ARPwave: therapy or gimmick?

New technology strives to heal injuries faster
Sunday, December 21, 2008 | 8:33 p.m. CST

BY ANGELA POTRYKUS

COLUMBIA — Columbia resident Jeff Powell and his business, Transformational Fitness Coaching, might just be onto something. Powell bought the rights to a recovery program that no one else in Missouri has, and he has athletes from around the state paying a pretty penny to come use it. Inside his gym, behind Kelani Salon and Spa, he says he is “fixing” injured athletes in a third of the time it takes using typical physical therapy. Part of fixing these athletes makes use of a machine that sends electrical currents into the muscles. But some physical therapists aren’t convinced and aren’t promoting this new program. They claim there’s nothing to prove the program’s success but the testimony of a few clients.

Powell’s program, ARPwave, stands for Accelerated Recovery Performance. The program claims to get to the root of an injury, help cure that injury 30 percent faster than any physical therapy, and get people back into the shape they once were.

MU grad Fiona Asigbee, a track and field athlete who ran hurdles at the Olympic trials this July, has a 3:30 p.m. appointment with Powell. She is wearing basketball shorts, an MU track and field shirt, and her hair is pulled back. She is ready for her session. Asigbee has had knee trouble for a while now and just went through surgery a couple months ago. Immediately after the surgery, she began working with Powell and his ARPwave program. On her initial visit, he conducted the first of three phases of the program, the muscle imbalance, in which he assesses the strengths, weaknesses and flexibility level in Asigbee’s muscles. To do this, Asigbee lays down on the training table, and Powell applies pressure on her quadriceps and instructs her to push in the opposite direction his hands are pushing. According to the ARP philosophy, the first step towards healing is making sure the body is in biomechanical balance.

“It’s the most important part of the whole program,” Powell says.

Asigbee is now in phase two of the program. She comes in for 15 minutes every day and Powell hooks her up to a machine that sends electrical currents into the muscles surrounding her injury. Similar to an e-stem machine — electrical stimulation machines common in most physical therapy offices — the ARP machine is meant to break up scar tissue and get the muscles working again in a normal, pre-injury way. The difference, as ARPwave contributing creator Denis Thompson says, is that this machine allows patients to move while it is hooked to their body. To Thompson, using an e-stem is ineffective because if there’s no movement, the body will cramp after receiving the electrical current.

About the size of a VCR, the ARP machine has various cords and switches protruding from it. The cords, which have round patches at the ends, are placed strategically on certain “hot spots,” as Powell calls them. Asigbee’s hot spot is on her quad above her knee. Powell puts one patch there and the other at her hip. They will send electric shockwaves that cause her muscles to pulsate. It’s simulating a workout she might get on the track, just without putting the strain on her body.

Powell asks Asigbee if she’s ready; she blows out some air and replys with a confident “yes.” Powell turns one of the knobs on the box, says he is starting her out at a low level of intensity but plans to increase that level quickly.

“Fiona can handle a lot of intensity,” he says.

Asigbee sweats, concentrates and begins breathing in a consistent pattern. She will be hooked up to the machine for 10 minutes. Powell increases intensity and Asigbee’s face shows some slight discomfort. He then instructs her to do some plymetrics exercises, which are part of the third phase called strength recovery. Powell asks her to do a low squat. Balancing with Powell’s hands, Asigbee is at first unable to bend far enough.

“It’s OK,” he assures her. “You’ve got it.”

But she is determined to do her squat the right way. On the next try, she makes it nearly to the ground and holds it there. Every once in a while her leg twitches. Powell reassures her that the twitching indicates normal progress.

The goal of the ARPwave program is to allow Asigbee to recover from her injury, and at the same time, get back to her old “in-shape” self. The program does that by putting the muscle under the same stress athletes face doing a normal workout. But because they can’t work out because of their injury,the ARP machine does it for them, putting the muscles, as Powell and Thompson put it, in high-risk situations, so the body can respond to the stress. Another goal is to make sure an athlete doesn’t lose muscle while recovering from an injury. It’s the kind of recovery Asigbee says athletes dream of. She says that once injured, it’s a constant uphill battle for top athletes to get back to the top of their game. There’s constant worry about getting hurt again, hoping to compete once more in an environment that never waits.

Powell thinks ARPwave might just provide the answer to those woes. And it’s not just the woes of top athletes. Alhough the NFL, NHL and MLB have incorporated ARPwave, the program is designed to heal anyone with an injury.

Powell, 36, was frustrated that it took so long for athletes to heal using corrective exercises. So when he found out about the ARPwave treatment a year ago at a conference in Arizona, he immediately decided to make the $15,000 investment to lease the machine for a year. Customers pay $60 per session and the recommended number of sessions for a full recovery is ten.

Although Powell isn’t a physical therapist, strength training and recovery is nothing new to him. A longtime Columbia resident, his background has been in martial arts and he is also a certified personal trainer. For a long time, he was known in Columbia for training fighters. Now, the ARPwave program is at the core of his business.

ARPwave was developed by a group of professionals, including Denis Thompson, an exercise physiologist, Jay Schroeder, a strength trainer, and Dr. John Pietila, a chiropractor. The trio also worked with ARP contributing inventor Gary Thomas. Thompson says they “developed the system out of frustration.” For years, they combined the skills from each of their professions to come up with an electrotherapy recovery system that they say simultaneously cures the injury, maintains the former body strength and neurologically balances the body in order to prevent the injury from occurring again. Five years ago, the group put their ARPwave program on the market. While individual ownership of the ARP machine is booming, the ARPwave program is less known. The ARPwave clinic, which is where Thompson, Pietila and Schroeder work, is based out of Burnsville, Minn. They don’t advertise at all and most of their success is from word-of-mouth.

“ARP goes through all the steps of basic physical therapy, does the RICE (Rest Ice Compression Elevation) method of healing an injury, works joint mobility and increases functional strength,” Thompson says. “But the difference is, ARP does it all at the same time, cutting down your possibly six months of recovery to three.

“The numbers weren’t adding up. Nobody was putting it all together and the only way we have been treating injury has been in the reactive way. We are targeting not just the injury itself, but the source of the injury. You get injured when a part of your body is unable to absorb force. With the ARPwave phases, we make sure your body can absorb that force, and we do it by breaking up scar tissue and barriers and then keeping your body strong at the same time.”

Although ARPwave is FDA approved, it has not been incorporated into the general medical field, Thompson says. He says that though the newness and “radical idea” of the system contributes to the ARPwave, not being known about in doctor’s offices or physical therapists, some just are turning away.

“There is a slight conflict with the general medical community,” Thompson says. “People just learn to do things a certain way and this idea of such fast recovery is so outside of the box right now, that it’s tough to take.”

Out of eight Columbia physical therapists contacted, three refused to comment, two had never heard of ARPwave and ARP technology, and two others never responded. But Kevin Marberry, a physician and MU Assistant Professor of Orthopaedic Surgery and Sports Medicine, has had experience with ARPwave.

“When I was in Indianapolis, I worked with the Indianapolis Colts and some of their players, Edgerrin James and Dwight Freeney, both used the ARP to prevent injury,” Marberry says.

As for why it’s not in physical therapy offices, Marberry says, “There is very little evidence in the medical literature stating that this works as it is intended. That doesn’t mean that it doesn’t work, it just means that there have been no good studies proving that it does work, or that it works better than what is currently being used. Most of the information we have is anecdotal and based on personal testimony.”

According to Marberry, little scientific evidence about ARPwave’s success is its one downfall.

But Boone County Hospital Obstetrician Dr. Bill Trunbower, who says ARPwave improved his quality of life, thinks the physical therapy community refuses to accept the system for reasons of pride.

“In general, professionals hate new things. With the ARP, if you use it, you may not need surgery for things like knee replacements,” Trunbower says. “People like to be in control and then they want (ARP) and don’t want others to have it.”

Powell says he thinks many might not know the extent of the program and how it works.

“My experience is that when somebody is trained in that way (in physical therapy), a normal medical fashion, most people will look at the machine and say, ‘Oh, that is e-stem,’ but it’s not,” he says. “E-stem units use AC current and the only thing they can do is cause your muscles to contract concentrically. For them it’s just like an expensive e-stem machine and they don’t care. They wonder why it costs so much. It costs so much because it’s not just the machine.”

Powell is working with the MU football team, coordinating with longtime friend and Assistant Athletic Director Pat Ivey. Three ARP machines exist in Columbia, two at Powell’s TFC and one at the MU athletic department. According to Ivey, MU is one of the few schools using the ARPwave system.

Right now, Thompson says ARPwave is used mostly with professional athletes, including 490 in the NFL, 260 in the NBA and 220 in Major League Baseball.

There are 700 facilities in the U.S. that use ARPwave, but according to Thompson, there are thousands of ARP machines used by individuals across the United States.

ARPwave recovery is not covered by insurance, but Thompson expects that the system itself will be in most physical therapy offices in the next 10 years.

As for Asigbee, she goes to Powell every day for her 10-minute ARP session, in hopes of getting back to her old self.

“It’s really amazing,” she says. “My leg would be so small if I didn’t do this. It is really helping me keep and restore my muscles.”

http://www.columbiamissourian.com/stories/2008/12/21/contraption-might-work/

For those with experience, is 10 sessions a legitimate recommendation, dependent on the nature of the injury?

Should/can ARP be used indefinitely?

In terms of performance enhancement, is there a quick plateau effect as seen with EMS, or is that just a narrow way of looking at the application of the device?

Thanks

How is Asigbee doing now?

“There is very little evidence in the medical literature stating that this works as it is intended”…is there evidence in medical literature that anything works?