Researching Rehabilitation

Purchasing exercise equipment can be the most challenging of all the tasks faced in starting or expanding fitness programs. The right piece can help boost offerings to a new level; the wrong selection can gather dust in a corner and drain the capital budget. And those outcomes are perhaps more pronounced when looking to enter the specialized but booming area of rehabilitation services.

For recreation officials without a healthcare background, the prospect of running a rehab program can be especially daunting. Cary Wing, executive director of the Medical Fitness Association, a trade group, says the first step is to assess the demographics of the area and the potential users’ needs.

Using Local Resources

“Define programs for ‘rehabilitation exercise’,” he says. “Is this post-rehab for shoulder/knee/back injuries, weight management and/or cardiac rehab Phase III/IV? Are there step-down programs available through the local hospital?”

He also suggests consulting with local healthcare practitioners on how they conduct rehab. “Get feedback on specific equipment they use most frequently during rehab and also what they recommend for post-rehab exercise.”

Valerie Paluszak, a physical therapist for Illinois’ Ingalls Health System, oversees five outpatient centers--including one in the fitness center of the Homewood-Flossmoor Park District--and agrees that talking with local experts is helpful.

“If you don’t have the experience, then seek out someone who does, so you can get feedback on what you are planning to purchase,” she says, adding that posing questions on professional e-mail listservs “is a quick way to obtain lots of feedback.”

Wing suggests that equipment should be simple to use, and easy to get on and off. “Machines with multiple uses that take up a small amount of floor space are preferable,” he said, pointing to one company’s dual-pulley system that allows for adjustable weight loads and accommodates people exercising from wheelchairs.

“Look at equipment that all members can utilize, not just those who are post-rehab,” says Wing. “It should be equipment that could be used for preventive as well as for post-rehab patients.”

Above all else, “a manufacturer’s reputation and the quality of the equipment are of the utmost importance,” stresses Paluszak.

Wing concurs: “Be certain to work with a manufacturer who has been in business for a period of time, as well as ask others for referrals.”

New Or Used?

Used or refurbished equipment can be attractive to center operators just starting out. The International Health, Racquet & Sportsclub Association says such products can sell for 30 percent to 70 percent of the original price.

Wing urges careful consideration of such equipment. “Used equipment varies considerably in quality,” he says, suggesting that centers purchase it directly from the manufacturer and make sure a warranty is still in place.

Going for the cheap buy at first can even result in a penny-wise, pound-foolish outcome: “Sometimes the cost of a used piece of equipment is attractive, but it may increase repair costs, making it less expensive to buy a new unit,” says Wing.

Paluszak says she never purchases used equipment. “The manufacturer’s warranty is important to me, as well as having a service agreement. I know that the equipment I purchase is going to be used heavily, so I want to start out with new.

“Also, the aesthetics of new equipment is important when opening a new facility, or even replacing equipment.”

How Much Is Enough?

Again, Paluszak says talking with local clinicians is critical in determining the scope of a new operation. “The quantity of equipment is somewhat complex, and will vary based on the patient population and the style of the clinician,” she says.

“Some clinicians are manual-therapy-based, and use little equipment. Others prefer to use free weights or machines. It is important to understand the population and the clinician preference before outfitting your space.”

Wing says an obvious factor in determining how much equipment is needed is the facility’s space, and local practitioners--exercise physiologists, physical therapists, athletic trainers, kinesiotherapists or physicians--can help. Equipment manufacturers also can provide insight about how their products can fit into a space.

Training Basics

Instructing the staff on maintaining and operating the new acquisitions can also be a challenge, one that varies with the type of equipment. Paluszak says new equipment includes a bonus: “The sales rep will come out and instruct the staff on proper care, usage and maintenance.

“Depending on the piece of equipment, care may be minimal (treadmill) or quite involved.”

Wing says the manufacturer’s suggestions for scheduled maintenance should be followed: “For example, the cables on a strength-training unit need scheduled cleaning and lubrication to avoid excess wear and tear.”

But overall, “the equipment that is manufactured for rehabilitation today should be no more difficult to maintain than any other exercise equipment.”

Generally, operating basic rehabilitation exercise products don’t require any special training, but specialized equipment may, says Paluszak. “This can be provided by the sales rep on-site, or can require a few days training at an off-site location.”

Wing says manufacturers can cover the basics, but certified/licensed specialists need to guide specific patient exercises. His association has developed guidelines covering qualifications, education/training and staffing.

Other Considerations

Wing also cautions that financial and legal issues need to be explored, including the topic of insurance reimbursements. “Self-pay with the appropriate staff and program can be a more viable path,” he says. “It’s also important to consider any regulations or restrictions in place at the facility or through the city and state.”

Agencies also need to look closely at market segments and consider the idea of formal partnerships with local healthcare practitioners.

“Rehab services are popping up everywhere,” says Paluszak. “In order to be successful, do a market survey to identify the services being offered in your area. Determine what will differentiate you from the competition.”

She says Ingalls has been bolstered by exploring niche markets, which include geriatric rehabilitation, neurological rehabilitation, aquatic therapy, women’s health and industrial rehabilitation.

And the partnership with the Homewood-Flossmoor Park District since the mid-1990s has helped her hospital as well. “Another way to be successful is to partner with other exercise providers, such as fitness centers, to be able to provide on-site services and consultations to members,” she says.

Dan Shortridge is a freelance writer and editor from Delaware. He worked for five years as an outdoor skills instructor and director at a Boy Scout summer camp in Maryland.

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Questions To Ask

Basic topics to address when selecting fitness equipment:

Ask yourself:

· What market segments are you targeting?

· What kind of space do you have?

· What are the power constraints?

· What is your budget?

Ask suppliers:

· How long have you been in business?

· How long is your typical downtime?

· What’s your warranty?

Ask others about the supplier:

· What was the installation like?

· What do members say about the equipment?

· What is the supplier’s service record?

Source: The International Health, Racquet & Sportsclub Association

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For More Information

The nonprofit Medical Fitness Association, an affiliate of the American Hospital Association, offers members industry research, conferences, vendor discounts and marketing tips. Contact: P.O. Box 73103, Richmond, VA 23235-8026; (804) 897-5701;

The International Health, Racquet & Sportsclub Association, a trade group of investor-owned, for-profit health clubs, offers research, fitness initiatives and public policy advocacy. Programs and publications are available at non-member rates for other facility types. Contact: 263 Summer Street, Boston, MA 02210; (888) 640-9580;