Patients with chronic pain, unfortunately, prefer not to exercise. It hurts too much. In fact, it is not uncommon to hear these patients complain that physical therapy makes them worse! Deconditioning and progressive weakness contribute to the chronic problems of these most unfortunate patients. We all would like to have some gentle, progressive toning up of muscle. Someone has called this a "kinder, gentler" type of exercise.

In fact, this kind of exercise is now possible in the new equipment for assisted exercise manufactured by Shapemaster Toning Systems. These new machines are capable of slowing the rate of muscle contraction to a more comfortable slower pace. No more of the shaking machines of the 80's. The principles of muscle toning dictate that the muscle be allowed to maintain isometric or isotonic contraction for several seconds to obtain maximum benefit on strength and, as side benefit, calorie expenditure and weight loss.

Some of these new tables can also be used for aerobic purposes, and thus to foster the production of endorphins sorely needed for chronic fatigue and pain. In general assisted acercise can contribute to the sense of well-being and help to overcome the depression that afflicts some patients.

Some types of exercise in these newer machines can be modified as well to include stretching of myofascial bands of muscle (i.e., painful chronic spasm). Patients with new prosthetic knees or hips can "graduate" from their C. P. M. (Constant Passive Motion) machines to these to continue, not only mobilization, but beyond this, strengthening of the affected limb."

Respectfully submitted, Pedro A. Gismondi, M.D.