Definition: What does KGG mean?
KGG stands for Krankengymnastik am Gerät – exercise-based physiotherapy using equipment. On your prescription you may also see:
Gerätegestützte Krankengymnastik
KG-Gerät
All of these mean the same thing: active physiotherapy with the help of training equipment. Unlike some other physiotherapy treatments, in KGG you work exclusively actively on devices – similar to a gym, but:
with medical-grade equipment
under close guidance from a physiotherapist
based on an individualised therapy plan
After a physiotherapy assessment, your therapist creates a training plan tailored exactly to your situation and goals.
Typical goals of KGG:
Targeted strengthening of weak muscles
Improving coordination and endurance
Making everyday movements easier
Reducing pain and increasing long-term stability
Increasing your physical load tolerance
Preparing you for independent training later on
Even though you train with machines, KGG is not simple “fitness training”, but a medical treatment. All exercises are guided, corrected and monitored by qualified physiotherapists to keep you safe.
Indications: When is KGG used?
KGG is used for many different conditions – both after injuries and with long-standing problems.
Orthopaedic conditions
After operations on the musculoskeletal system e.g. anterior cruciate ligament reconstruction, artificial hip or knee joint
After fractures rebuilding muscle strength and mobility
Back and joint problems
Chronic back or neck pain
Osteoarthritis (wear-and-tear joint changes)
Other joint problems (e.g. hip, knee, shoulder)
Here, KGG helps by:
building up supporting muscles
stabilising the spine and joints
reducing pain through better load distribution
Neurological conditions
For example:
Mild stroke
Parkinson’s disease
Multiple sclerosis
After nerve injuries
Goal: make the best possible use of remaining muscle functions and maintain or improve independence.
General weakness and deconditioning
After long hospital stays
After chemotherapy
In chronic illness with reduced physical performance
KGG then serves as a safe, structured re-entry into physical activity, step by step.
Comparisons to other physiotherapy treatments
“Normal” physiotherapy vs. KGG
The biggest differences are duration, setting, and focus.
Aspect | Conventional physiotherapy (KG) | Equipment-based physiotherapy (KGG) |
Setting | 1:1 individual treatment | Small group (up to 3 people) |
Duration per session | ca. 15–25 minutes | ca. 60 minutes |
Content | Mix of manual therapy and exercises | Pure device-based training (strength, coordination, endurance) |
Main aim | Pain relief, mobility | Muscle building, stabilisation, performance improvement |
Both forms aim to:
relieve pain
improve function
increase your resilience
However, KGG is purely active and, due to the longer duration, aims for a stronger training effect – visible muscle gain and better endurance.
Medical Training Therapy (MTT) vs. KGG
At first glance, KGG and Medical Training Therapy (MTT) look similar: both involve training on machines. But in the healthcare system, they are quite different.
MTT
Not a classic remedy (Heilmittel) in the statutory catalogue
Often used in rehab clinics, BG (work accident) clinics, pension insurance (DRV) programmes
Frequently part of programmes like EAP, IRENA, T-RENA
Typical for people in an active rehab phase or self-payers wanting intensive training
KGG
Official remedy in the Heilmittelkatalog of statutory health insurers
Offered in physiotherapy practices that meet certain quality and equipment standards
Mainly used by statutory-insured patients with a corresponding prescription
Particularly useful after operations or with persistent problems of the musculoskeletal system
Requirements: What does a practice need to offer KGG?
A physiotherapy practice may only offer KGG if it meets specific structural and equipment requirements.
Minimum equipment includes:
Two cable pulley systems (universal pull units) side by side
A leg press or similar “functional press” device
One device specifically for trunk training e.g. hyperextension bench, incline table or back extension machine
A vertical pull unit e.g. lat pull-down
In addition:
A separate training area of at least 30 m²
All devices must be medically certified
Training and qualification: Who is allowed to offer KGG?
Basic physiotherapy training only partially covers training on devices. To offer KGG independently and bill it to health insurers, physiotherapists must complete a certified KGG course.
Common providers:
Major physiotherapy associations (IFK, ZVK, VPT)
Private academies and training centres
Course content (approx. 40 teaching units):
Training science fundamentals
Device and equipment handling
Designing and progressing training plans
Safety aspects and risk management
For you, this means: if your therapist offers KGG, they have passed this extra training and exam.
Process: What else is important?
Group size: How many people train at once?
KGG is carried out in small groups of up to 3 people.
One physiotherapist supervises maximum three patients in the training area at the same time.
Important:
Each person has their own individual training plan
Devices are adjusted personally (weight, seat position, range of motion, etc.)
The therapist circulates, corrects, explains, and adapts exercises as needed
So you are training in a group atmosphere, but your programme is still personalised.
Duration: How long does a KGG session take?
A single KGG session lasts around 60 minutes.
The time usually includes:
Warm-up – e.g. bike ergometer or treadmill
Main training phase – circuit on various devices for legs, trunk, arms and back
Cool-down – light movement or stretching
At the first appointment, the therapist often performs a detailed initial assessment:
joint mobility
muscle strength
posture and movement patterns
current pain and load tolerance
Based on this, your individual training plan is created. From the second session onwards, the full training session usually takes place.
Example structure:
10 minutes warm-up
40–45 minutes circuit training on various devices
5–10 minutes cool-down
Prescription: How often can KGG be prescribed?
As a rule, doctors initially prescribe: 1 prescription = 6 KGG sessions
Depending on your diagnosis, up to 3 prescriptions in a row are often possible: Maximum of 18 KGG sessions back-to-back
The usual frequency is: 1–3 times per week, often around 2× per week
Too frequent (daily) KGG is not useful – your muscles need time to recover.
After using up 18 sessions, the guidelines usually require about a 12-week break, unless you have a recognised long-term need (e.g. severe chronic conditions).
Combination: Can I do KGG and “normal” physiotherapy at the same time?
Yes. In many cases this combination is very sensible.
For example:
1× per week conventional physiotherapy (KG): more focus on manual techniques, mobilisation, specific pain treatment
1–2× per week KGG: focus on active training and muscle building
Often, treatment starts with conventional KG when pain is still high. Once things have calmed down, KGG is added to stabilise and maintain improvements.
Red flags: When should you be careful or stop training?
While KGG is generally safe, you should be alert for warning signs.
Stop training and talk to your therapist or doctor if:
Acute, sharp, increasing pain during the exercise
New swelling or redness after training in the treated area
Dizziness, nausea or heart racing during exertion
Recent surgery and you’re unsure about load limits – always clarify with your doctor first
Safety always comes first. If you’re unsure, ask – both your therapist and your doctor are there to help.
Long-term prescriptions: Who can receive ongoing KGG?
A long-term or ongoing prescription (long-term remedy need) is possible in the case of severe chronic illness with continuous treatment needs.
Typical diagnoses include:
Neurological diseases, e.g. multiple sclerosis, Parkinson’s disease, severe stroke
Muscular or genetic diseases, e.g. muscular dystrophies
Severe rheumatic diseases
Serious structural damage to the spine
If such a long-term need is recognised and approved, you can receive ongoing KGG prescriptions, without repeatedly having to justify the amount of therapy.
D1 remedy combination (“mini rehab”): What is it and when is it used?
The D1 remedy combination is often nicknamed “mini rehab”.
With one D1 prescription, a doctor can prescribe a combination of several therapies, for example:
conventional physiotherapy (KG)
physical therapies (e.g. heat, massage)
device-based training (KGG)
This is particularly useful in complex cases, for example:
after major operations
cruciate ligament reconstruction
spinal surgery
when both passive and active treatment are needed at the same time
Advantages for you:
Several therapy forms in one combined appointment
Typically around 60 minutes treatment time per unit
You don’t have to commute between different practices
Costs: How much does KGG cost and what do you pay yourself?
KGG is part of the official remedy catalogue of statutory health insurers. If you have a valid prescription, your health insurance covers the majority of the costs.
Statutory health insurance (Germany)
From age 18, you pay:
10% of the treatment costs
plus €10 prescription fee per prescription
Example:
6 KGG sessions with a total value of about €150
Your share: 10% = €15 + €10 prescription fee = €25 total
The remaining approx. €125 is paid by your health insurance.
If you are exempt from co-payments (because you exceeded your personal burden limit), you pay nothing for KGG. Just show your exemption to the practice.
Private insurance
Billing according to the relevant fee schedule
Most private insurers cover KGG when prescribed, depending on your contract
As a guideline, calculate with approx. €40–60 per 60-minute KGG session
Beihilfe (for civil servants)
KGG is generally eligible for Beihilfe. Your Beihilfe and private insurance together cover the costs according to your individual rate and tariff. It’s best to ask your Beihilfestelle and insurer for exact details.
Summary: The most important points
KGG = Equipment-based physiotherapy under professional guidance
Purely active treatment, no passive techniques
60 minutes per session in small groups of up to 3 people
Usually 6 sessions per prescription, up to 18 in a row possible
Statutory health insurance pays most of the costs; you pay 10% + €10 prescription fee
Can be combined with conventional physiotherapy, which is often very effective
If you’re not sure whether KGG is right for you, talk to your doctor or physiotherapist. They can assess whether device-based training is suitable and when the right time is to start.
