The term ‘mechanotherapy’ was introduced by Swedish physician Gustav Zander to define a method of treating certain illnesses through massage and exercise, particularly using mechanical equipment. The exercises were drawn from the work of countryman Pehr Henrik Ling, but the equipment was Zanders, and in 1865 he opened the world first Institute of Mechanotherapy in Stockholm. The two main benefits of the Zander machines were the ability to standardise and finely progress resistance, and to reduce the need for assistant workers.

Mechanotherapy offered the medical profession the opportunity to harness the therapeutic benefits of massage, mobilisation and exercise, without engaging with a low-status and labour-intensive manual practice, or employing a lay practitioner with questionable professional loyalty (Nias, 2017). Over 100 Zander institutes were opened throughout the world and even the ill-fated ship Titanic had a mechanotherapy gymnasium on-board.

Zander’s machines enjoyed extreme popularity in Germany, partly due to the mandatory accident insurance that was imposed on employers in 1884 (Hansson & Ottosson, 2015). Using Zander’s machines to rehabilitate individuals with chronic or acute musculoskeletal injuries could lower insurers’ economic burden because patient care did not require as large a staff.

Viennese physician Anton Bum opened his own Institute of Mechanotherapy in 1896 and with physician colleagues Max Herz and Robert Grünbaum developed a global reputation. Visiting Australian proto-physiotherapist, Josephine McCormack described her visit to the Institute on her European study tour in 1903,

In Vienna also I visited Dr Bumm’s [sic] famous gymnasium. Here the breathing exercises were especially good and interesting to me, though the Herz apparatus for deformities, as well as for all nervous or muscular diseases, with either passive or active movements, is a triumph to modern science.” (Bensusan, 1904).

Whilst we have little more information on the Institute, we can gain some insight be exploring the contributions of the three extraordinary individuals who led it and their impact upon physiotherapy.

Dr Anton Bum

Anton Bum was born in 1856, in Brünn (now Brno, Czech Republic) (Mentzel, 2024a). He graduated from the local German Gymnasium (secondary school), studied medicine at the University of Vienna, and received his doctorate there in 1879.

Bum worked initially as a junior doctor, and then as an assistant surgeon at the Wieden Hospital. In 1885, he was sent to Sofia by the Ministry of Foreign Affairs to support the medical care of soldiers wounded in the Serbian-Bulgarian War. In the following years, Bum undertook study trips to Holland and Sweden to train in gymnastics, massage and mechanotherapy.

Bum returned to Vienna and in 1893 published the book “Mechanotherapie”, which he clearly defined with the subtitle “Massage und Gymnastic”. In his opening paragraphs he describes the two terms:

By massage we mean a series of manual techniques through which the physician’s hand mechanically influences the tissues of the resting, passive body of the patient; by gymnastics, we mean a series of methodical movements carried out either by the physician, as in massage, on the passive patient, or by the patient alone or together with the physician”.

In 1896, Bum published the “Handbook of Massage and Therapeutic Gymnastics”, which was printed in several editions. In 1904, he published the “Encyclopedia of Physical Therapy, Dietetics, and Nursing: for general practitioners”, and in 1906, “Physiology and Technique of Massage.”

By 1896 Bum had founded the Institute for Therapeutic Gymnastics and Massage in Vienna, where he also offered orthopaedic gymnastics for children. In 1898, he joined with physician colleague Max Herz, relocated and renamed the clinic the “Institute for Mechanotherapy, Orthopedics, Mechanical Therapeutic Gymnastics and Massage”.

Dr Max Herz

Max Herz, born in 1865, also studied medicine at the University of Vienna and received his doctorate in 1890 (Mentzel, 2024b). His primary interest was in the heart and vascular diseases but also distinguished himself as a designer of a number of medical devices, including a simpler blood pressure measuring device, gymnastic equipment for heart patients and the use of an irregular shaped cam to vary the resistance of a weight stack through a joint’s full range.

Herz explained in his patent how his pulley system accomplished the goal of increasing resistance in the range of motion at which the lifter is strongest:

 …in working with such apparatus, during the whole movement, the muscles shall be exerted in accordance with their momentary tension or pulling force.” (Wellcome Collection).

In other words, there would be no sticking points during the exercise – the muscles would work with the same degree of effort throughout the entire movement (Goss, 2012).

When Herz joined Bum, they expanded the Institute with his mechanical equipment producing the most advanced gymnasium in the world.

Herz published a number of monographs, such as the “Textbook of therapeutic gymnastics in lectures” in 1903, “Heilgymnastik” in 1907, and “Heilgymnastik” in 1911. In 1907 Herz was founding member of the Society for Physical Medicine, of which he was the first and long-standing president, and in which Anton Bum served as vice president and Robert Grünbaum also served on the board.

Dr Robert Grünbaum

Robert Grünbaum, born in 1874, graduated from the Academic Gymnasium in Vienna in 1891 and  studied medicine at the University of Vienna, receiving his doctorate in 1897 (Mentzel, 2024c).

From 1898 he worked at the “Institute for Mechanotherapy”, where he served as chief physician alongside Anton Bum from around 1904. Here Grünbaum published “The Influence of Movement on Pulse Rate” and “On Traumatic Muscle Ossification” in 1901, “Further Contributions to Hot Air Treatment” in 1902 and “On the Physiology and Technique of Hot Air Treatment” in 1903, as well as the essay “Iconometry: A New Method of Scoliosis Drawing and Measurement”.

In 1912, Grünbaum opened his own institute for physical therapy in Vienna which offered a dedicated children’s department with specific therapies for children as well as a radium laboratory.

The Fall of Mechanotherapy

Mechanotherapy’s rise was rapid over the late 19th century and early 20th century; and with its systemisation and scalability it became a natural adjunct for the rehabilitation of the multitudes of injured soldiers, especially in the First World War (Hamel, 1916). However its success was also its downfall. Twinned with a past that many wanted to forget, mechanotherapy fell out of favour post war.  The timing coincided with Zander’s own death, advances in medicine providing new orthopaedic surgical options and the world wide depression causing the high cost of installing Zander’s machines to become prohibitive (Hansson & Ottosson, 2015).

It would take almost 50 years for gym machines to make a comeback, this time in the form of the Nautilus concept, invented by Arthur Jones from the USA.

References

Bensusan I. (1904). The future of the figure: A chat with Miss Josephine MacCormick, of Melbourne. The Critic, Adelaide, South Australia, 24 February. Accessed online at https://trove.nla.gov.au/newspaper/article/211402842?searchTerm=josephine%20mccormick

Goss, K. (2012). The science of strength curves: The evolution of variable resistance training. From the website of Bigger Faster Stronger, 38-41. Accessed online at http://office.biggerfasterstronger.com/uploads2/12_NovDec_38.pdf

Hansson N & Ottosson A. (2015). Nobel Prize for Physical Therapy? Rise, Fall, and Revival of MedicoMechanical Institutes. Physical Therapy, 95(8), 1184-1194.

Hamel G. (1916). Physical treatment of war injuries: Zander mechanotherapy. The Hospital, November 25, 161-163.  Accessed online at https://pmc.ncbi.nlm.nih.gov/articles/PMC5230905/?page=1#floats-group1

Mentzel W. (2024a). From the medical history holdings of the Ub MedUni Vienna [280]: Bum, Anton – Surgeon and physiotherapist, founder of the Institute for Mechanotherapy in Vienna. Van Swieten Blog of the Univesitätsbibliothek Medizinische Universität Wien. Accessed online at https://ub.meduniwien.ac.at/blog/?p=43609. Translated by Google Translate.

Mentzel W. (2024b). From the medical history holdings of the Ub MedUni Vienna [280]: Bum, Anton – Surgeon and physiotherapist, founder of the Institute for Mechanotherapy in Vienna. Van Swieten Blog of the Univesitätsbibliothek Medizinische Universität Wien. Accessed online at https://ub.meduniwien.ac.at/blog/?p=43607. Translated by Google Translate.

Mentzel W. (2024c). From the medical history holdings of the Ub MedUni Vienna [278]: Grünbaum, Robert – Owner of the Institute for Physical Therapy in Vienna, Nazi persecuted. Accessed online at https://ub.meduniwien.ac.at/blog/?p=43605. Translated by Google Translate.

Nias, K. (2017). Negotiating Intimacies: Gender, Rehabilitation and the Professionalisation of Massage in Britain, c.1880-1920. Doctor of Philosophy Thesis from Exeter University.  Accessed online at https://ore.exeter.ac.uk/repository/bitstream/handle/10871/33172/NiasK_TPC.pdf?sequence=1&isAllowed=y