Breg K.T.K. User manual

Knee
Therapy Kit
Instruction
Booklet

K.T.K.
Knee Therapy Kit
CONTENTS:
Warnings and Notes ................ 1
Special Instructions ................. 3
Range of Motion ...................... 4
Stretching ................................ 6
Strengthening .......................... 9
Functional .............................. 17
Exercise Schedule .................. 22
Warranty ................................ 24
1
WARNINGS:
Federal law restricts this device to sale by or on the order of
a licensed health care practitioner and should only be used
under the supervision of a licensed health care
practitioner.
CAREFULLY READ ALL INSTRUCTIONS PRIOR TO USE.
The K.T.K. is a tool provided to the health care practitioner
to be used as appropriate in the treatment of patients. While
certain features are incorporated in the design of the device
to provide for its safe use, it is strongly suggested that its
use be directly controlled and monitored by the health care
practitioner.
PRIOR TO EACH USE, CAREFULLY INSPECT FOR ANY
WORN OR BROKEN COMPONENTS. Parts will deteriorate
with age and use.
AW-1.00210 REV H 0113

2K.T.K.
Knee Therapy Kit
PLEASE NOTE:
Do exercises only as instructed by your therapist.
Use pain as an exercise guideline. If a specific exercise
increases pain, discontinue that exercise and notify your
therapist.
Do exercises slowly and carefully.
PRIOR TO EACH USE, CAREFULLY INSPECT FOR ANY WORN
OR BROKEN COMPONENTS. Parts will deteriorate with age
and use.
Not all exercises shown are appropriate to every patient.
Some may be contra indicated for specific knee instabilities
or injuries. A licensed health care practitioner must specifi-
cally assign both the appropriate exercises to perform as well
as the frequency and number of repetitions for each patient.
Exercises illustrated are for the right leg.
5 lb
1 lb
2 lb
3 lb
4 lb
5 lb
1 lb
2 lb
3 lb
4 lb
Carrying Bag
Instruction Booklet
Door
Strap
Two Rubber Tubings
Rope &
Pulley
Ankle Strap
Quick Links
Belt
Pillow
Weight Bag

K.T.K.
Special Instructions
HOLD-RELAX STRETCHING
Hold-Relax Stretching, one of the most effective ways to
increase range of motion and enhance muscle relaxation,
can be easily accomplished with the Knee Therapy Kit.
Many of the stretching and range of motion exercises in this
booklet can be performed using the Hold-Relax technique
described below:
1. Actively move the muscle you wish to stretch to the
end of its range.
2. Contract the tightened muscle firmly, while preventing
motion by holding your leg with your hand or with the
Rope and Pulley.
3. Hold for 5 to 10 seconds then relax.
4. Now again actively move the muscle to the end of its
range. The range will have increased.
5. Repeat the above steps until no more range of motion
can be achieved.
The following example, using the Hamstring Stretch
exercise on page 8 in this booklet, will further illustrate the
proper technique for Hold-Relax Stretching:
1. Attach the Door Strap and Ankle Strap as shown and lie
on your back with your leg straight.
2. Raise your leg toward your chest as far as it will go.
3. Contract your Hamstrings by trying to move your leg
back toward the floor, but resisting any motion with the
Rope and Pulley.
4. Hold for 5 to 10 seconds then relax.
5. Now raise your leg toward your chest again. It will have
an increased range of motion indicating increased
muscle stretch.
6. Repeat the process several times until no more range of
motion can be achieved.
PATELLOFEMORAL DYSFUNCTION
During the rehabilitation of P-F Dysfunction several points should be em-
phasized. Patients with P-F Dysfunction usually show consistent symptoms.
Most often these patients have; (1) poor patellar tracking (primary lateral
deviation), (2) poor quadriceps control, strength and endurance, (3) tight
hamstrings, (4) tight hip flexors, and (5) poor hip control, strength and
endurance. During the rehabilitation process, these areas must be targeted
without causing high patellofemoral shearing and loading forces. The
exercises with the “PF” symbol in the lower right corner of
the illustrations address the needs and restrictions associated
with P-F Dysfunction rehabilitation. Patients should advance in their
exercise programs gradually, using pain and swelling as their guide to
progression.
3

1
2
K.T.K.
Range of Motion Exercises:
Assemble the Rope and Pulley to
the Door Strap and Ankle Strap with
Quick Links, as shown. Position the
Door Strap as shown for each exer-
cise.
Make sure the rolled end of the Door
Strap is placed in the door jamb so
that when pulled, the door will pull
closed rather than open.
When positioning the Door Strap at
the bottom of the door, place a bar,
stick or similar object through the
strap to prevent inadvertent
release.
Wall Slides: lie on the floor as shown. Slowly slide your
affected leg down the wall by bending your knee as far as
possible. Hold for 5-10 seconds. Use your unaffected leg
to help raise your affected leg back to the starting position.
Passive Knee Flexion: Position yourself on the floor as
shown; gently pull the rope handle until your knee is flexed to
the point of tightness. Hold for 5-10 seconds, and then relax.
4

3
4
Range of Motion Exercises continued:
Using warm water, fill each half of
the Weight Bag equally to the de-
sired weight as indicated on the bag.
When not in use, leave the fill plugs
open.
Passive Knee Extension: Lying on a firm surface with the
inflated pillow under your ankle, place the Weight Bag over
your knee. Relax leg muscles as much as possible allowing
full extension.
Prone Leg Hang: Lying with your legs hanging off the end of
a bed or on the floor using the Pillow as shown, allow your
lower leg to hang freely. To assist in gaining full extension, the
Weight Bag may be hung over your heel.
5
5 lb
1 lb
2 lb
3 lb
4 lb
Before use, fully inflate Pillow.

5PF
6PF
K.T.K.
Stretching Exercises:
Calf Stretch: Stand against the wall with feet positioned
as shown. With rear leg straight and heel on the floor, lean
toward the wall until the calf is tight. Do not bounce. Hold for
10 seconds, and then relax. Repeat until loose.
Groin Stretch: Positioned as shown, push your knees
inward against your elbows firmly, hold 10 seconds, and then
relax. Actively spread your knees farther apart and repeat until
loose.
6

7PF
8PF
Stretching Exercises continued:
Hip Flexor Stretch: Lying on the floor as shown, bend your
knee 90 degrees. Lift your thigh off the floor until tight. Hold
for 5-10 seconds, and then relax. Repeat until loose.
Quadriceps Stretch: Positioned as shown, or while holding
your ankle by hand, bend your knee until tight and perform the
Hold-Relax technique as described on page 3. Alternatively,
perform the same exercise without the Rope and Pulley by
lifting your ankle until tight and holding for 10 seconds, then
relax. Repeat until loose.
7
Assemble the Rope and Pulley to
the Door Strap and Ankle Strap with
Quick Links, as shown. Position the
Door Strap as shown for each exer-
cise.
Make sure the rolled end of the Door
Strap is placed in the door jamb so
that when pulled, the door will pull
closed rather than open.
When positioning the Door Strap at
the bottom of the door, place a bar,
stick or similar object through the
strap to prevent inadvertent
release.

9PF
10 PF
Hamstring Stretch: Positioned as shown and with your leg
straight, lift your leg until tight and perform the Hold-Relax
technique as described on page 3. Alternatively, perform the
same exercise without the Rope and Pulley by lifting your
ankle until tight and holding for 10 seconds, then relax. Repeat
until loose.
Bent Knee Hamstring Stretch: Positioned as shown and with
your knee bent 90 degrees, straighten your leg until tight and
perform the Hold-Relax technique as described on page 3.
Alternatively, perform the same exercise without the Rope and
Pulley by lifting your ankle until tight and holding for 10 sec-
onds, then relax. Repeat until loose.
8
Assemble the Rope and Pulley to
the Door Strap and Ankle Strap with
Quick Links, as shown. Position the
Door Strap as shown for each exer-
cise.
Make sure the rolled end of the Door
Strap is placed in the door jamb so
that when pulled, the door will pull
closed rather than open.
When positioning the Door Strap at
the bottom of the door, place a bar,
stick or similar object through the
strap to prevent inadvertent
release.
Stretching Exercises continued:

11 PF
12 PF
K.T.K.
Strengthening Exercises:
Quad Set: Sit on the floor with your legs out straight and your
toes pulled back toward you. Tighten the muscles on the front
of your thigh as tightly as possible. Hold for 10 seconds while
attempting to increase the tightness each second, then relax.
Straight Leg Raises: Lie on the floor with your legs
extended and toes pulled back toward you. Tighten the
musclesonthefrontofyourlegasmuchastightaspossible,then
raise your leg 6 inches above the floor, keeping your muscles
contracted tightly while holding for 5-10 seconds, then relax.
9

13 PF
14 PF
Connect the Ankle Strap and Door
Strap as shown. Wrap the Ankle
Strap securely around your forefoot
and use the Door Strap as a handle.
Toe Raises: Stand with your feet shoulder length apart and
raise up on your toes as high as possible. Hold for 5-10
seconds, and then relax.
Calf Strengthening: While seated as shown and with the
Ankle Strap around your forefoot, point your toe away from
you while resisting with your hand.
10
Strengthening Exercises continued:

15 PF
WARNING
Not all exercises shown are appropriate to every patient. Some
may be contra indicated for specific knee instabilities or inju-
ries. As an example, patients with Anterior Cruciate Ligament
instabilities or reconstructions should not do Knee Exten-
sions exercises 15-20 without physician approval.
Before use, fully inflate Pillow.
Short Arc Knee Extensions w/o Resistance: Sitting on the
floor with the pillow under you knee as shown, pull your toes
toward you, tighten your quadriceps and extend your leg to a
fully straight position. Hold for 5-10 seconds, and then relax.
11
Strengthening Exercises continued:

16 PF
17 PF
Straight Leg Raises with Weight: Lie on the floor as shown,
tighten the muscles on the front of your leg as tight as possible,
then raise your leg 6 inches above the floor. Tighten your mus-
cles harder while holding for 5 seconds, and then relax.
Short Arc Knee Extensions with Weight: Sitting on the floor
as shown, tighten your quadriceps and extend your leg to a
fully straight position. Hold for 5-10 seconds, and then relax.
12
Using warm water, fill each half of
the Weight Bag equally to the de-
sired weight as indicated on the bag.
When not in use, leave the fill plugs
open.
5 lb
1 lb
2 lb
3 lb
4 lb
Strengthening Exercises continued:
Before use, fully inflate Pillow.

18/19 PF
Resistive Knee Extension: Sit in a chair with the Pillow, Rope
and Pulley positioned as shown. Starting with your knee bent
to approximately 90 degrees, straighten your leg while provid-
ing resistance with the Rope Handle.
Isometric Knee Extension: Sit in a chair with the Pillow and
Rope and Pulley positioned as shown. Starting at 90 degrees
of knee flexion, contract your quadriceps to extend your leg,
but using the Rope and Handle, do not allow the leg to extend.
Hold for 5-10 seconds, and then relax. Repeat the exercise at
approximately 75, 60, 45, and 30 degrees of knee flexion.
13
Assemble the Rope and Pulley to
the Door Strap and Ankle Strap with
Quick Links, as shown. Position the
Door Strap as shown for each exer-
cise.
Make sure the rolled end of the Door
Strap is placed in the door jamb so
that when pulled, the door will pull
closed rather than open.
When positioning the Door Strap at
the bottom of the door, place a bar,
stick or similar object through the
strap to prevent inadvertent
release.
Strengthening Exercises continued:

20 PF
PF
21
For single Rubber Tubing resistance,
connect the Tubing Clips to the Door
Strap and Ankle Strap, as shown.
For Clip adjustment see below.
For double Rubber Tubing resis-
tance, slide the Tubing through the
Door Strap and connect both Tubing
Clips to the Ankle Strap, as shown.
For Clip adjustment, see below.
To release Tubing Clip from Rubber
Tubing, push both trailing pieces of
tubing simultaneously back through
the slot in the Clip.
To attach Tubing Clip, fold the
Rubber Tubing over at the desired
attachment place and slide the fold
through the slot in the Clip. Then
loop the folded tubing over the top of
the Clip and pull tight.
Hip Flexion Strengthening: Standing facing away from the
door with the Ankle Strap and Rubber Tubing connected as
shown and your leg straight, flex your leg forward at the hip,
then return to the starting position.
Hip Extension Strengthening: Standing facing the door with
the Ankle Strap and Rubber Tubing connected as shown and
your leg straight, extend your leg backwards at the hip, then
return to the starting position.
14
Strengthening Exercises continued:

22 PF
23 PF
For single Rubber Tubing resistance,
connect the Tubing Clips to the Door
Strap and Ankle Strap, as shown.
For Clip adjustment see below.
For double Rubber Tubing resis-
tance, slide the Tubing through the
Door Strap and connect both Tubing
Clips to the Ankle Strap, as shown.
For Clip adjustment, see below.
Hip Adductor Strengthening: Standing sideways to the door
as shown with your leg straight, pull your leg away from the
door and across your other leg, then return to the starting
position. Use a chair or table for balance support, if needed.
Hip Abductor Strengthening: Standing sideways to the door
as shown with your leg straight, pull your leg away from the
door and your other leg, then return to the starting position.
Use a chair or table for balance support, if needed.
15
Strengthening Exercises continued:

24 PF
25
Short Arc Knee Extension with Resistance: Attach the Door
Strap and Rubber Tubing as shown. Adjust the Rubber Tubing
for correct length. Pull your toes toward you, fully extend your
leg and hold for 5 seconds, then relax.
Hamstring Strengthening: Sit in a chair facing the door with
the Ankle Strap and Rubber Tubing attached as shown. Start-
ing with your leg straight out with resistance from the tubing,
flex your knee as far as you can, then return to the starting
position.
16
For single Rubber Tubing resistance,
connect the Tubing Clips to the Door
Strap and Ankle Strap, as shown.
For Clip adjustment see below.
For double Rubber Tubing resis-
tance, slide the Tubing through the
Door Strap and connect both Tubing
Clips to the Ankle Strap, as shown.
For Clip adjustment, see below.
Strengthening Exercises continued:

26 PF
27
K.T.K.
Functional Exercises:
One-Quarter Squats: Stand with your feet shoulder length
apart and toes pointed straight ahead. Keeping your back
upright, squat one-quarter of the way down and return.
Forward Lunges: From a standing position, place your hands
on your hips and step forward 2-3 feet with your affected leg.
As your foot strikes the floor, allow your knee to bend approxi-
mately 90 degrees. Control your downward motion, then press
hard to reverse your motion and stand back up.
17

28 PF
29/30 PF
Connect Tubing Clips to Belt Loops
as shown. Adjust Rubber Tubing for
proper exercise length.
Step Ups: Stand with your affected leg next to a 6-8 inch high
step. Step up with the inside foot, then with the outside foot.
Next, step down with the outside foot, then with the inside
foot.
Squats with Resistance (both legs): Standing as shown, squat
down to approximately 90 degrees, hold for one count, then return.
Squats with Resistance (one leg): Perform as above except
on one leg only.
18
Functional Exercises continued: