PHOTO CAPTION: Two large-ticket items every physical therapy clinic should have include a treadmill and a fitness bike. Ensure that both pieces of equipment are commercial grade so they can stand up to daily wear and tear.
A veteran clinic owner shares what he’s learned about how to successfully outfit rehab facilities with equipment.
by Reece Jensen, DPT, OCS
Thirty years ago, I was hired to run the first PRN Physical Therapy clinic in Encinitas, Calif. The clinic had 1,500 square feet of space that included four private treatment rooms and a large gym floor. It was my job to fill the facility with equipment so we could provide positive outcomes for our patients through physical and occupational therapy treatments. Three years later, I was tasked with repeating my playbook for success at PRN’s second clinic in La Jolla, Calif. The La Jolla clinic was a different animal altogether. It featured a large room full of medical strengthening device machines and a team of exercise physiologists and athletic trainers at my disposal. In 1996, I returned to the Encinitas clinic, where I became a partner in 2010. Since becoming a partner, I have consulted for many of PRN’s Northern California clinics to help configure, stock, and staff their facilities. With over 30 years of experience in managing physical therapy facilities, I have developed an expertise for creating functionally designed clinics that feature the most appropriate equipment to support the needs of the clinicians that work there and the patients they serve.
When deciding what pieces of equipment you need in your clinic, you first need to determine what patient population you will be treating. Whether you plan to emphasize outpatient physical or occupational therapy, hand therapy, aquatic rehabilitation, workers’ compensation therapy, or some combination of these specialties, the equipment you purchase needs to reflect the population of patients you will be serving. Different patient populations require unique facility design and equipment. There are common pieces of equipment that will be used across many types of patients, like treadmills, bikes, and Swiss balls, but the specialty services your clinic offers will determine the unique training equipment needed to complete your treatment floor.
Designing a functional and visually appealing facility is an art. If you have difficulties visualizing the flow of patient care in your clinic, it may be beneficial to hire a consultant to provide mock-ups and ideas. It is important to build a smooth flow for patients and employees between your private treatment rooms, gym floor space, bathrooms, employee charting, and break spaces. A well-designed facility will maximize space, optimize flow and utilization, make access easy for your patients, and reduce stress on your staff.
Large Equipment Recommendations
Big pieces of equipment‚ which include items like treadmills, bikes, stair climbers, Total Gyms, multi-station frames, and isotonic/isokinetic testing devices‚ are core pieces of equipment that every physical therapy clinic should have. The space you have to play with in your clinic will help determine which of these key components you can purchase. One of the most important things to remember when purchasing large-ticket items is to ensure they are commercial grade and can stand up to plenty of wear and tear as they will be used daily.
For all 30 years that I have been practicing, I have had a Total Gym from Carlsbad, Calif-based Total Gym Global Corp in my clinic. The Total Gym is one of the best and most versatile pieces of equipment as it is gravity-based and appropriate for all patient populations. It offers a range of exercises and training exercises for a physical therapist, including graded weight-bearing exercises, core work, and upper extremity strengthening. The Total Gym allows for a variety of treatment protocols and modalities that can help accelerate patient outcomes. The best part about the Total Gym is that it is one of the longest-lasting pieces of equipment I have ever owned. The only things that wear out are the cables and vinyl top, and they are easy to replace, making this piece of equipment a great investment for your clinic.
Two other key pieces of equipment every physical therapy clinic should have on their treatment floor are a treadmill and an exercise bike. Both items help patients with active recovery and general conditioning, making them staple pieces. Most clinics should have at least one treadmill on their floor, if not two, as so many patients utilize this piece of equipment. Treadmills are great as they can be used for conditioning, lower extremity strengthening, and gait training. Meanwhile, a recumbent bike is perfect for low-impact cardiovascular training and is used in rehabilitation for many lower extremity diagnoses. For some younger populations, a spin-style bike can be more appropriate than the recumbent. The key thing to remember for these large-ticket purchases is to make sure you find one that fits your space and is commercial grade.
Another piece of equipment that I recommend every clinic have is an upper body ergometer. These are great for patients with upper extremity injuries, and they allow a patient to combine cardio and strength training. My upper body ergometer is going on year 10 and is in great shape. I use it with patients for everything from cardiac rehabilitation to core work and upper extremity postoperative conditions.
Finally, when it comes to large pieces of equipment, I recommend adding a stair stepper to your gym floor if you have the space and funds. A stair stepper can be used with patients to work on traditional stair climbing, both forward and backward, which is great for occupational therapy. The stair stepper can also be used to do a modified leg press with patients. A wonderful thing about stair steppers is that they are strong, durable pieces of equipment. Mine has lasted 20 years and is still going strong.
Some equipment that physical therapy clinics need and use extensively is fixed equipment such as pulleys, mirrors, and anchors for resistance bands. Each of these is an important item that needs to be purchased for the clinic and properly mounted to studs by a licensed contractor for safety.
Mirrors are an especially important feedback tool for patients and clinicians alike and need to be placed properly throughout the clinic. Anchors for resistance bands and any pulley systems need to be strategically placed to allow room for patients to safely carry out the exercises. I have three mounted devices in my clinic, including a ballet bar with a mirror behind it, an adjustable anchor for resistance bands, and a pulley system. These stations are all in the gym portion of the clinic. To use these items successfully with patients, it’s imperative to have solid anchors installed and sufficient space for exercising.
Most physical therapy clinics are made up of a large gym and treatment floor as well as private treatment rooms. Both the private rooms and main treatment floor should include a mix of hi-lo and fixed-height treatment tables. Treatment tables can range in cost from $500 to $3,500 depending on if they’re fixed-height tables or electric hi-lo tables with all the bells and whistles. When I originally purchased hi-lo tables for my clinic, I purchased them as a bundle to get the best deal. The motors and foot switches for hi-lo tables wear out quickly, so be sure to do extra research when purchasing to ensure you receive a good warranty and service option. Meanwhile, the fixed-height treatment and massage tables are strong, durable pieces of equipment that you should hopefully only need to purchase once upfront. Be sure to look for durable tables that you can make updates to yourself as needed. The simple thing to remember is that the better you take care of your tables, the longer they will last.
As physical therapists, there is an array of specialty tools we use daily ranging from modalities for massage to manual therapy tools. I recommend purchasing goniometers, tape measures, reflex hammers, and inclinometers for each therapist or having a few on hand in the clinic that can be shared. The certifications you and your team have may help determine the style and brand of tools you purchase. There are several types of instrument-assisted soft tissue mobilization tools you can go with, so be sure to research what is best for you and your team. I highly recommend getting trained in one of these systems, as it will lead to better outcomes and reduce stress on your clinicians’ hands and joints over time.
As physical therapists, the specialty equipment we use with patients is often what comes to mind first when thinking about purchasing for your clinic. Many are quick to overlook the administrative and business-related equipment that is crucial to operating a successful physical therapy clinic. Be sure to budget for larger pieces of administrative equipment like printers, fax machines, and laptops for charting. The amount of administrative equipment needed to run your clinic will depend on how large of a clinic you have, how many patients you treat regularly, and how many clinicians you employ. Administrative equipment like this is critical to your ability to market and grow your business, so do not overlook these purchases.
Making the Right Choices
No two clinics will be the same in size, style, staffing, or layout. Making good, well-informed choices from the start and being conservative in initially stocking your clinic is key. You can always add more specialized pieces of equipment as you grow and gain a better understanding of what your key demographics and patient type is. It is important to do your homework by conducting your own research, stay cost-minded, and have fun during the purchasing process by making your clinic your own. RM
Reece Jensen, DPT, OCS, is the clinic owner and director at PRN Physical Therapy in Encinitas, Calif. He received his Doctor of Physical Therapy from Boston University and is certified as an orthopedic specialist by the APTA. For more information, contact [email protected].