**5. Statistical studies**

We evaluated the efficacy of the rehabilitation therapy using the plantar pressure measurement platform, for example, the pressure mat system MatScan (Tekscan, USA). The patients were assessed using plantography and posturography, during both the start and the completion of treatment. During the measurement process, the patients stood up and had their eyes open. The results were compared before and after the INFINITY method® therapy. We compared the values measured before and after the intervention of the INFINITY method® [2]. Several variables were measured such as bilateral pressure on the right and left soles of the feet, gravitational forces between both soles, anteroposterior (A-P), and mediolateral (M-L) displacement of COF [3] (COF being the center of gravity of the body between both soles of the feet). During a 30-second period, we recorded the change in value of the COF and the area defined by the movement of A-P and the M-L of the COF. These data allowed us to calculate the difference in COF and COF area before and after INFINITY method® therapy. A total of six dependent variables were statistically evaluated. Five of these variables were the posturographic measurements and are presented in **Table 2**.



Dist, distance; Var, variability; AP, anteroposterior directions; ML, medial-lateral directions. \*Statistical significance at *p* < .05.

**Table 2.** Posturographic parameters—results of the paired samples test.

exercise in their mind, and in normal patients, this type of visualization activates muscles and the central nervous system with no overload or damage. The same is valid for micromove-

The method is very effective when applied in patients with muscle imbalance, patients with changes of muscle tonus (e.g. trigger and tender points), and patients with low tissue quality (mainly older patients). We have achieved excellent results in patients with scoliosis, posture

Rehabilitation treatment can also be given to patients with degenerative changes of the musculoskeletal system affecting function, structure, and pain (such as spondyloarthritis, spondylosis including root syndromes, and osteoarthritis of other joints), to patients after surgery (orthopedic and trauma surgeries like arthroscopy, joint replacement), and to patients after

We evaluated the efficacy of the rehabilitation therapy using the plantar pressure measurement platform, for example, the pressure mat system MatScan (Tekscan, USA). The patients were assessed using plantography and posturography, during both the start and the completion of treatment. During the measurement process, the patients stood up and had their eyes open. The results were compared before and after the INFINITY method® therapy. We compared the values measured before and after the intervention of the INFINITY method® [2]. Several variables were measured such as bilateral pressure on the right and left soles of the feet, gravitational forces between both soles, anteroposterior (A-P), and mediolateral (M-L) displacement of COF [3] (COF being the center of gravity of the body between both soles of the feet). During a 30-second period, we recorded the change in value of the COF and the area defined by the movement of A-P and the M-L of the COF. These data allowed us to calculate the difference in COF and COF area before and after INFINITY method® therapy. A total of six dependent variables were statistically evaluated. Five of these variables were the posturo-

ments where the range of movements is in millimeters.

malfunction, as well as patients with spinal pain.

graphic measurements and are presented in **Table 2**.

**Feet parallel, eyes open Feet parallel, eyes closed**

**Parameter Mean (cm) SD (cm) Parameter Mean (cm) SD (cm)** Area before\* 2.76 4.88 Area before\* 3.09 4.46 Area after\* 2.23 3.01 Area after\* 2.40 5.47 Dist before 37.72 16.64 Dist before\* 50.30 30.56 Dist after 36.97 15.26 Dist after\* 46.68 27.50 Var before 0.03 0.02 Var before\* 0.04 0.03 Var after 0.03 0.02 Var after\* 0.04 0.02 AP Exc before 2.75 1.25 AP Exc before\* 3.25 1.61

other traumas.

208 Clinical Physical Therapy

**5. Statistical studies**

A VAS was used to assess each patient's personal assessment of pain [2]. Given the results, it can be stated that due to the rehabilitation process, there was a statistically significant improvement of the above parameters (**Table 3**). There were significant differences in measurements between pre- and post-rehabilitation treatment.

Measurements in the antero-posterior direction of movement of the COF, medial-lateral movement of the COF, the area covered, the COF distance, and the variation of COF were all reduced. The subjective assessment of pain also showed a statistically significant reduction. The results of this study show that the INFINITY method® rehabilitation treatment resulted


**Table 3.** VAS parameter—results of the paired samples test.

in statistically significant improvements in the observed plantographic and posturographic parameters of stance stability. Subjective pain using VAS was also much lower, which must be considered as being extremely beneficial to overall patient health [2].

There are various rehabilitation techniques employed in clinics that exhibit different success for the given diagnosis. Our empirical evidence initiated further theoretical studies of the musculoskeletal system based on mathematical modeling (**Figure 1**).

The mathematical models can assess muscle activity of various motion patterns and can validate the effectiveness of the motion pattern used in the INFINITY method®. It was hypothesized that a figure of eight motion contributes to the stabilization and the strengthening of trunk muscles, including the deep stabilization system. Advances in mathematical modeling and technology are creating new opportunities that may be able to quantify the effect of physiotherapy on the lumbar spine [4]. The overall aim of one particular study was to compare the effect of a figure of eight movement on deep muscle activation and spinal load with simple movements during rehabilitation.

The spinal muscle and L5/S1 load were assessed using mathematical modeling. The model was designed to study the INFINITY method® that is primarily based on small micromotions [2]. The study indicates that a more complex motion provides higher frequency load to passive structures and requires complex activation of muscles enhancing neural system involvement. The conclusions were that the complexity of motion pattern directly influences the spinal load and muscle activation pattern [5]. Simple pendulum-like or circular-like motions do induce harmonic muscle activation and spinal load. But the results show that the figure of eight pattern (∞) proposed in the INFINITY method® doubles the frequency of spinal loading while conditions complex muscle activation patterns that could induce remodeling in passive structures, strengthen active structures, and effectively train the central neural system (**Figure 2**).

**Figure 1.** A Rear view, B Front view - spine muscles, C Front view - abdominal muscles.

Special Rehabilitation Treatment Methodology: INFINITY method® http://dx.doi.org/10.5772/67968 211

**Figure 2.** Movement patterns.

#### **6. Conclusions**

in statistically significant improvements in the observed plantographic and posturographic parameters of stance stability. Subjective pain using VAS was also much lower, which must

There are various rehabilitation techniques employed in clinics that exhibit different success for the given diagnosis. Our empirical evidence initiated further theoretical studies of the

The mathematical models can assess muscle activity of various motion patterns and can validate the effectiveness of the motion pattern used in the INFINITY method®. It was hypothesized that a figure of eight motion contributes to the stabilization and the strengthening of trunk muscles, including the deep stabilization system. Advances in mathematical modeling and technology are creating new opportunities that may be able to quantify the effect of physiotherapy on the lumbar spine [4]. The overall aim of one particular study was to compare the effect of a figure of eight movement on deep muscle activation and spinal load with simple

The spinal muscle and L5/S1 load were assessed using mathematical modeling. The model was designed to study the INFINITY method® that is primarily based on small micromotions [2]. The study indicates that a more complex motion provides higher frequency load to passive structures and requires complex activation of muscles enhancing neural system involvement. The conclusions were that the complexity of motion pattern directly influences the spinal load and muscle activation pattern [5]. Simple pendulum-like or circular-like motions do induce harmonic muscle activation and spinal load. But the results show that the figure of eight pattern (∞) proposed in the INFINITY method® doubles the frequency of spinal loading while conditions complex muscle activation patterns that could induce remodeling in passive structures, strengthen active structures, and effectively train the central neural system (**Figure 2**).

be considered as being extremely beneficial to overall patient health [2].

musculoskeletal system based on mathematical modeling (**Figure 1**).

**Figure 1.** A Rear view, B Front view - spine muscles, C Front view - abdominal muscles.

movements during rehabilitation.

210 Clinical Physical Therapy

The INFINITY method® is a rehabilitation therapy and exercises developed by Michaela Tomanová, MD, PhD, who is the head physician and director of a large rehabilitation clinic in the Czech Republic. The clinic has 220 beds. Based on clinical experience gained in the years of practice, Dr. Tomanová has developed a system of diagnosis and therapy for patients with musculoskeletal problems. The basis of INFINITY method® was laid out in the beginning of this century, and the method has been improved and developed since then. The method has been based on knowledge gained in works published already.

The method utilizes motion in all three planes of the body and in all possible directions. The method primarily addresses muscles and connective tissues that are used in an incorrect manner due to our modern lifestyle, that is, muscles that are overloaded or underloaded. Corrective motion patterns similar to daily activities are used. Relaxation and strengthening of individual muscles and muscle groups occur during therapy, and the quality of connective and soft tissues is influenced as well. The muscle tone is normalized. Movements in an upright standing position are necessary to correct the optimal body posture, including neutral positions. Therapy and exercises gradually and automatically lead to improvement in posture. The method also improves body segment positions because it impacts the whole posture and spine stabilization with the help of gravity effects. The emphasis is on proprioception, exteroception, sense of position, and sense of movement, as well as the patient's awareness of his or her own body and its motion.

The considerable advantage of the INFINITY method® is a wide range of autotherapy techniques, well-understood principles, and a wide range of variations. Using these treatments and exercises, the musculoskeletal system is loaded, but not overloaded, and it activates and often relaxes these structures as well. The patient experiences whole-body stabilization after treatment and practices the method with the assistance of a therapist. The treatment also results in biomechanical rebalancing and body symmetrization in a space allowed by structures of the musculoskeletal and central neural system. This should also result in improvement in quality and effectiveness of the motion, and also in improvement in connective and soft-tissue quality and functionality (muscles, ligaments, tendons) as well as a reduction of pain in the musculoskeletal system.
