The document discusses a Therapeutic Gymnasium, which is a room or building equipped for physical exercise and rehabilitation. It contains various types of exercise equipment designed to strengthen muscles, improve mobility, and aid in physical therapy. The gymnasium provides therapeutic exercise programs to help patients recovering from injury or chronic illness improve their functioning and reduce health risks. Key equipment discussed includes treadmills, stationary bikes, elliptical machines, weight machines, and various devices to strengthen specific muscle groups or movements. The document outlines the benefits of exercise and goals of the therapeutic gymnasium to improve patients' overall health and physical abilities.

1. Therapeutic Gymnasium
Dr.Harshal Patel (MPT)
(Musculoskeletal and sports science)

2. Introduction
•Therapeutics means having medicinal or healing
properties.
• The word gymnasium is the latinisation of the Greek
noun gymnasion, whose meaning is to “Train in
gymnastic exercise” generally “ to train to exercise”
•Historically, such a place was a place for both exercise,
as well as bathing, especially social (communal)
bathing.
•In 1598, the term was adopted from a "place to be
naked" to a "place of exercise".
•The abbreviation to gym was introduced in 1871.

3. • Therapeutic Gymnasium is room or building
equipped for indoor sports or a large room
containing equipment such as bars, weights, and
ropes, for physical exercise.
• Healthcare consumers (patients and clients)
typically seek out or are referred for physical
therapy services because of physical impairments
associated with injury, disease or disorders that
interfere with their ability to perform or pursue any
number of activities that are necessary or important
to them.

4. • Health care consumers are directly benefited from the
Therapeutic Gymnasium.
• Physical therapy services may also be sought by those
individuals without any impairment who wish to
improve their overall level of fitness or reduce the risk
of injury or disease.

5. Definition:
Therapeutic Gymnasium is room or building equipped
for indoor sports or a large room containing equipment
such as bars, weights, and ropes, for physical exercise
or building or room with equipment for physical
exercise.

6. • Gym based Therapeutic Exercise is rehabilitation
oriented fitness program that are designed to
improve strength, stamina, stability, flexibility,
functionality, and/or mobility
• This can be using exercise equipment that is
specifically designed to meet needs of patients with
acute or chronic health conditions, physical
disabilities or other problems or through
individualized exercise routines that improve or
restore physical function so that activities of daily
living are no longer a challenge, reduce risk factors
and improve overall health and fitness.

7. Therapeutic gymnasium should have the following
facilities:
1. Therapeutic treatment private rooms
2. Remodeling of dressing rooms and bathroom
facilities, with a large area for lockers.
3. Large windows that contribute to a bright
environment and an ample and cosy atmosphere.
4. New physiotherapy state-of-the-art equipment.

8. • The main advantage of this service is the
interdisciplinary work, carried out by kinesiologists,
physical therapists and doctors together with the
medical professional ordering the treatment.
• All procedures are carried out under the strict
medical protocol, inherent to each respiratory,
cardiovascular or physical therapy specialty.

9. • Equipment There's a cardio section and there is an
aerobic section.
• The gymnasium is spacious, replete with electric
treadmills, cycle treadmills, weights, equipment's for
strength training like wall bars, triceps table, multi-gym,
television and music system etc.
• It has wooden flooring and latest equipment's like
mobilization couches with adjustable height, traction
unit, dumbbells, treadmills (electric and cycle), and
multi-exerciser machines, in addition to regularly
required equipment's like parallel bars, wall bars,
quadriceps table etc.

10. Exercise benefits/effects from the gym include:
1. Increased muscle strength
2. Increased flexibility
3. Weight Management
4. Reduced Stress
5. Improved sleep patterns
6. Enhanced self-image
7. Increased energy
• The ultimate effect of therapeutic gymnasium is to
improve overall health and physical fitness

11. Health Benefits of Gym Exercise and Physical Activity:
# Reduce the risk of premature death
# Reduce the risk of developing and/or dying from heart
disease
# Reduce high blood pressure or the risk of developing
high blood pressure
# Reduce high cholesterol or the risk of developing high
cholesterol

12. # Reduce the risk of developing colon cancer and breast
cancer
# Reduce the risk of developing diabetes
# Reduce or maintain body weight or body fat
# Build and maintain healthy muscles, bones, and joints
# Reduce depression and anxiety
# Improve psychological well-being
# Enhanced work, recreation, and sport performance

13. Equipment used for :
1. Therapeutic training
2. Strength training
3. Balance training

14. Therapeutic training
Treadmill
• A treadmill is a device for or running while staying
in the same place
• The machine provides a moving platform with a
wide conveyer belt driven by an a electric motor or
a fly wheel

15. Advantage
• Treadmill give a great cardiovascular workout and
help to improve heart health
• Each time you step on a treadmill you strengthen
your heart
• And as your heart grows stronger you lower your
blood pressure
• Running or walking help to get the blood flowing
which reduce the stress on your heart

16. Stationary cycle
• A stationary bicycle (also known as exercise bicycle,
exercise bike ) is a devise with saddle, paddles, and
some from of handlebars arranged as on a bicycle,
but used as exercise equipment rather than
transportation

17. Uses
• Exercise bike are used to increase generalise fitness
and for training cycle event
• The exercise bike has long being used for physical
therapy because of low impact , safe , and effective
cardiovascular exercise it provide
• Stationary bike are also used to exercise for
weightless
• It is used to increase lower limb strength and
endurance

18. Elliptical trainer / cross trainer
• It provide non impact, reciprocal resistance to the
lower extremities in upright, weight bearing
position Both type of equipment also provide
reciprocal resistance to the upper extremities.

19. PLINTH (COUCH)
•Used for treating
patients.

20. Multi-gym :-
• Parts – seat, back rest,
handle, shin pad, thigh pad,
fixed & movable pulley,
ropes, weights & knobs
• Uses –
• Used to give strengthening
exercise to various body parts
(upper & lower limb, back &
chest)

22. •Four Station Multi Gym
• Lat pulley, Pec deck, Arm pulley, Leg curling
/extension
•Six Station Multi Gym
• Lat pulley, Pec deck, Chest / Shoulder press, Arm
pulley, Leg curling / extension, Standing calf raise
•Ten Station Multi Gym
• Lat pulley, Rowing pulley, Pec deck, Chest press,
Shoulder press, Arm pulley, Leg curling / extension,
Leg press, Standing calf raise, Dip, chin-up,
abdominal unit

23. SHOULDER WHEEL
• It is a wheel mounted on the
wall.
• Consists of fulcrum, handle and
hand piece.
• Two types are available – one
with giant wheel & other with
axial rod
• Parts – giant wheel or axial rod,
fulcrum, handle, resistance
knob, vertical bar to change the
height
• Used for shoulder exercises.
• Even used for elbow exercises.

24. •Principle – 2nd order lever
•Fulcrum at Centre of wheel, effort
applied at handle & resistance applied
through the knob
•Patient stands besides the wheel and
moves wheel in clockwise as well as
anticlockwise direction.
•Useful in shoulder circumduction
movement.
•Increase ROM of shoulder abduction,
flexion & circumduction

25. ROPE AND PULLEY
•Consists of pulley
attached on the ceiling.
The rope is wounded
around the pulley. It also
has hand piece.
•Used in performing
shoulder exercises.

26. •Patient sits on a chair and grips the hand piece.
•Patient keeps the upper limb forward for performing
shoulder flexion and keeps upper limbs by the side for
performing shoulder abduction.

27. FINGER LADDER
•It is the wooden ladder
mounted on the wall.
•Patient places the finger
tips on it and climbs up.
•Used for shoulder
exercises.

28. •Patient stands in front of the ladder to
perform shoulder flexion. Stands
besides to perform shoulder
abduction.

29. WAND(STICK)
• Use to perform self-assisted
shoulder exercises.
• Use for shoulder exercises like
flexion, extension, horizontal
abduction-adduction and
combination of movement.
• Cane (stick) can be used in
place of wand.

30. • Patient is positioned in supine or
standing
In supine- flexion, horizontal
abduction-adduction.
In prone- extension, combination
of movement.
In standing- all the movements.
Maintain shoulder in external
rotation while performing
abduction (thumb out). Maintain
shoulder in internal rotation while
performing flexion (thumb in).

31. WRIST ROLLER
•It is a wooden rod
mounted on the wall.
•Consists of varying
diameter for different
grips of patient.
•Used for wrist flexion
and extension exercises.
• To increase gripping power

32. • Principle – 2nd order lever
•Fulcrum at centre, effort applied through hand &
resistance through knob
•Patient stands in front of the device and grasps the
rod and roll it clockwise and anticlockwise.

33. SUPINATOR – PRONATOR EXERCISER
• It is a device mounted on the wall.
• Consists of wheel and a hand grip.
Uses –
• To strengthen muscles of supination
& pronation
• To mobilize radio ulnar joints &
increase ROM of supination &
pronation movements.
• To give resisted exercises for
supination & pronation.
• Hand gripper also present which can
be used to increase gripping power
of hand & fingers.

34. •Patient stands in front of the device. Shoulder is
in adduction and elbow 90 degrees flexion.
•Holds the hand piece and then rotates in
clockwise and anticlockwise direction. So that
supination and pronation occurs.
• Principle – 2nd order lever
• Parts-circular board, handle, resistance
knob
•Fulcrum at centre of circular board,
effort applied at handle & resistance
through knob

35. PEG BOARD
•It is a wooden board with
holes in which pegs are
placed.
•Are of different types
based on their colour,
weight, shape, texture,
etc
•Used for co-ordination
exercises and gripping
exercises.

36. •Patient grasps the peg from the board and keep it aside
than again can place it back.
•Uses finger flexors.
•Helps to improve gripping power of patients with
weakness in prehension
•Useful to give game-like activities along with co-
ordination training in patients with cerebral palsy &
mental retardation

37. SPONGE BALL
•It is a soft ball.
•Used for gripping
exercises.
•Wrist should be in neutral
or slight extension
position while
performing exercises.

38. FINGER EXERCISE SPRINGS
Consist of set of 5 springs
Each spring is of different size and
resistance
Resistance gradually increases from
spring 1 to 5.
USES:
Finger flexion exercises and opponent
muscles of thumb.

39. FINGER EXERCISE RING
•Consist of metallic ring
with 5 springs fitted to
the ring, each spring for
fingers and thumb.
Spring ends have leather
loops for inserting
fingers.
USES: Finger flexion
exercises.
•Avoid wrist flexion while
exercising

40. HAND ROLLER EXERCISE BOARD
•Board has different small rollers
of different diameters, which
provide different amount of
resistance and also has one square
block with loop and one roller
with side knob.
•Here Velcro arrangement is used
to provide the resistance.
USES:
For finger muscles strengthening
Wrist flexors and extensors strengthening
Supinator-pronator strengthening

41. PUSH UP BLOCK
• They are the two metal
rods with hand grips.
• They placed on both sides
of patient in sitting position
and can perform
strengthening of latissimus
dorsi.
• It is by taking weight on
ULs and lifting buttocks
• Can be used in prone lying. Patient does extension of trunk by
taking weight on ULs.
• It is used to strengthen triceps.

42. SKATES ROLLER
• Consists of a skates with a ball
bearing rubber wheels
Straps are there so that it can be
secured with the exercising part.
Ball bearing arrangement reduces the
friction so movement will be easier.
• USES
In UL, elbow flexion-extension,
horizontal add-abduction of shoulder.
Also rotation of shoulder.
In LL, knee flexion-extension.

44. SUPINATION – PRONATION DUMBBELLS
•Consists of a set of 3 wooden dumbbells of different
size and weight
Resistance provided by the dumbbells increases as
the size of dumbbell increases, so it is useful for the
PROGRESSIVE RESISTED EXERCISES.
•USES: To develop the strength of forearm muscles
To develop strength of supinator's and pronators.

46. QUADRICEPS EXERCISE TABLE
•It is a table with fixed
arm and swing arm.
•A roll is attached to fixed
arm and resistances can
be attached on the swing
arm.
•If there is back support
than it is called
quadriceps exercise chair.

47. •Patient sits on the table. Places leg behind the roll on
fixed arm and than knee extension is done.
•Resistances can be adjusted accordingly.
•If the angle is fixed and swing arm are changed it can
be used for hamstring muscles for that in sitting
position patients places leg in front of the roll and does
knee flexion.
•Trick Movements :- Trunk movements.

48. QUADRICEPS EXERCISE TABLE

49. BALANCE BOARD
•It is a wooden board with
a rod or a disc below it.
•It makes the board
unstable.
•Used for balancing
exercises.

50. •Patient stands on the board and moves the board in
front, back and side to side.
•Patient stands on board with both the feets apart and
tries to maintain the balance.
•Balance training initially is carried out in a parallel bar
with support, then gradually progress to out of
parallel bar without support.

51. WOBBLE BOARD

52. ANKLE EXERCISER
•Consists of two hinged
planes one is horizontal
and other one is inclined.
•There is spring attached
between the two planes.
•Used for plantarflexor
strengthening.

53. •Patient sits on the chair and the device is placed in
front.
•Patient places the foot on the device with heel at the
bottom and toes at the top. Than presses the plane
down.

54. ANKLE EXERCISER
•Parts: aluminum foot plate
with straps, secured
horizontally over the
wooden base, springs are
there to provide the
resistance. resistance can
be adjusted.
•USES: strengthening of
plantarflexors and
dorsiflexors
Patient position- sitting, position the foot over the
foot rest so that knee is directly over the footrest.

55. HEEL EXERCISER
•Parts: wooden base,
piston arrangement to
provide the resistance,
footrest with the straps.

56. EXERCISE STAIR CASE
(CORNER TYPE)
•It is L – shaped stair case.
•Has railings on the side.
•Uses :- training the
patient for stair ascending
and descending.

57. PARALLEL BAR
•It is a wooden floor with
two horizontal rods on
the sides with four
vertical rods.
•Height of the horizontal
rods can be adjusted at
the level of greater
trochanter of patient.
•Mirror is placed in front
of the parallel bars.

58. •Uses :- Sit to stand, Standing with support and without
support, Gait training with support and without
support, Balancing exercises.
•Patient is asked to see in mirror and make corrections
in posture accordingly.

59. TILT TABLE
•It is a table which can be
tilted.
•Angle of tilt can be
changed from below.
•Patient is asked to lie
down on table and is
secured by straps around
pelvis and thoracic
region.

60. •Then angle of tilt is changed so patient can be brought
in standing position.
•Uses :- Helps to bring patient in standing position.

61. QUADRICEPS BOARD
•Made up of two hinged
wooden planks, out of
these two planks one is
hinged and one is straight
having zigzag
arrangement. With these
arrangement (zigzag n
hinged plank) any angle
can be adjusted and
progressed over time as
patient gain strength.

62. •USES
Knee extensors strengthening in terminal range.
Sand bag can be tied to patient’s ankle for additional
load-more strengthening.

63. WHEELCHAIR
•It is one of the walking
aids.
•Consists of seat, back
support, arm rests, foot
rests, hand rims, wheels,
brakes.
•Uses :- Transfer of
patient.

64. WALKER (ADJUSTABLE, FOLDABLE)
•It is used for training gait
in patient with support.
•Made up of plastic or
aluminium.
•Consists of four tubular
rods, ferrules and hand
grips.
• Its height can be
adjusted.

65. ELBOW (FOREARM) CRUTCH
•Made up of plastic or
aluminiun.
•Consists of single upright
rod, ferrule, hand piece
and forearm cuff.
•Height can be adjusted.
•Used for gait training.

66. AXILLARY CRUTCH
•Made up of plastic or
aluminium.
•Consists of axillary bar,
hand piece, ferrule and
double uprights which
are joined distally into
single upright.
•Height could be adjusted.
•Used for gait training.

67. STICK (CANE)
•Made up of plastic or
aluminium.
•Consists of single
upright, ferrule and has a
curved hand piece.
•Used for gait training.

68. THERABANDS
•Made up of rubber.
•One set consists of 6 thera bands of
different colours according to
resistance offered.
•Used for strengthening exercises.
1. Yellow Resistance Band (lightest)
2. Red Resistance Band (light)
3. Green Resistance Band (light-
medium)
4. Blue Resistance Band (medium)
5. Black Resistance Band (heavy)
6. Silver/Gold-resistance (heaviest)

69. Theratube

70. Flex bar
•Improve grip strength in
the arm, hand and
shoulder

71. WEIGHT CUFFS
•Used for strengthening
exercises.
•Cuff contains sand or
small pieces of metal.
•Tied over the distal part
of the segment.

72. DUMBBELL RACK
•Rack consists of variety
of dumbbells of different
size and resistance.
•Used for strengthening
exercises.

73. PHYSIO BALL (SWISS BALL)
•An exercise ball, also known
as a yoga ball, is a ball
constructed of soft elastic
with a diameter of
approximately 35 to 85
centimeters and filled with
air.
•The air pressure is changed
by removing a valve stem and
either filling with air or
letting the ball deflate.
Use- Core strengthening, sitting balance training, upper
limb lower limb exercise

74. SUSPENSION FRAME
(GUTHRICK SMITH’S APPARATUS)
•Frame consists of rope,
pulley, sling, cuff and
hooks.
•Used for suspending limb
for active assisted
exercises.

75. WALL BARS
•Wooden bars are
mounted on the walls.
•Uses:-
• Can make patient stand.
• Hanging

76. STATIC CYCLE
•Used for improving
fitness of patient
•Also for lower limb
exercises.

77. ROWING MACHINE
•Parts: tubular frame,
padded seat, 4 big nylon
castors which slides
smoothly over the frame,
two foot plates with
straps and springs.
Resistance can be
adjusted by the number
of springs.

78. •Ask the patient to push over the footrests and
straighten the knees.
•USES
Strengthening of LL extensors, plantarflexors.

79. CONTINOUS PASSIVE MOTION
(CPM)

80. BOLSTER

81. PEDAL CYCLE