Enraf Nonius Quadriceps Bench Manual De Uso página 13

4.2. The end of the ROM is set with pin 2 and disc C
(see fig 2).
Pull pin 2 completely and turn ½ a stroke clock-
wise (thus 180°). This will unlock both disc B
and disc C. Now one should move the resist-
ance arm to the desired angular position, and
rotate the ROM limiter of disc C to the limiter
pin. In this position one should turn pin 2 a ¼
of a stroke counter clockwise (thus 90° back
from it's previous position). This will fix disc C.
4.3 The beginning of the ROM is set with pin 2 and
disc B (see fig 3).
From the position as realized in 4.2 (where pin
2 only fixes disc C, and disk B is still able to
move freely) one should rotate the resistance
arm to the desired initial position. Now rotate
the ROM limiter of disc B to the limiter pin. In
this position one should turn pin 2 a ¼ of a
stroke counter clockwise (thus again 90
from it's previous position). This will fix both
disc B and disc C. Be assured that both discs
are well fixed now.
The scale at the discs indicate the angular de-
grees (in steps of 20
Example
How can we train a m. quadriceps femoris from 90°
flexion to full extension, whereby the maximum re-
sistance (torque) of 10 Nm is produced at 60° ?
Realization of the example
• Position the patient at the Quadriceps bench and
adjust the back support. Align the rotation axis
of the Quadriceps bench with the (imaginary) ana-
tomical joint axis of the knee (which is the line
through both the lateral and medial epicondyl).
• Before any weight disc is added to the lever arm,
the resistance arm is to be unlocked with pin 2,
and both ROM limiters should be placed in their
0 position.
• Now unlock disc A with pin 1. Move both the
resistance arm as well as the lever arm to 60
(which can be seen at disc C). From this position
the lever arm only is moved onwards to the hori-
zontal position. Fix the lever arm with pin 1 in this
horizontal position.
• After this one should pull pin 2 and turn it ½ a
stroke to release both ROM limiters. Now move
the resistance arm to the end of the ROM and fix
the ROM disc C by means of turning pin 2 ¼-th
of a stroke backwards.
0
back
0
).
• Now the resistance arm should be moved to the
initial position in the ROM, and the ROM limiter of
disc B should be fixed in this position. Be assured
that both disc B and C are well fixed with pin 2 !
• In order to realise a resistance of 10 Nm at 60°
one should add 8 weight discs of 0.5 kg at 25
cm of the rotation axis. As 8 x 0.5 = 4 kg, which
is equivalent with 40 N, the lever arm distance
(the distance between the rotation axis and the
added weight discs) should be 25 cm, since
0.25 m x 40 N = 10 Nm.
With these settings, the resistance at 90° flexion will
10 Nm x cos (60°) = 10 Nm x 0.5 = 5 Nm
and at full extension:
10 Nm x cos (30°) = 10 Nm x 0.87 = 8.7 Nm.
Absolute contra-indications:
• Myocardiac dysfunction in an unstable phase
• HNP in the (sub) acute phase (with irradiation and
neurological signs)
• Severe osteoporosis
• Acute fractures
• Severe mechanical instability
• Early post-surgical joint modification
Relative contra-indications:
• Myocardial dysfunction in a stable phase
• HNP in the sub-acute phase (with irradiation and
neurological signs)
• Mild osteoporosis
• Late post-surgical joint modification
• Tumours
• Inflammations in the involved area
• Non desired articular load in the involved area
(p.e.. with M. Osgood-Schlatter, bursites, etc.)
• Non desired ligamentous load in the involved area
(p.e. sprain with hydrops)
• Non desired soft tissue load in the involved area
(p.e. with severe atrophy)
• Cardiovascular restrictions
• Pulmonary restrictions
• Psychological restriction
0
• Pain of such cause that movement would not relief
CONTRA-INDICATIONS
11