ATM® Concept Overview

The ATM® Concept - Abstract

An integrated neural/passive/active functional approach for treating musculoskeletal disorders

Introduction

Active Therapeutic Movements (ATM®s) provide immediate and long-lasting benefits to many back, neck, shoulder, pelvis, hip, and knee sufferers.  By definition ATM®s consist of active neuromuscular movements superimposed upon a specific passive holding.  ATM®s aim to immediately alter symptoms, by affecting the Central Nervous System (CNS) control.  The ATM2® is a clinical tool designed to enable effective user operated ATM®s.

Background

The CNS governs the dynamic movement stability components, namely the neural, passive, active (Panjabi, 1992) and emotional components (Vleeming & Lee, 2000).  These components work throughout the anatomical structures of the musculoskeletal system.  Normal dynamic stability provides the healthy body with the ability to perform normal, good quality, low-energy / high-efficient movements.  In the case of pain, the CNS will change its neuromuscular activation strategy, to a high energy / low efficient movement.  This altered CNS movement control is clearly visible and recognizable in the presence of pain.  More subtle physical tests, EMG investigations and imagery techniques can detect significant muscle control changes in individuals with a history of chronic back pain, even if asymptomatic at the time of testing (Hodges, 2000).
According to a prospective study on 100 ATP players, 40% were found to have had presence of low back symptoms for greater than 2 weeks limiting tennis performance (Vad, Dines, & Altchek, 2002), and were categorized by the authors as symptomatic low back sufferers.  In studies ATM®s have been found to immediately reduce pain, and increase range of motion in low back sufferers (Moran, 2002).  Additionally, clinical data demonstrates a significant reduction in the amount of treatments necessary to resolve various specific and non-specific lumbar disorders (Archambault, 2002).

ATM®s (Active Therapeutic Movements)

ATMs are neutral-range active functional movements superimposed upon a specific passive positioning and holding. A few (10-30) movements are performed towards the impaired movement. The passive holding is an essential setup for the ATMs, because it will ensure that the superimposed active movement will alter the CNS activation strategy form pathological to normal. In this starting position the active neuromuscular training will be of therapeutic value, and produce immediate pain reduction and improved range of motion. Perhaps due to improved CNS governed dynamic stabilization of the specific movement.

The ATM2®

The ATM2®is a clinical device designed specifically to enable clinicians to prescribe quality user operated ATMs, i.e. weight-bearing active movements towards the previously impaired movements. Passive joint repositioning and stabilizing is obtained via restraining belts connected to the ATM2 support pad to reduce the symptoms, and then specific ATMs are performed via a harness connected to a resistance band.

Conclusion

ATM®s are a new approach to treating musculoskeletal disorders.  Their specificity and immediate effect provide new avenues in the professional outpatient and sports medicine setting.

References

Archambault, M. L. (2002). The PelvicRestrainer (PR3000) is a breakthrough in treating Lower Back Pain. Windsor, CA: BACKtoGOLF Performance & Fitness Physical Therapy.
Hodges, P. (2000). Dealing with the challenges to spinal stability; The mechanisms of motor control of the trunk. Paper presented at the IFOMT 2000, Perth.
Moran, K. (2002). The immediate effect of a single exercise session using the PelvicRestrainer® on lumbar symptoms in chronic lumbo-pelvic pain subjects. Dublin: Dublin City University.
Panjabi, M. M. (1992). The stabilizing system of the spine. Part I. Function, dysfunction, adaptation, and enhancement. J Spinal Disord, 5(4), 383-389; discussion 397.
Vad, V. B., Dines, D., & Altchek, D. W. (2002). Range of motion in professional tennis players. New York: Hospital of Special Surgery.
Vleeming, A., & Lee, D. (2000). Joint function: Developement of an integral model for diagnosis and treatment. Paper presented at the IFOMT 2000, Perth.

 

Information for Patients

Overview

An ATM based treatment is a combined clinician/patient effort to manage and control acute and chronic musculoskeletal pain.
Significant results of lowered pain level, improved range of movement, general feeling, and functional goals have been achieved with patients immediately during and after treatment. These achievements are then maintained and controlled by the patient her/himself using an ATM2 system.

Our Mission

Our mission is to enable suitable pain sufferers participating in this project to lead a normal life, controlling their problem independently. This will benefit the patient's quality of life, reducing the time, trouble, and costs of repetitive individual back treatments.
ATM Clinicians will provide immediate significant symptom relief for the suitable patients.
Referring doctors or health-care providers will benefit from the significant help their patients will receive, and from the reduced costs involved.

The challenge: Chronic low back pain

The ability to cure chronic back and neck pain appears to be one of the biggest challenges clinicians worldwide have to face. The novelty of the ATM Concept is that, in all most all cases, not only can it effectively and immediately reduce current symptoms in the clinic phase, but if indicated it will give the patient a tool to take home and control the disorder in the future. If the pain levels are eliminated or maintained at a minimum, and the correct muscles are trained daily or as needed in an efficient and comfortable manner, patient control over their own disorder might be within reach.

The ATM® concept has three phases

The Examination Phase

The patient is evaluated to determine weather the ATM Concept is suitable. A full examination is undertaken, and contraindications to the ATM2 are searched for. These include pregnancy, internal diseases or conditions, communication problems, psychological factors and others. The patient’s readiness to undertake such a project is required. The most important indicator to use the ATM Concept is the ability to significantly decrease the symptoms using the ATM2.

The Clinic Phase

After the evaluation, and deciding that the patient is suitable for the ATM treatment, the clinician will set the patient on the ATM2 so that the specific painful movement will become totally pain-free. The patient performs 1-2 minutes of comfortable exercises while supported by the patented ATM2 device. Immediately after the treatment the clinician will release the patient from the ATM2 and expect the previously painful movement to have an immediate and significant reduction in pain and increase in range of motion. The clinic phase will last several sessions depending on the patient’s condition.

The Home Phase

After a successful clinic phase the patient will know how to operate an ATM2 system independently. Daily home exercise sessions using a portable rented or aquired ATM2, at the patient’s convenience will provide long-term control over the disorder, and might prevent future episodes. 

 

Video Clips

The following video clips are cut from the beginning and end of a 20 minute video recording of a full and successful session with the ATM2.
The full, unedited, 20 minute video recording is available upon request.
Please note that our intention is not to give the impression that this is a miracle cure, or that such results are guarantied!

Extension Before Treatment Extension After Treatment
Flexion Before Treatment Flexion After Treatment