Resistance and rehabilitation: from dumbbells to intelligent devices

It takes a certain type of person to not only challenge convention, but to back themselves to flip established practices on their head. An enquiring mind, perseverance and perhaps a dash of stubbornness are qualities that come to mind. To find those qualities in a 17-year old schoolboy is extremely rare. That was Arno Parviainen’s age when he travelled from Finland to the United States in 1973 to meet with a leading exercise equipment company. Arno was interested in physical fitness and training and the burgeoning industry developing around it in the early 1970s. The original article is published by our Australian partner, Getback.

‘I was very excited about the cam technology they had designed to regulate resistance in training equipment,’ Arno recalls on a recent trip to Melbourne. ‘We went to Florida and had a chance to try these machines.’ He was so excited that when he returned to Finland, he decided to make a copy of the cam in his school metal class. ‘I made a pullover machine and a bicep, tricep, arm machine,’ Arno says. ‘It was in the school gym and it created quite a bit of interest.  ‘A medical journal visited us and wrote an article about it, and that’s when I decided “This is something I want to do.”’ A year later he flew back to the United States to meet with the exercise equipment company’s founder.

‘I said that I would love to bring the technology to Scandinavia on a license.  ‘He said “We’re too busy… come back in five years and we can talk.’ Though disappointed that he’d been brushed off, Arno put the initiative on hold and set about getting an Economics degree. Exactly five years later, he wrote a letter to the company founder.  ‘I still have a copy of that letter,’ Arno recalls. ‘I explained my plan to him in detail. ‘But I never got an answer.’ At this point, most people would have shelved the project for good. But Arno wasn’t about to take no – or radio silence – for an answer. ‘I thought “Okay, I’m able to do this for myself,”’ Arno recalls.  ‘So I started a company.’

With a small grant from the Finnish government, Arno began making prototypes of a pullover machine with a similar cam design.  But while testing the device, he discovered a fundamental limitation with its biomechanical properties.

‘We noticed that when you got tired, the range of motion got shorter and shorter. I wondered, “Why is that?”’ ‘Then we shaved part of the cam off and put it back together, maybe 20 times. ‘The result was that we could actually squeeze the full range of motion with a steady speed.’ Arno was puzzled that the training effect of his re-fashioned prototype was the opposite of the established cam design. ‘I was very confused,’ he says. ‘This was a multimillion-dollar US company, and we were nobodies, and somehow our results were totally different.’ Eager to verify his findings, Arno consulted with Professor Paavo Komi, head of the Department of Biology and Physical Activity and director of the Neuromuscular Research Center at the University of Jyväskylä, Finland. Professor Komi suggested a study using Electromyography (EMG) to analyse how effectively activities spread through the range of motion on Arno’s devices. ‘Although the loading curve was dramatically dropping towards the end of the extension on our device, EMG activity stayed exactly the same,’ Arno says.

The study papers were published in the mid 1980s gave what Arno says was ‘a very solid scientific foundation that we had found something unique about how to regulate loading in devices.’ The rest, as they say, should have been history. But there were barriers in finding the right application for the new design. ‘We were working with the sports and fitness industry at that time, and our clients were predominantly ex-bodybuilders who started fitness clubs,’ Arno says.  ‘When I tried to explain the the beauty of the loading curves, it fell on deaf ears sometimes.  ‘What is really odd is that even today, fitness equipment in the marketplace is not correctly designed.’

Despite the barriers, Arno’s new company – David Health – had some success distributing the new devices in Europe and the United States. ’In the late ’80s David was quite a well known brand in the US,’ Arno recalls. ‘We had these beautiful white devices with a big David logo that were quite iconic, and they attracted women.  ‘We were even featured in beauty magazines in France!’ But he still felt there was a gap in clients understanding the full capabilities of the devices.  ‘I was disillusioned for a time,’ he says. ‘Until Professor Komi suggested we look to adapt the technology for rehabilitation.’ It was the killer application that Arno had been searching for.

‘What was unique about the idea was that nobody was really using strength training or exercise in that format for rehabilitation,’ Arno explains. ‘The only devices that were really accepted were isokinetic devices, where you start pushing the movement arm, and it escapes at a steady speed. ‘But the idea of using a load, or a weight in rehabilitation was quite unique. ‘You’re actually pushing against load that you have to lower down with your force.  ‘The difference was that the variable resistance in our devices worked so beautifully. ‘It felt very smooth and easy to handle for patients. They really loved it.’

The devices were quickly adopted in the rehabilitation environment, particularly for back conditions. Arno developed a franchise, David Back Clinic, which peaked at around 200 clinics in 20 countries.  But like all great innovators, Arno wasn’t about to rest on his laurels.  When his son Lauri, a doctor who had started an IT company making medical software and his daughter Elina, a consultant in the health sector joined the business, a turbo-charged phase of development was in the making.

‘At the time we were working with both the medical field and fitness industry, and it was becoming a beast with no clear direction,’ Arno says.  ‘We decided to scrap maybe 100 different product models from the fitness side to concentrate on six back rehabilitation devices.’ It was a brave strategic move to choose a more difficult route into the medical field.

‘You’re not just fighting against competition, you’re fighting against the establishment,’ Arno says. ‘All the systems and lobbies and financial insurance schemes had to be dealt with. ‘It was a very difficult road ahead.’ Another major change of tack for the company was to develop a new generation of ‘intelligent devices.’ ‘In those days, the devices were dumb,’ Arno explains. ‘There were no computers or connections, but you could test isometrically with a cassette that was put in the devices. ‘We put a major effort into connecting the devices to the cloud and building software around it.’ The software enabled data from the back rehabilitation devices to be automatically collected and stored during every exercise therapy treatment. ‘When you combine structured data with devices, you create very precise prescription methods,’ Arno says. ‘The graphical interface on the devices also showed the patient very clearly the prescribed speed, range of motion and workload, as well their level of compliance to the program. ‘The system was very empowering and motivating for patients.’ Today, David Health devices are utilised in more than 600 centres in 45 countries – including 22 clinics in Australia overseen by getback.

Recent changes in healthcare guidelines recommending exercise therapy as first-line treatment for musculoskeletal disorders have also reassured Arno that prioritising a medical approach was the right call. ‘Exercise therapy is now becoming part of mainstream medical systems,’ he says. ‘My long term belief is that that exercise therapy in a scientific, documented and quantified manner will be a huge, core part of healthcare.’

But there is still work to do, and the quest continues for Arno. ‘I’m 68 with no plans to retire at this point, because I have so much energy and so much work to do.’ Perhaps ironically, he is now looking back to the fitness industry, where he sees the potential to merge with medical services to offer mass preventative health, particularly for ageing populations – what Arno calls ‘Population Health’. ‘It’s become very clear to me that we have to bring the medical and fitness sides together now,’ he says.  ‘Right now, they’re very far from each other. They don’t talk to each other, and they don’t trust each other. ‘It’s going to reverse, but it will take time. We’re never going to give up.’

Part II of the interview with Arno Parviainen – where he outlines his vision for ‘Population Health’ – will be published soon.

 

Bastiaan Meijer