harder. Families are seeing their loved ones walking for the first time in years. It s truly amazing! Bill Broglie, Physical Therapist New Beginnings Community Center for Brain Injury Rehabilitation, NY 16

17 BioStep 2 Semi-Recumbent Elliptical Gait Trainer 3 Unweighing System Balance System SD Gait Trainer 3 Prompts patients into proper gait patterns with real time audio-visual biofeedback of step symmetry, step length and step speed. Documents progress with comparison to normative data. Expand your mobility program with the Gait Trainer 3, featuring an instrumented deck that monitors and records step length, step speed and right-to-left time distribution. Audio and visual biofeedback prompts patients into their proper gait pattern. Biofeedback can play a critical role in providing the best quality rehab in the shortest period of time. Objective Documentation Body in Balance serves patients of all ages with a broad range of neurologic and orthopedic conditions, although approximately 80% are geriatric. To treat this spectrum of patients, Body In Balance combines the latest in Biodex rehabilitation technology with specialized therapeutic approaches such as Schroth scoliosis treatment and the Farley BIG strategy for Parkinson s disease. That equipment includes the Biodex Balance System SD, the Biodex Gait Trainer 3, the Biodex Unweighing System and the Biodex BioStep 2 Semi-Recumbent Elliptical. The objective of Parkinson s disease patients on the Gait Trainer is to encourage them to take big steps, Ms. Hagan explains. Their idea of a big step is usually a lot smaller than ours. And so, when I put them on the Gait Trainer, I place a large gym ball at the head of the Gait Trainer track. When they re walking at a comfortable pace, we ask them to take big steps, and to try to kick the ball, first with their left toe, and then with their right: left, right, left which forces them to take very large steps. Then we ask them to turn and sidestep to kick that ball with the side of their foot as they take each big step." Research has shown that Parkinson s disease patients who practice walking backwards with an exaggerated step length have a bigger walk, a more functional walk, a safer walk, when they're on solid ground. Eleanor ( Ellie ) Hagan, PT, Owner Body in Balance Physical Therapy and Fitness Center, NJ Balance System SD Improves balance and weight shifting, important components of gait and mobility. Document progress with comparison to normative data. Build core balance with the Balance System SD. Designed to improve balance, increase agility, and develop muscle tone. Used for Fall Risk Screening and Conditioning, the Balance System goes beyond fall programs to significantly improve ambulation. Older adults enjoy using this product. Objective Documentation I have eight or nine active patients right now, revealed Daup, most coming in three times per week for treatment. Each was referred by a primary care physician or by a neurologist. Depending on what deficits and functional problems people have when they arrive, we design a personalized program to address their needs. The Biodex Balance System allows us to focus on a variety of pathologies that utilize the Balance System including static and dynamic balance, weight shifting, increasing limits of stability, and improving reaction time. Alan Daup, OTR/L, MBA,- Balance and Vestibular Center Gothenburg Memorial Hospital, NE For more information on Biodex Balance and Mobility visit BIODEX 17

18 Date 01/20/ :30 PM FOOT PLACEMENT Left Right PROTOCOL Name AMANDA GREYSON Foot Angle Platform Setting 8 Height Heel Position D6 D16 Test Trials 1 Age 56 Cursor ON Diagnosis Pattern Full Device BioSway Skill Level Time to Complete Test Moderate 100 secs Direction Control Actual Goal 1. Overall Forward Backward Left Right Forward/Left Forward/Right Backward/Left Backward/Right Comments Clinician BioSway Now with AUTOMATED G-Code CALCULATIONS SIx Prove Need. Progress. Outcome All test results and training sessions can be stored and printed. Comparison to normative data helps communicate need, progress and outcome. POSTURAL STABILITY TRAINING Emphasize specific movement patterns or strategies by placing markers anywhere on the screen. Score reflects how many times a target is hit. LIMITS OF STABILITY TRAINING Challenges the patient s balance within their sway envelope. CTSIB Indexed Pad (included) standardizes foot positioning for improved consistency and result comparisons. Adjustable stand, printer and printer stand sold separately WEIGHT SHIFT TRAINING Patients are challenged to shift and control their center of gravity within two parallel lines, in the medial lateral, anterior posterior and transverse planes of movement. Changing the width of the lines controls the degree of difficulty. Score is kept to track progress. MAzE CONTROL TRAINING This defined movement pattern encourages proprioception and motor control. Add or subtract sections to vary the challenge Visit our website to view product video Objective Documentation - Now with G-Code reporting Limits of Stability Test Results % GOAL Impairment percent with associated modifier code Functional Limitation G-code categories Patient Status: (current and discharge) Easy-to-read 8.5" x 11" reports RANDOM CONTROL TRAINING An undefined movement pattern where the patient is challenged to keep pace with a moving target. Target size and movement speed can be varied to match skill level. Ideal for motor control and vestibular training. PERCENT WEIGHT-BEARING TRAINING Target zones change color when within % weight bearing targets THERE IS A DIFFERENCE THE BIODEx ADVANTAGE. For therapists in-clinic or on the go, Portable BioSway features static balance platform used for balance assessment for concussion management, older adults/fall screening, neurological, vestibular, post-surgical or trauma patients. 18 INTERACTIVE CATCH GAME FOR BALANCE TRAINING The CATCH game offers various progressive skill levels to promote interaction and help keep patients engaged. CATCH also offers the ability to create a custom protocol geared toward specific training activities.

19 Portable Balance Assessment FEATuRES: Lightweight instrumented platform sets-up in minutes to provide static force testing for interactive training modes or standardized testing environments, including the Clinical Test for Sensory Integration of Balance (CTSIB). Fully Portable BioSway is conveniently portable within a facility for in-resident care. For satellite locations, the optional hard-shell travel case provides added protection when transporting to community-based health fairs or school settings for athletics. The case fits easily into small car trunks. NEW Automated G-code Calculations and Impairment Level Reports Increases efficiency and productivity, improves documentation of rehab effectiveness fostering continuity of care, helps with audits, efficiencies and reduces claims denial. NEW Enhanced Sensory Integration Balance Testing Capabilities Ability to perform a modified version of a Balance Error Scoring System (BESS) test of postural stability, popular for concussion management. Modify existing or create custom protocols for both the CTSIB and BESS tests. Objective Documentation Printed color reports track progress and document outcomes ideal for insurance reimbursement. (Printer sold separately.) Custom Reporting Allows entry of unique comments to test results and assignment of CPT codes. Six Training Modes and Three Testing Protocols Standardized testing for true progress assessment. Test results are compared to agebased normative. NEW Normative Databases New healthy populations stored for test comparison of older adults for fall screening and student athletes for concussion management. Audio Biofeedback Used for cueing successful target hits. Visual Biofeedback Prompts patients into proper balance control. Allows the clinician to easily monitor the patient and acts to motivate the patient during interactive testing/training. Large Display Features 12.1" touch-screen display, powered by a Windows CE operating system. Simple to learn and operate, leading the user step-by-step through testing protocols and training modes. a c Display Stands The BioSway includes a tabletop stand (a) that can also be used to wall mount (b) the display. A telescoping Adjustable Stand (c), available separately, is compact and portable with its own travel bag. The display can even attach to compatible display mounts (d). b d STANDARDIZED TESTING ENvIRONMENTS Postural Stability, Limits of Stability and Clinical Test of Sensory Integration of Balance (CTSIB) are all included. Expanded Connectivity Allows connection to larger monitors and LCD projectors to enhance interaction for visually impaired patients. USB Compatibility Accommodates external keyboard, a mouse, printing devices for remote operation and USB memory devices for data transfer and software upgrades. Video and Audio Out Bolsters connectivity options to other devices. NEW Patient Data Collection Software Utility (complimentary download) Facilitates download and transfer of patient data allowing for unlimited storage capacity, reporting or exporting as a.csv file and import into Excel to run statistical analysis for normative data generation. SPECIFICATIONS: Patient Weight Capacity: 500 lb (227 kg) Power: 115V/ 230VAC, 50/60 HZ, 15 amp line Dimensions: Platform Dimension: 21.25" w x 19" l x 2.56" h (54 x 48 x 7 cm) Weight: 19 lb (8.6 kg) Color Touch-Screen Display Dimension: Viewing Area:12.1" (30.7 cm) diagonal screen; 9.75" w x 7.25" h (24.8 x 18.4 cm) Angle: Adjustable from vertical back to approximately 45 Hard Case Dimension: 23.75" w x 22.75" l x 10.75" h (60 x 58 x 27 cm) Total Weight (including case): 44 lb (20 kg) Certification: ETL listed to UL and CAN/CSA C22.2 No.:601-1-M90. CE conformity to EN , EMC compliance to EN Warranty: one year parts and labor BioSway 12.1" LCD with Tabletop Stand and Case, 115V/230V 50/60Hz...$6, BioSway 12.1" LCD with Tabletop Stand, 115V/230V 50/60Hz...$6, Includes: Instrumented platform, CTSIB Indexed Pad, 12.1" color touch-screen LCD display with tabletop stand/wall mount bracket, AC adapter for V input... and two blindfolds. Resources NEW elearning Tutorials for increased product utilization. Marketing Support for Balance Assessment for Concussion Management. Optional BioSway Travel Case (Fits 12.1" Display)..$ Adjustable Height Stand for 12.1" Display...$ HP Office Jet Printer (compact portable printer)...$ HP InkJet Printer..$ (full size color printer) Printer Stand...$ To order, call Biodex toll free Int'l

20 BioStep 2 The world s first semi-recumbent elliptical cross trainer heart Rate Monitoring by BioStep Semi-Recumbent Elliptical shown with optional Stabilization Package. Ideal for older adults. Visit our website to view product video BioStep 2 Stabilization solutions offered as either Basic or Advanced. Basic Stabilization Kit includes: Foot Straps Hand Straps Seat Belt, and Movable Armrests Advanced Stabilization Kit includes all the Basic Kit components, plus: Padded Foot Restraint Pivoting Calf Support, and Hand/Wrist Cuff Seat Belt Movable Armrest Hand/Wrist Cuff The Padded Foot Restraint and Pivoting Calf Support Foot Strap Hand Strap THERE IS A DIFFERENCE THE BIODEx ADVANTAGE. Combine the benefits of smooth, elliptical cross-training exercise with the comfort, safety and stability of semi-recumbent positioning. Zero joint impact plus biomechanically correct arm, leg and ankle motion emulates natural walking patterns. 20

21 The difference is in the motion -FEATuRES: Elliptical motion - provides smooth continuous zero joint impact exercise Self-powered, selfcharging, cordless capability - use it anywhere 1:1 arm to leg motion - for natural arm swing rhythm Pivoting handgrips provide comfort for patients with forearm or wrist impingements Rotating seat to 90 on either side and stepthrough design - for easy and safe entry and exit Optimized seat height - for wheelchair transfers and controlled hip flexion Up to 600 watts - to accommodate a wide spectrum of users Constant resistance with 20 effort levels - provides greater program options Heart Rate Monitoring - Polar contact handgrips (telemetry compatible) to ensure proper training intensity Sturdy, well-placed grab handles to facilitate patient transfer Large easy-to-use Quick Start display - features time, RPM, watts, calories, METs, distance, total steps, heart rate Large utility holder - provides a convenient storage place for water bottles and allows for hands-free reading Robust design - for heavy institutional use Optional Stabilization Packages - Standard and Advanced Easy to use with QUICK START display features time, RPM, watts, calories, METs, heart rate, distance and total steps. Naturally smooth positively effective The elliptical motion of the BioStep 2 is naturally smooth and continuous; very different from the stuttering stop-start motion associated with other recumbent steppers. The stepthrough frame, simple easy-tosee and use display and comfortable, robust design make the BioStep 2 the obvious choice for cross training. The Biodex BioStep 2 helps Patients and their Therapists Achieve Multiple Rehabilitation Objectives If there is one piece of equipment for all your patients... this is it. The BioStep 2 s fluid, elliptical motion is forgiving on the knees, ankles, hips and lower back a natural closed-chain low-impact functional exercise. The BioStep 2 reduces joint impact because the user is not required to lift and strike their feet on the walking surface. By combining lower extremity motion with upper body, the BioStep 2 provides a total body workout in both forward and reverse directions, thereby involving different muscle groups. Ideal for Older Adults Low impact total body exercise is ideal for senior fitness. The lowimpact elliptical motion of the BioStep 2 reduces the jarring impact often associated with the stop-start motion so common with other recumbent steppers. The BioStep 2 s motion also helps strengthen the muscles important to maintaining function; those muscles specifically associated with mobility, walking and balance. APPLICATIONS: Senior Rehab Wellness and Fitness Centers, Neurorehabilitation, Cardiac Rehabilitation, Orthopedic/Sports Medicine, and more Great for Cardiac Rehabilitation BioStep 2 incorporates both the upper and lower extremities into the cycling motion; patients experience less local muscle fatigue. This allows similar heart rates to be achieved at lower rates of perceived exertion when compared to traditional exercise ergometers. Blood pressures can be checked while the patient continues to exercise by simply releasing one arm while the other three extremities comfortably continue to perform the exercise. BioStep 2 is ideal for patients who may experience leg claudication during exercise. Patients can easily reduce the effort in the involved leg, while keeping heart rate elevated, by transferring a greater portion of the workload to the non-involved extremities. When the cramping subsides, exercise can be transferred back, proportionately, to all four extremities. Wellness/General Aerobic Conditioning BioStep 2 provides a zero impact, safe and comfortable total body workout in both forward and reverse directions, making it ideal for general aerobic conditioning of your adult population. SPECIFICATIONS: Dimensions: 54" l x 28" w x 44" h (137 x 71 x 112 cm) Resistance: Constant resistance with 20 effort levels Work Rate Range: Up to 600 watts (120 rpm) Heart Rate Monitoring: Polar contact handgrip (telemetry compatible) Readouts: Time, RPM, watts, calories, METs, heart rate, distance and total steps User Capacity: 500 lb (227 kg) Weight: lb (92 kg) Power: Self-Powered; no external power requirement at user work rates over 30 watts and 50 rpms; adapter is provided to power system and charge battery during applications below 30 watts and 50 rpms; battery automatically recharges at work rates above 30 watts and 50 rpms. AC Adapter included. Certifications: ETL listed to UL and CAN/CSA C22.2 No M90. CE conformity to EN , EMC compliance to EN Warranty: Two years parts; one-year labor BioStep 2, VAC..$4, Export models available. Optional Stabilization Kit, Basic...$ Includes: Foot straps, hand straps, seat belt and movable armrests Stabilization Kit, Advanced...$ Includes: foot straps, hand straps, seat belt, movable armrests, pivoting calf support, padded foot restraint and hand/wrist cuffs Hand/Wrist Cuffs (Pair)...$ To order, call Biodex toll free Smooth elliptical motion Int'l Study validates BioStep as an exercise device that older adults will find very tolerable. In the study by Mendelsohn, Connelly, Overend and Petrella, published in the Journal of Aging and Physical Activity, April 2007, the BioStep was shown to be a valid and reliable aerobic exercise device. If you are looking for an effective device for exercise testing and training in an older population look no further. PubMed ID #

22 Upper Body Cycle An upper-body ergometer that will exercise individuals with limited lowerbody function, help rehabilitate a wide variety of shoulder, back, neck, wrist, and elbow patients, and give healthy athletes a grueling workout. Heart Rate Monitoring by Clinical Pro Upper Body Cycle Visit our website to view product video Removable seat and adjustable head and cranks allow for easy, stable standing exercise. THERE IS A DIFFERENCE THE BIODEx ADVANTAGE. The only Upper Body Cycle designed for rehabilitation exercise that offers an adjustable pivot head for sitting to standing total body involvement, including core stabilization exercises. Adjustable cranks allow for incremental and progressive strengthening to full range of motion. 22 The seat assembly is removable to accommodate wheelchairs. EZ-Grip TM handgrips, available on the Clinical Pro, accommodate patients with hand control limitations. Large rotating seat, available on the Clinical Pro, accommodates patients with ambulatory difficulties. The optional hand/wrist cuffs allow users with limited or no hand strength or control to enjoy the benefits of upper body exercise.

23 Invaluable for upper extremity rehabilitation and conditioning FEATuRES: Self-powered, selfcharging, cordless capability use it anywhere! Pivoting actuator accommodates wide range of cycling positions Adjustable Crank Length crank adjusts from 6" to 16" to help control range of motion provided for a variety of arm and upper body exercises Instantaneous retro-cycling Up to 600-watt work rate range to accommodate a wide spectrum of patients Isokinetic Resistance (speed control) for building strength Heart Rate Monitoring Telemetry compatible to ensure proper training intensity Easy-to-use Quick-Start control panel with large buttons Large, easy-to-view LED display Ergonomically correct for patients from 4'6" to 6'10" tall, and weighing up to 500 lb Removable seat for wheelchair or standing access uniquely Clinical Pro: Large rotating seat with seat belt and grab handles - easier wheelchair transfers - belt and handles provide added security, especially for patients with balance deficiency or palsy EZ-Grip handgrips allow patients with hand control limitations to hold onto crank handles Functional Diversity The Biodex Upper Body Cycle is a versatile ergometer that meets the demands of any orthopedic rehabilitation, cardiac, sports medicine, wellness, or general conditioning program. unique Self-Powering System Use the Upper Body Cycle anywhere. There is no need for AC power at work rates at or above 30 watts and 50 rpms. The battery-supported system maintains all settings and LED displays before and after cycling. The internal battery is automatically recharged when work rates reach or exceed 30 watts and 50 rpms. An AC adapter is provided for extended use at work rates below 30 watts and 50 rpms. user-friendly The Quick-Start feature gets your first-time cyclists right into their exercises. Isokinetic (speed control) provides accommodating resistance throughout the cyclist s entire range of motion for the duration of the exercise period. Resistance continuously matches effort, accommodating to variations in the patient s force output due to weakness or pain at specific points in the individual s range of motion, and to fatigue over the course of the cycling period. With a selection of 15 speeds (50 to 120 deg/sec), this resistance mode maximizes strength gains while minimizing the potential for injury. APPLICATIONS: Orthopedic, Sports Medicine and Athletic Training Exercise, Cardiopulmonary Exercise, Older Adult Exercise Full-Function Retro-Cycling Rehabilitation and conditioning capabilities are expanded by providing bi-directional cycling to alternately work reciprocal muscle groups. Built for high-use Environments The welded heavy-gauge steel frame, epoxy powder-coat finish, and moisture-resistant ABS plastic enclosure, round out a rugged and durable design that will withstand extensive use in the busiest settings. Large wheels make transporting and repositioning easy. Heart rate monitoring can be achieved with a telemetry chest strap to track heart rate without interrupting exercise useful for protocols utilizing target heart rate, and for monitoring high-risk patients. SPECIFICATIONS: Dimensions: 62" l x 29" w x 72" h (157 x 74 x 183 cm) Crank Axis Height: Adjustable from 37" to 58" (94 to 147 cm) Crank Arm Length: Adjustable from 6" to 16" (15 x 41 cm) Resistance: Isokinetic (speed control): 15 speed settings (increments of 5 deg/sec) Work Rate Range: Up to 600 watts (120 rpm) Speed Control Range: 50 to 120 deg/sec Readouts: Time, RPM, watts, calories, METs, heart rate, total work, total cycles Heart Rate Monitoring: Telemetry compatible Communication: RS232 Patient Capacity: 500 lb (227 kg) Weight: 230 lb (105 kg) Power: Self-powered; no external power requirement at user work rates over 30 watts and 50 rpms; 115 VAC adapter (230 VAC available) is provided to power system and charge battery during applications below 30 watts and 50 rpms. Battery automatically recharges at work rates above 30 watts and 50 rpms. Certification: ETL listed to UL , and CAN/CSA C22.2 No.: M90. CE conformity to EN , EMC compliance to EN Warranty: Two-years parts; one-year labor Cycle, Upper Body...$3, Cycle, Upper Body, Clinical Pro...$3, Includes: Large rotating seat and EZ-Grip TM handgrips Export models available. Optional Hand/Wrist Cuffs (Pair)...$ Upper Body Cycle , shown with standard seat. To order, call Biodex toll free Int'l

24 RTM600 Rehab Treadmill 12.1" high resolution color touch-screen LCD display Sturdy Functional Support Bar A treadmill designed for physical rehabilitation clinics. It starts at 0 mph and will not overspeed. It allows for prescribed retro-walking, forward and reverse, uphill and downhill. Heart Rate Monitoring Safety Lanyard handrail CONFIGuRATIONS: Open Platform Starting Speed - always starts at 0 mph with 0.1 mph speed increments Shown with Extended Handrails Shown with Geriatric/Pediatric Handrails Exact-Track Belt Elevation 0-15% grade Reverse Belt Direction Low Profile versatile SOFTWARE The LCD touch-screen display allows for easy selection of modes of operation: Quick Start, Manual Start and Profile. Quick Start gets you up and going fast with.25 mile scaled track views. Large print screen settings, simple to use, easy to see perfect for the older adult. Five pre-programmed and 12 custom profile modes allow patient-specific treatment protocols freeing up valuable therapist time. THERE IS A DIFFERENCE THE BIODEx ADVANTAGE. True zero starting speed with forward and reverse, uphill and downhill and retro-walking. 24

25 Medical details make the difference... FEATuRES: Speed Range Starts at 0 mph with 0.1 mph speed increments (0-10 mph range); safely accommodates diverse patient populations. Exercise Profiles - Choose from one of the preprogrammed profiles or design your own and store it in memory for instant recall. Reverse Belt Direction Ranges from 0-3 mph, promoting knee extension, ankle dorsiflexion and eccentric hamstring control and allows for up to a -15% decline. Great for eccentric loading. Elevation Incline 0-15% grade Exact-Track Belt Eliminates belt shift and tracking problems, even for patients with uneven gait. Safety Stops A large red emergency button or the detachment of the safety lanyard worn by the patient will stop the belt immediately for maximum safety. Heart Rate Monitoring Polar contact handgrips (telemetry compatible) ensures proper training intensity. Low Profile 7" step-up height allows easy patient on/off and therapist interaction. Large Display Features 12.1" color touch-screen display, powered by a Windows CE operating system. Multipurpose Connectivity Allows connection to color touch-screen monitors and LCD projectors for visually impaired patients. The RTM600 Rehabilitation Treadmill is the only treadmill to offer a true zero starting speed, 1/10 mph speed increments over a range of 0-10 mph, plus powered incline and decline in both forward and reverse directions. Extremely versatile, perfect for exercise with acute post-operative, neurologic, pediatric, cardiopulmonary, respiratory, orthopedic/sports medicine and older adult patients in need of strengthening and aerobic conditioning. APPLICATIONS: Orthopedic, Sports Medicine and Athletic Training Exercise Use uphill or downhill walking and jogging to emphasize specific muscle groups or motions. Use retro-walking to promote the use of reciprocal muscle groups not normally exercised during forward walking alone. Cardiopulmonary Exercise Monitor heart rate with Polar contact handgrips. MET level displayed for easy compliance to patient exercise prescriptions. Belt speeds as low as 0.1 mph to accommodate even the most deconditioned patient. Older Adult Exercise With the RTM s zero starting speed for maximum safety there s no need for patients to straddle the bed. Simulate uphill and downhill ramp walking. Retrowalk to reduce flexion contractures with total knee and total hip replacements. Retro-walk is also great for promoting dorsiflexion. Choose the RTM s dual height Geriatric/ Pediatric Handrails. Pediatric Exercise The RTM s zero starting speed and small, precise speed increments make this treadmill ideal for use with children too small to straddle a belt. The RTM dual height Geriatric/Pediatric Handrails 24" h and 36" h (61 cm and 91.5 cm) are comfortably positioned for children and small adults. Display tilts to ensure easy viewing. Neurorehabilitation Exercise Treadmills have long been used in therapy and conditioning to encourage patient compliance. Now, the RTM s zero starting speed, 1/10 mph speed increments and specially configured handrails permit the neurologically impaired to safely benefit. Like endless parallel bars, when combined with the Biodex Unweighing System, the RTM provides neurological patients with a safe environment to re-establish functional ambulation while allowing the clinician to remain stationary beside the treadmill for easier patient observation. SPECIFICATIONS: Dimensions: 86" l x 27" w (218 x 69 cm) Running Area: 64" l x 20" w (160 x 51 cm) Deck: 1" thick (2.5 cm) reversible Teflon impregnated high density composite fiber Motor: 2 HP with 4Q-Pulse Width Modulation Control Speed Range: Forward: 0-10 mph ( km/h) Reverse: 0-3 mph (0-4.8 km/h) in.1 mph (.16 km/h) increments Elevation: 0-15% grade Heart Rate Monitoring: Polar contact handgrips (telemetry compatible) Power: 115 VAC, 50/60 Hz, 20 AMP dedicated line, or 230 VAC, 50/60 Hz, 20 AMP dedicated line; includes hospital grade plug with 12' (3.7 m) power cord Patient Capacity: 400 lb (182 kg) Weight: 395 lb (179 kg) Certification: ETL listed to UL and CAN/CSA C22.2 No.:601-1-M90. CE conformity to EN , EMC compliance to EN Warranty: Two-years parts; one-year labor 0413 RTM " LCD display heart Rate Monitoring by RTM600, 115 VAC...$7, Includes Support Bar RTM600, 115 VAC...$7, Includes Extended... Handrails RTM600, 115 VAC...$7, Includes Geriatric/ Pediatric Handrails Export models available. To order, call Biodex toll free Int'l

26 Gait Trainer 3 Now with AUTOMATED G-Code CALCULATIONS 12.1" High Resolution Color Touch-Screen Display Audio-visual Biofeedback Safety Lanyard Sturdy Functional Support Bar Heart Rate Monitoring Open Platform Footfall Screen Elevation 0 to 15% grade Instrumented Deck - monitors and records step length, step speed and right-to-left time distribution Starting Speed - always starts at 0 mph with 0.1 mph speed increments Visit our website to view product video Reverse Belt Direction Exact-Track Printer and Printer Stand Included - allows for printing of progress reports and patient information. Low Profile Heart Rate Monitoring by Histogram Screen - plots right and left step lengths / symmetry Audio and visual biofeedback of step length, step speed and step symmetry. handrail CONFIGuRATIONS COMPLIMENTARY PUBLICATION A Clinical Guideline for the Treatment of Patients with Neurologic Conditions using Biodex Unweighing System and Gait Trainer. Gait Trainer 3 shown in use with the Offset Unweighing System. Shown with Extended Handrails Shown with Geriatric/Pediatric Handrails Download from the web: THERE IS A DIFFERENCE THE BIODEx ADVANTAGE. The only treadmill with an instrumented deck that monitors and records step length, step speed and right-to-left time distribution, providing a comparison of real-time footfall to target step length. Audio and visual biofeedback prompt patients into a proper gait pattern. Performance is documented with a printed color report. 26

27 More than a treadmill with real-time biofeedback... FEATuRES: Instrumented Deck The Gait Trainer 3 is the only treadmill with an instrumented deck that monitors and records step length, step speed and right-to-left time distribution (step symmetry). Open Platform enables patient access for therapist manipulations and accommodates BWSTT with the Biodex Unweighing System. Objective Documentation Exercise Summary and Progress Reports track progress and document outcomes - ideal for insurance reimbursement. Show need, progress and outcome for specific gait parameters, including: Average walking speed over time Total exercise time Total distance and steps taken Average step length: RT vs. LT Step length variablity: RT vs. LT Time on each foot: RT vs. LT NEW Automated G-code Calculations and Impairment Level Reports Increases efficiency and productivity, improves documentation of rehab effectiveness fostering continuity of care, helps with audits, efficiencies and reduces claims denial. Normative Data Ageand gender-based for comparison to healthy populations for assessment of patient results. Audio and Visual Biofeedback Motivates patients with real-time biofeedback, prompting proper gait patterns. Biofeedback helps patients stay "on target" in each phase of rehabilitation; steps lengthen, step speed increases and symmetry improves. Heart Rate Monitoring Polar contact handgrips (telemetry compatible) ensures proper training intensity. Larger Display Features 12.1" color touch-screen display, powered by a Windows CE operating system. Expanded Connectivity Allows connection to larger monitors and LCD projectors to enhance interaction for visually impaired patients. USB Compatibility Accommodates external keyboard, a mouse, printing devices for remote operation and USB memory devices for data transfer and software upgrades. NEW Patient Data Collection Software Utility (complimentary download) Facilitates download and transfer of patient data allowing for unlimited storage capacity, reporting or exporting as a.csv file and import into Excel to run statistical analysis for normative data generation. APPLICATIONS: Used for Older Adult, Orthopedic Patients, Stroke/Traumatic Brain Injury, Spinal Cord Injury, Amputation of a Lower Extremity, Parkinson s Disease, Neurologic Patients, Vestibular Patients Objective Documentation - Ideal for insurance reimbursement Normal range shown in green For sample reports, CPT codes, testimonials, applications, bibliographies and warranty information, click in at " color touch-screen display Progress Report Display Prove Need. Progress. Outcome All test results and training sessions can be stored and printed. Comparison to normative data helps communicate need, progress and outcome. SPECIFICATIONS: Dimensions: 86" l x 27" w (218 x 69 cm) Walking Area: 64" l x 20" w (160 x 51 cm) Printer Stand: 24" l x 24" w (61 x 61 cm) Deck: 1" thick (2.5 cm) reversible Teflon impregnated high density composite fiber Motor: 2 HP with 4Q-Pulse Width Modulation Control Speed Range: Forward: 0-10 mph ( km/h) Reverse: 0-3 mph (0-4.8 km/h) in 0.1 mph (.16 km/h) increments Gait Trainer Mode: Speed limited to 3 mph (4.8 km/h) Elevation: 0-15% Grade Heart Rate Monitoring: Polar contact handgrips (telemetry compatible) Display: Color Touch-Screen Printer: HP DeskJet Power: 115 VAC, 50/60 Hz, 20 AMP dedicated line, or 230 VAC, 50/60 Hz, 20 AMP dedicated line. Includes hospital grade plug with 12' (3.7 m) power cord. Patient Capacity: 400 lb (182 kg) Weight: 395 lb (179 kg) Certification: ETL listed to UL and CAN/CSA C22.2 No.:601-1-M90. CE conformity to EN , EMC compliance to EN Warranty: Two-years parts; one-year labor Gait Trainer 3, 115 VAC 50/60 Hz...$11, Includes Support Bar Gait Trainer 3, 115 VAC 50/60 Hz...$12, Includes Extended Handrails Gait Trainer 3, 115 VAC 50/60 Hz...$12, Includes Geriatric/ Pediatric Handrails Includes printer and printer stand Export models available. U.S. Patent No. 6,645,126 B1 RTM600 Plus... The Gait Trainer 3 can also serve as a traditional treadmill, with all the features and benefits of the Biodex RTM600 Rehabilitation Treadmill. To order, call Biodex toll free Int'l

28 Unweighing System I need a simple, cost effective way to reduce a patient s body weight during rehabilitation exercises Offset frame design offers improved access to manually assist patient footfall and weight shift. COMPLIMENTARY PUBLICATION A Clinical Guideline for the Treatment of Patients with Neurologic Conditions using Biodex Unweighing System and Gait Trainer. Download from the web: Facilitates lifting from a wheelchair Visit our website to view product video The Unweighing System support uprights are offset to allow unobstructed viewing/access. Use with treadmills RETuRN patients To A functional gait The Biodex unweighing System allows functional gait patterns to be practiced. Accommodates pediatric patients Pelvic rotation is a critical component of functional gait mechanics. As patients progress in therapy, the Biodex single-point suspension system allows functional pelvic rotation to occur. Vertical displacement is also a critical component of functional gait mechanics. The Biodex dynamic suspension system allows up to 4" of vertical displacement which enables the patient to respond to ground reaction forces. If pelvic stabilization is required, the Biodex Unweighing System includes Pelvic Stabilization Straps to govern the degree of pelvic rotation. Stabilization straps are made of Thera-Band and adjustable nylon hooks. THERE IS A DIFFERENCE THE BIODEx ADVANTAGE. The only mobile Unweighing System that provides quantifiable, dynamic partial weight-bearing therapy without electric motors,weights or air compressors; plus a universally fitting support vest. 28

29 Early rehabilitation, BWSTT or over ground... FEATuRES: Dynamic suspension - allows for natural vertical displacement of center of gravity Patented off-loading mechanism - maintains constant force; simply dial in amount to off load Single-point suspension - permits functional pelvic rotation Unobstructed open access - Offset design provides full access for easy patient interaction Attachment rings - on support vest allow single or two-point pelvic stabilization when desired Low-effort manual operation - no power cord, no weights, no air compressor Adjustable and removable patient handrails - accommodates diverse patient populations and allows for easy treadmill access Unweighing Harness - fits a variety of patients Adjustable height - can be assembled at reduced height for use in rooms with 8-foot ceilings Adjustable suspension - accommodates children and adults Therapist seats - provide a place to sit during assistive exercise and provides a safer environment for therapist interaction The Biodex Unweighing System enables partial weight-bearing therapy to be conducted with the assurance of patient comfort and safety, and with convenient access to the patient for manual assistance and observation. Unlike the simple patient lift devices, Biodex Unweighing System incorporates a dynamic suspension system that accommodates the vertical displacement of the center of gravity that occurs during normal gait. Biodex s patented off-loading mechanism maintains constant force; simply dial the amount to off load. When walking, an individual s center of gravity typically moves through a vertical range from one to four inches, depending on walking speed. The Biodex system accommodates up to four inches of vertical displacement while maintaining a consistent level of unweighing. Another component of normal gait is pelvic rotation. Twopoint suspension systems have a tendency to restrict rotation on the horizontal plane. They respond to pelvic rotation similar to the way a playground swing undulates back to neutral after being twisted. The singlepoint suspension of the Biodex system allows unrestricted pelvic rotation. Patients can train for weightbearing ambulation without compromising proper gait kinematics. Should pelvic stabilization be desired, retention cords can be attached to special attachment rings on the sides of the support vest, secured to the frame, and adjusted for the specific degree of pelvic stabilization. The ability to allow rotation has other advantages. When training with a treadmill, single-point suspension permits functional pelvic rotation and versatility when walking, sidestepping, retro-walking and turning. With a Biodex Unweighing System, the patient can change direction without repositioning the entire patient support system. STANDARD unweighing harness The Biodex Unweighing Harness is designed to provide vertical lift through three shared points of pressure: through the hip straps, gluteal fold straps and the lumbar-thoracic harness. The design improves comfort and prevents slippage without limiting lower extremity range of motion. Assuring that the patient is comfortable is essential when lengthy exercise sessions are required. Patient weight capacity of harness is 450 lb (204 kg) Warranty: 60 days, parts Standard Unweighing Harness...$ (See next page for product details) APPLICATIONS: Used for Spinal Cord Injury, Stroke/Traumatic Brain Injury, Parkinson's Disease, Low- Back Patients, Older Adult, Amputation of the Lower Extremity and Orthopedic Patients. SPECIFICATIONS: Dimensions: 41.5" w x 50" depth x 106" h (105 x 127 x 270 cm) accommodates patients from pediatric up to 6 11" (210 cm) on a standard treadmill; alternate height setting for facilities with low ceilings: 93.5" h (241 cm) accommodates patients from pediatric up to 6 2" (188 cm) on a standard treadmill Accommodates Treadmill up to 35" wide Vertical Adjustment: 60" (152 cm) Unloading Weight Capacity: 180 lb (82 kg) Patient Capacity: 500 lb (227 kg) Power: 9V Battery Certification: ETL listed to UL and CAN/CSA C22.2 No.:601-1-M90. CE conformity to EN , EMC compliance to IEC Warranty: Two-years parts; one-year labor Unweighing System...$7, Includes: Standard Unweighing Harness, removable arm supports, pelvic stabilization straps and two therapist seats U.S. Patent No. 6,302,828 To order, call Biodex toll free Int'l

30 What do you have when you combine the Gait Trainer 3 with Unweighing System? THE biodex GaIT TRaINING SYSTEM + = Most inpatient and outpatient PT facilities first encounter a patient with Parkinson s disease only after a series of falls often with serious physical and emotional consequences. Despite its resemblance to an ordinary treadmill, the Biodex Gait Trainer 3 differs in ways that illustrate its specialized rehabilitation design for neurologically impaired patients including an instrumented deck that yields audio & visual biofeedback and objective documentation. TREADMILL TRAINING Protas and colleagues at University of Texas, Galveston, initiated a randomized, controlled trial to assess the benefit of gait and step perturbation training. Subjects were randomly assigned to a trained or control group, and polled for any falls 2 weeks prior to and 8 weeks after the gait training period. Gait speed, One example of neural plasticity is the improvement seen in locomotion of patients with stroke or spinal cord injury through partial body weight supported treadmill training. This rapidly developing form of therapy is based on two fundamental observations. First, that the spinal cord of all vertebrates, including man, contains neuronal circuitry that encoded the locomotor pattern, and which can be activated by stimulation at supraspinal, suprasegmental, or segmental levels or even by intrathecal drug administration. The activation of locomotor circuitry does not therefore require moment-to-moment control of individual muscles by the brain. The second observation was that repeated activation of the central pattern generating circuit by treadmill training could result in long lasting enhancement of locomotor output. In human trials, this resulted in improved locomotion months and even years after training was discontinued. Excerpt from: The Role of Neural Plasticity in Neurorehabilitation Michael E. Selzer, MD, PhD., Associate Dean of Graduate Education University of Pennsylvania Medical College,USA cadence, and step length were tested on an instrumented walkway. Gait training consisted of walking on a treadmill at a speed greater than over ground walking speed while supported in a harness for safety. Findings: Gait speed increased in the trained group from 1.28 ± 0.33 meters/sec to 1.45 ± 0.37 meters/sec, but not in the control group (from 1.26 to 1.27 m/s). Stride lengths increased for the trained group, but not the control group. Body weight support treadmill training (BWSTT) has demonstrated of benefit in many studies of Parkinson s disease patients, some of the earliest by Miyai and colleagues. i The Osaka team found BWSTT patients had significantly greater improvement in ambulation speed, number of steps and performance in activities of daily living than an age- and diseasestage matched individuals receiving conventional physical therapy. i Miyai, I (2000), Treadmill Training with Body Weight Support: Its Effect on Parkinson s Disease, Arch Phys Med Rehabil Vol 81, pp va hospital STuDy* SuPPORTS ThE CONCEPT OF ThE BIODEx unweighing SySTEM If the system does not allow for vertical movements, gait is markedly distorted. The subject may still be able to move on the treadmill, since the walking surface is moving below him, but this unnatural gait is not the goal of therapy. SPECIFIC RECOMMENDATIONS: - Support up to 40% of patient s body weight - Allow for 5.5 cm of vertical movement to permit normal gait - Report reliably to ensure the correct degree of unloading - Enable easy adjustment to the amount of body weight support as the subject improves or fatigues during a training exercise *VA Hospital Study: Source: Wilson M, Qureshy H, Protas E, Holmes A, Krouskop T, Sherwood A.: Equipment Specifications for Supported Treadmill Ambulation Training, J of Rehab, Rehab and Development, Vol. 37 No. 4, July/August 2000, pp

31 Harness unloading & SuPPORT Patient comfort, safety and support for use on the Biodex FreeStep SAS or Biodex Unweighing System. Harnesses are designed to accommodate a range of patient populations. Support harness DLx A comfortable, supportive harness that is quick and easy to put on and off. Worn as a vest around the upper torso, the Support Harness DLX provides patients with security and safety from falling when used with the FreeStep SAS or Unweighing System. Versatility includes double shoulder point connections to spreader bar or, a single connection point for low ceiling applications with tall patients (6'3" on a treadmill or 6'11" on the floor). A pelvic support strap is included to keep the harness in place when limited body weight support is intended. Note: This vest is not intended for patient unloading, but can be used with the Biodex Unweighing System when support is required. SPECIFICATIONS: Torso Circumference: 28" to 50" (71 to 127 cm) Patient Capacity: rated for 300 lb (136 kg) Warranty: 60 days, parts Harness, Support, DLX...$ Includes Pelvic Support Strap For use with the Biodex Unweighing System and FreeStep SAS Pediatric harness Support for the lightweights For use with the Biodex Unweighing System or FreeStep SAS, the Pediatric Harness supports and unloads for children-size torsos. SPECIFICATIONS: Torso Circumference: 14" to 36" (36 to 91 cm) Patient Capacity: rated for 30 to 100 lb (13 to 45 kg) Warranty: 60 days, parts Harness, Pediatric...$ For use with Biodex Unweighing System and FreeStep SAS. Standard unweighing harness Designed for patient unloading, provides safety and support most popular for Biodex Unweighing System The Standard Unweighing Harness grips patients around the torso as well as the thighs to provide a secure fit when offloading a patient s weight during partial weight-bearing therapy (PWBT) on the Biodex Unweighing System. The harness is also suitable for use with the FreeStep SAS to provide patient support. Facilities with both systems can share the vest. SPECIFICATIONS: Torso Circumference: adjustable from 25" to 60" (64 to 154 cm) Patient Capacity: rated for 450 lb (204 kg) Warranty: 60 days, parts Harness, Standard Unweighing...$ For use with Biodex Unweighing System Note: Standard Unweighing Harness included with Biodex Unweighing System Harness, Standard Unweighing For use with Biodex FreeStep SAS Bariatric Harness Support for larger patients Similar in design to the Standard Unweighing Harness, the Bariatric Harness grips patients around the torso and thighs for a secure fit when offloading a patient s weight during partial weight-bearing therapy (PWBT) on the Biodex Unweighing System. SPECIFICATIONS: Torso Circumference: 52" to 72" (132 to 183 cm) Patient Capacity: rated for 600 lb (272 kg) Warranty: 60 days, parts Harness, Bariatric...$1, For use with Biodex Unweighing System and FreeStep SAS To order, call Biodex toll free Int'l

32 FreeStep FEATuRES: Provides patient support during rehab activities: - Sit-to-stand - Over ground, treadmill walking - Climbing and descending stairs - Balance training Reduces number of therapists needed to safely assist patient ambulation Minimizes fear of falling that inhibits patient effort Protects therapists and care givers from injuries when guarding patients Accommodates concurrent use by multiple patients Reduces liability risks for the facility by reducing patient falls as well as Worker s Compensation claims Create a safe, supported ambulation environment without using additional floor space or staff The need is clear. Biodex FreeStep SAS is an overhead track and harness system that provides a safe ambulation environment for both therapist and patient. Without the fear of falling, patients can focus more fully on their tasks of gait and balance. Likewise, therapists can focus on assisting, rather than supporting. According to an article in the American Journal of Occupational Therapy, 2009 May-Jun;63(3):351-62, a startling 62% of PTs and 56% of PTAs reported injury to the low back while assisting patients. And for stroke patients alone, as many as 39% were reported to have fallen during inpatient rehabilitation. Stroke, 1995;26: FREESTEP SAS IS SuITABLE FOR ANy FACILITy WORKING WITh WEAKENED OR BALANCE DEFICIENT PATIENTS: Nursing Homes and Assisted Living Facilities Stroke Rehabilitation, Parkinson s patients Head Injury, TBI and SCI patients Amputee rehabilitation Orthopedic patients, especially total hip/knee, where a fall could be a major set back Over ground walking is key to gait rehab and activities of daily living - but can be risky for patients and therapists. FreeStep SAS reduces the risk of falling, bolsters confidence and encourages patients to focus on the task at hand. Safe ambulation and support over ground, stairs, parallel bars or equipment. Multi-user capacity optimizes equipment and staff in a safe environment. To view the FreeStep in action, click in to 32

33 An overhead track and harness system for patient and therapist safety SAMPLE CONFIGuRATIONS Custom Configuration to suit your facility and need Biodex FreeStep SAS can be custom configured to your facility, complementing the existing equipment floor plan. Install as a simple loop for continuous ambulation over stairs or through parallel bars, or add side branches for equipmentspecific stations to include treadmill exercise or balance training. Whatever material is behind your ceiling, FreeStep SAS can be installed wood beam, steel or even concrete. Standard installation can support up to 750 lb per, or two 375 lb patients on one 8-foot track. The construction of FreeStep SAS allows multiple users performing varying exercises to benefit from supported ambulation without increasing PT attention. Therapists can treat high-risk patients one-on-one, without adding a second therapist to assist. Simple loop with side bars. The First Step toward FreeStep Determining the best layout for your track system begins with a basic drawing of your existing or future equipment floor plan. Detailing clear dimensions is essential. A Biodex Product Specialist will work with you to realize optimum utilization of your equipment, space and supported ambulation enhancements. Simple loop with side bars set over stairs and parallel bars. CuSTOMIZED LAyOuT using BIODEx FLOOR PLANNER FreeStep provides safety for patient managing an obstacle course on their own. Improving balance and strengthening core using the FreeStep. Customize your own floor plan using Biodex Floor Planner. Available at To order, call Biodex toll free Int'l

34 ThE BOTTOM LINE Biodex Rehabilitation Equipment is commonly used in rehabilitation services based on a physician referral for these ICD-9 codes. Physician referral and ICD-9 codes: V15.88 Personal History of Fall Muscle weakness Leg weakness Degenerative joint disease Secondary localized osteoarthritis Abnormal gait Difficulty in walking Joint pain Joint stiffness Instability of joint Visit us on the web for sample reports, CPT codes, testimonials, applications, bibliographies, warranty information, supporting reference articles, product manuals and more. Biodex University Get the most from your investment. Click in for upcoming workshop schedule and co-sponsored events. Follow Biodex on Facebook Let s get a discussion going Biodex University Biodex-Physical Medicine & Rehabilitation Calendar of Events Coordinate product demonstrations with the purchase decision. Click in for upcoming calendar of trade shows where Biodex products will be featured Dizziness Imbalance Concussion without LOC Concussion with brief LOC Concussion with LOC<30 minutes Concussion LOC 31 to 59 minutes Concussion with unspecified duration of LOC Concussion unspecified (NOS) Post-concussion Syndrome (PCS) The following CPT codes may be applied. Reimbursement amounts vary among plans and states Therapeutic procedure, one or more areas, each 15 minutes; therapeutic exercise to develop strength, endurance, range of motion and flexibility Neuromuscular re-education of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities Gait Training (includes stair climbing) Therapeutic activities, direct (one-on-one) patient contact by the provider (use of dynamic activities to improve functional performance), each 15 minutes Self-care/home management training (eg, activities of daily living (ADL) and compensatory training, meal preparation, safety procedures, and instructions in use of assistive technology devices/adaptive equipment) direct one-on-one contact by provider, each 15 minutes Physical performance test or measurement (eg, musculoskeletal, functional capacity) with written report, each 15 minutes CONDITIONS OF PURCHASE CREDIT TERMS: Net 30 days, available to qualified accounts only. Accounts not paid within 30 day period are subject to a 1.5% charge for each additional month. PRICE: All prices in this catalog are F.O.B. shipping point and are subject to change without notice. INTERNATIONAL CUSTOMERS: Prices in this catalog are for U.S. customers only. Prices do not include duty, shipping, VAT, international packing, international labeling, language options, warranty, installation, service or support. Biodex products are sold and supported by a worldwide network of qualified distributors. Visit our web site for the name of your local distributor, DOMESTIC MINIMUM ORDER: $50.00 INTERNATIONAL MINIMUM ORDER: $ METHOD OF PAYMENT: Visa, MasterCard, American Express, Discover and personal, prepaid checks accepted. SHIPPING POLICY SHIPPING: Shipment of orders is handled by a computerized system to assure the lowest cost possible. Under 70 lb UPS. Over 70 lb - Motor Freight. (All motor freight charges are collect unless otherwise stated.) All orders will be charged actual shipping fees. When ordering by prepaid check, call to confirm shipping charges and applicable tax. RUSH ORDERS: Emergency orders can be shipped next-day air or second-day air, incurring additional freight charges. DAMAGE IN SHIPMENT: At time of shipment, all goods are inspected and warranted to be in first-rate condition. Our packaging of all products complies with, and in most cases, exceeds requirements of Motor Freight Classifications. Despite the care used in packaging, damages occasionally happen in transportation. Upon receipt of shipment, open immediately and inspect for concealed damages. If damage is sighted, stop unpacking. Hold shipment container and ask delivering carrier for an inspection for concealed damages. This notification to the carrier must be made within 10 days of receipt of shipment for claim purposes. CLAIMS: Any claim for damages should be made against the transportation company. Our responsibility ceases upon receipt of shipment by the carrier, but if we can be of any assistance in processing a claim, please advise us by calling SATISFACTION GUARANTEED EXCHANGES AND RETURNS: Thank you for choosing Biodex. If you are not satisfied with your order, it can be returned for credit or exchanged for a more suitable product. The customer is responsible for return freight charges and for certain transactions, subject to a restocking charge. In the event of an incorrect product shipment, due to Biodex s error, Biodex is responsible for return freight charges. Products returned must be unused, in resalable condition and in original packaging. For complete terms of Biodex Exchange and Return Policy, LIMITED WARRANTY: Biodex Medical Systems, Inc., (Biodex), hereby warrants its products sold to buyer to be free of defects in workmanship and material for a period of one year from date of shipment, unless stated otherwise in the specifications of the specific product. THE FOREGOING WARRANTY IS EXPRESSLY IN LIEU OF ALL OTHER WARRANTIES EXPRESSED, STATUTORY OR IMPLIED. INCLUDING, BUT NOT LIMITED TO, THE IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. Final determination of the suitability of the products for the use contemplated by Buyer is the sole responsibility of Buyer, and Biodex shall in no way be responsible for the suitability of the Products for any particular use. Claims for defects in workmanship or material must be presented to Biodex in writing and received by Biodex prior to the expiration of the warranty period. BUYER'S SOLE AND EXCLUSIVE REMEDY, AND BIODEX'S SOLE OBLIGATION, UNDER THIS WARRANTY SHALL BE REPAIR OR REPLACEMENT OF THE DEFECTIVE PRODUCT AS DETERMINED AT BIODEX'S SOLE OPTION. IT IS UNDERSTOOD THAT UPON REPAIR OR REPLACEMENT, BIODEX SHALL HAVE NO FURTHER OBLIGATION TO BUYER WITH RESPECT TO THE DEFECTIVE PRODUCT. UNDER NO CIRCUMSTANCES SHALL BIODEX BE LIABLE TO BUYER OR ANY THIRD PARTY FOR SPECIAL, INCIDENTAL OR CONSEQUENTIAL DAMAGES, LOSSES OR EXPENSES IN CONNECTION WITH, OR BY REASON OF THE INABILITY TO USE THE PRODUCTS FOR ANY PURPOSE, OR FOR DAMAGES AND/OR INJURIES INCURRED BY BUYER, ITS AGENTS ˆˆ ¼ AND EMPLOYEES, BY VIRTUE OF DEFECTS IN THE PRODUCTS, EVEN IF BIODEX HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. Use or misuse by the buyer and/or agents, employees or others will, at the option of Biodex, void all product warranties. This catalog information herein is the property of Biodex Medical Systems. Copying in whole or in part, transmittal to other individuals or companies, and use for any purpose other than that for which it is intended, are expressly prohibited. 34

35 The Clinical Advantage Rehab Biodex Balance & Mobility - an integrated approach to rehabilitation Stroke Parkinson s Disease Multiple Sclerosis TBI Older Adult/Deconditioned Biodex Balance and Mobility Clinically Proven to Advance Patients Toward Functional Independence BioStep 2 Improves cardiovascular endurance and builds strength of muscles associated with gait and mobility. Gait Trainer 3 Prompts patients into proper gait patterns with real time audio-visual biofeedback of step symmetry, step length and step speed. Document progress with comparison to normative data. Balance System SD Improves balance and weight shifting, important components of gait and mobility. Document progress with comparison to data. Unweighing System Offloaded support during assisted ambulation before a patient is fully weight-bearing. The Biodex Gait Training System combines the Gait Trainer 3 & Unweighing System BWSTT Biodex Style with audio-visual biofeedback, normative data and objective documentation. Biodex Documentation Progress is clearly documented in easy-to-understand color reports, and compared to age-matched normative data, simplifying assessment of a wide variety of patients. now includes Automated G-Code Calculations and Impairment Level Reporting. Demonstrate Need, Progress and Outcomes more efficiently with Biodex. Treat up to FOUR patients simultaneously Lease the Biodex Balance and Mobility Package together for only $972 per month. Ask about leasing details. BIODEX Int l FN: /14

36 BIODEX Biodex Medical Systems, Inc. 20 Ramsey Road, Shirley, New York, CHANGE SERVICE REQUESTED SUBSCRIBE to BIODEX NEWSLETTERS BLOGS Follow Biodex-Physical Medicine Let's get a discussion going MADE IN U. S. A. FN: /14 The Clinical Advantage biodex Gait Trainer 3...More Than a Treadmill Now with AUTOMATED G-Code CALCULATIONS advantages of the biodex Gait Trainer 3: Biofeedback Objective Documentation Normative Data Biofeedback can play a critical role. Immediate correction, both visual and audible, provides the best quality rehab in the shortest period. > WHY Biofeedback In stroke patients, the Biofeedback group improved step length by 79% and the group with traditional gait therapy improved step length by [only] 43%. Montoya, R. Dupui, P. Pages, B. Bessou, P. (1994). Step length biofeedback device for walk rehabilitation. Med Biol Eng Comput, 34, See Pages > WHY Treadmill Training Treadmill training with partial bodyweight support in hemiparetic subjects allows them to practice a favorable gait characterized by a greater stimulus for balanced training because of the prolonged single-stance period of the effected limb, a higher symmetry, less plantar flexor spasticity, and more regular activation pattern of the shank muscles as compared to floor walking. Hesse, S. Konrad, M. Uhlenbrock, D. (1999). Treadmill walking with partial body weight support verses floor walking in hemiparetic subjects. Archives of Phys Med Rehabilitation, 80, (28) > WHY Objective Documentation Estlack et al., found only slight to moderate reliability for 54 physical therapists observing kinematic and tempro-spatial variables in three patients with rheumatoid arthritis. Estlack, M.E. Arvidson, J. Snyder-Mackler, L. Danoff, J.V. McGarvey, C.L. (1991) Interrater reliability of videotaped observational gait analysis assessments. Phys Ther, 71, (6) BIODEX Int l