Since there was no one to come to his aid, Alexander began watching his every move. He spent much time looking into mirrors, trying to determine what he might be doing wrong. Over a period of nine years, he came up with a solution: the Alexander Technique. The system Alexander designed did the trick of restoring his voice. Some of them are heat, acupuncture, ultrasound, and electrical stimulation. There is a need for physiotherapy in amputee rehabilitation that no other discipline can fill. It is a basic kind of help that anyone who has lost a limb can use. Some amputees decline treatment because they do not think it is necessary. This way, physiotherapy costs will come as little surprise to one. The only question is what kind of payment arrangements will be made. If the patient has no insurance, all physiotherapy costs will be due in full at the time of service. Clinics often help arrange the payment of physiotherapy costs by contacting workman's comp or insurance companies for one. Every exercise the physiotherapy personnel go through with the spinal cord injury patient should be video-taped. This allows work to go on at home with an example of each exercise. Range-of-motion exercises are done by a caregiver, who moves the limbs so that they will not become set in one position. Ultrasound is especially useful as a passive therapy for anyone with acute lower back pain. It delivers heat deep into the muscles of the lower back. This not only relieves pain. It can also speed healing. Back exercises may be assigned by a physiotherapist. These exercises will help with lower back pain if one does them correctly and faithfully. People with rheumatoid arthritis can benefit from manual procedures, such as massage. A person with the stiffness that accompanies rheumatoid arthritis can be very limited in how far he can move his joints. Massage improves movement and increases this range dramatically. One of the most important functions a physiotherapist serves for patients with rheumatoid arthritis is as a motivational coach.