un-weigh mobility trainer, imi 3204 & 3207
TRANSCRIPT
UN-WEIGH MOBILITY TRAINER UN-WEIGH MOBILITY TRAINER IMI 3204, IMI 3207IMI 3204, IMI 3207
(General Information & Working Manual)(General Information & Working Manual)
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INDIA MEDICO INSTRUMENTSS-46, Badli Industrial Estate Phase-1, Delhi 110042 (India)
Office : 2-3 Gurwalon Ki Dharamshala, Angoori Bagh, Delhi 110006
Email. : www.indiamedico.com
INTRODUCTION INTRODUCTION
PARTIAL WEIGHT BEARING GAIT THERAPY AND BALANCE TRAINING (1)
The loss of the ability to ambulate can be one of the most debilitating aspects of many
Neurological and musculoskeletal disorders. Any of the three main components of locomotion
- posture, balance and coordination - can be affected by a variety of neurological or
musculoskeletal pathologies resulting in the disruption of an individual’s ability to walk
Normally. Partial Weight Bearing Gait Therapy (PWBGT) has shown great promise in helping
a wide Variety of impaired patients as they relearn walking function. It is an appropriate
modality to use whenever gait therapy is prescribed for patients who are unable to support
their own body weight or lack the upper body strength to support themselves during assisted
ambulation. In addition to aiding gait pattern regeneration, partial weight bearing therapy
allows patients to perform cardiovascular workouts in conjunction with a treadmill, enhance
balance and improve posture. Partial Weight Bearing Gait Therapy makes use of a patient
suspension system, such as the IMI Un-weighing Trainer, to reduce the amount of weight born
by a patient and provide proper upright posture. The suspension system is used to remove a
pre-determined portion of the weight load from the patient’s legs and redistribute it to the
patient’s trunk and upper thighs, thus freeing up the arms and legs.
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INTRODUCTIONINTRODUCTIONPARTIAL WEIGHT BEARING GAIT THERAPY AND BALANCE TRAINING (2)
With the patient supported by the suspension system, horizontal movement is provided by
setting the treadmill to a slow speed. The constant rate of movement provided by the treadmill
provides rhythmic input to reinforce coordinated, reciprocal movement of the legs. The
therapist can provide further assistance, especially with severely involved patients, by manually
placing the patient’s feet and/or assisting the patient in weight shifting. Once the patient begins
to gain a feel for the proper coordinated movement pattern the Treadmill speed and/or the
amount of weight borne by the patient can be gradually increased to better simulate natural
walking conditions. The increase in weight bearing and treadmill speed also helps the patient to
relearn dynamic balance. Having achieved preset goals on the treadmill, the patient can be
progressed to ambulating over ground with the aid of the suspension system. Ultimately, it is
hoped the patient will be able to ambulate over ground independently or with an assistive
device. PWBG Therapy sessions typically last 30 minutes to an hour and are scheduled three
to four times per week. Each hour of the session can be divided into three or four periods of
activity followed by a rest period. Activity periods can be as short as three minutes with five
minutes of rest but should not exceed 15 minutes if the patient is supported or partially
supported by the suspension system. Each period should end at its predetermined time,
especially if the patient’s gait deteriorates or the patient or therapist feels fatigued. Because the
repetition of coordinated walking patterns is the most essential element to the success of this
therapy, be sure to provide consistent training without interruptions or breaks.
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INTRODUCTION INTRODUCTION
PARTIAL WEIGHT BEARING GAIT THERAPY AND BALANCE TRAINING (3)
Patients are evaluated over a Two-week period and are expected to make some gains in
their ability to coordinate movement during treadmill walking in this time frame. Continue
the program for Eight to 12 weeks if sufficient progress is demonstrated. Continue for up to
an additional Four weeks for cases showing slower improvement. For acute patients who
show little on no progress after the first Two weeks of therapy, time may be better spent on
different learning activities. The Un-weighing System can be used in the recovery of
balance and posture for patients with compromised posture or balance mechanisms. Toss
the patient a ball to catch or provide perturbation manually to challenge their balance. The
suspension system will prevent the patient from falling while providing proprioceptive cues.
The amount of support can be reduced as the patient progresses.
NOTE : Extreme caution should be taken to assure the stability of autonomic reflexes
(in acute stages) as well as bone and muscle integrity (in chronic cases).
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UN-WEIGH MOBIILITY TRAINER UN-WEIGH MOBIILITY TRAINER IMI 3204IMI 3204
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ASSEMBLING THE UNWEIGHING SYSTEMASSEMBLING THE UNWEIGHING SYSTEM
NOTE : At least two people are required to complete the following procedure. Ensure that the Un-weighing system will be assembled on a level surface. Ensure that there is enough room to move easily
around the Un-weighing system frame during installation. After final assembly the Unit will be like this drawing/photo. (see page 5)
Tools: Spanners & Screw Driver are provided with the unit for assembly.
1. Using a knife slice open the Bundles & open Boxes and remove the packing.
2. Support legs with wheels should be bolted to Base Frame (with matching Numbers & printed name facing you) making it to look-like a Horseshoe.
3. Bolt the chrome-plated Support Pillar’s Base Plate on the top of Base Frame with positioning/adjustment holes on the outer side.
4. Now slide down first Handle Bar bracket, second Steering Handle bracket & last Suspension Bracket (large one). The Locking Pins of Brackets should match with Holes in the Support Pillar.
5. Fix digital Panel on Suspension Bracket.
6. Fix with Straps UPS in SS tray provided on the Base Frame, the out-put sockets should face Support Pillar.
7. Insert patient support handles into the handrail receiving tubes so that they face in toward the center of the unit.
8. Snap a black finishing cap into each of the bolts fixed.
9. To attach the harness, open the harness attachment clips, attach the harness and snap the clips back together to secure.
NOTE : 1. Un-weighing System uses a special harness to support the patient. It is vital that the harness fits properly on the patient.
2. Never leave a patient unattended on this device. Check all cables, harnesses and fittings
before each use.
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BENEFITS OF DYNAMIC UN-WEIGHING THERAPYBENEFITS OF DYNAMIC UN-WEIGHING THERAPY
Partial Weight-Bearing Therapy, also known as Un-weighing, is a concept of
rehabilitation that uses an external device to support a percentage of the patient’s body
weight, allowing them to perform a variety of therapeutic activities in an upright and safe
environment.
Typically used with Neurological Pathologies, the patient’s body weight is supported
between 20-40% to assist with developing proper gait patterns and improvements in
cardiovascular and muscular endurance with less physical demand.
The ability to initiate exercise early in the rehabilitation process can benefit the patient
by allowing development of neural pathways through muscular patterning.
Research has shown the benefits of Un-weighing to occur in a variety of physiological
ways.
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PHYSIOLOGICAL BENEFITSPHYSIOLOGICAL BENEFITS
Symmetrical Loading of the Lower extremities - This assists with equal weight distribution over the base of support. Equal weight distribution in turn provides the proper biomechanics to correct step length deficits and time distribution between limbs.
Reduction of Muscular Splinting - Parasympathetic tones typically associated with neurological pathologies can be reduced through partial-weight therapy.
Minimizing parasympathetic stimuli helps to reduce muscular tension in turn allowing
for increased range of motion and focus on motor control exercises.
Reduction of Cardiovascular and Metabolic Demands - Relieving graded portions of body weight allow the patient to exercise with less stress to the cardiopulmonary system, this is beneficial for extremely deconditioned patients as it allows them to initiate exercise without increasing cardiopulmonary demand. VO2 levels are maintained better at 40% un-weighing than at 0%, the patient can then also exercise for a longer period of time. This application can be beneficial for cardiac and pulmonary rehabilitation, as well as obese patients as exercise can be prolonged to enhance conditioning.
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OTHER BENEFITSOTHER BENEFITS
Acute Injury and Post Surgical – Un-weighing can also provide a safe environment to start acute therapy following injury or surgical procedures. This is especially true with patients suffering from low back pain, whether it’s acute or chronic. Un-weighing provides an environment around the injured joint with reduced gravitational effects, this can be coupled with exercise to enhance joint stability. Vertical traction is accomplished to provide patient relief. This same approach can be taken with other orthopedic injuries. By using the Un-weighing System you can be assured that your patient is working in a dynamic environment unloaded to physician specifications. Since the weight of the patient is supported, there is increased safety for them and the clinician, should a fall occur.
Balance Training - The Un-weighing System provides a safe environment during balance training. Securing your patient in the Un-weighing System will eliminate the risk for falling during balance training. The somatosensory input provided by the harness provides proprioceptive feedback in regards to location of the trunk over the base of support and will allow your patient to work with more confidence during rehabilitation.
Digital Display of Un-weighing Load - The digital display incorporated on the Un-weighing System provides feedback in regards to the amount of weight being relieved from the patient. This is beneficial as it allows for consistency between treatments thus providing a therapeutic environment to improved gait mechanics and neurological patterning.
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POSITIONING THE UN-WEIGHING SYSTEM FOR POSITIONING THE UN-WEIGHING SYSTEM FOR USE WITH TREADMILLUSE WITH TREADMILL
1. Roll the un-weighing system into
position so the display faces
toward the front or back of the
treadmill deck. The treadmill
control panel should be easily
accessible.
2. The patient should be placed in the
center of the treadmill belt and
closer to the front than the back.
3. Lock all four locking casters.
4. Adjust un-weighing as needed.
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DETERMINATION OF BODY WEIGHT DETERMINATION OF BODY WEIGHT SUPPORT SUPPORT
1. Heel / Ground contact during ambulation is lost in patients when weight relief is
in excess of 40% body weight.
2. Chose a level of weight relief in which the patient achieved heel/ground contact
bilaterally for ten consecutive steps.
3. When determining body weight support, keep in mind the patient's pathology
level of involvement and comfort. A patient who is considerably challenged
may require a greater percentage of weight relief.
4. The digital panel shows the Total Body-weight of the Patient in Green window
and the Red window shows the Body weight being lifted.
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USING THE SUPPORT HARNESSUSING THE SUPPORT HARNESS
1. Two Harnesses are supplied with the system. (Small harness for thin patients & Large for fat patients)
2. To assure patient compliance and successful rehabilitation, the Support Harness must be properly adjusted to provide a comfortable environment for your patients. There are Two harnesses to accommodates a wide variety of patient sizes and shapes.
3. The Velcro straps are easily adjusted while the harness is on the patient and allow for quick removal once therapy is completed.
4. The harnesses can accommodate patients with torso sizes measuring from 24" to 50".
Follow the directions below to ensure a proper and safe fit.
CAUTION:
A snug fit is necessary to provide safe un-weighing and improved patient compliance.
It is necessary to ensure that the straps do not lay over pressure points or where friction may occur.
These areas may include, but are not limited to, under arms, between legs, and at the edges
of the harness.
For purposes of hygiene and comfort, it is recommended that the patient wear clothing under the contact areas of the harness at all times.
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PUTTING THE HARNESS ON THE PATIENTPUTTING THE HARNESS ON THE PATIENTNOTE: You can perform the following procedure with the patient in a supine, seated or standing position.NOTE: You can perform the following procedure with the patient in a supine, seated or standing position.
1. Undo the Buckle straps on the front of the harness. (The front of the harness is the side with the red button on the seat belt buckle).
2. Place the patient’s arms through the shoulder straps on each side of the harness.
3. Place the middle torso strap over the iliac crest. Make necessary adjustments to the vest using the Velcro straps in the front and back to provide an equal and snug fit.
NOTE: The buckles should align up along the middle of the patient's body on both the
front and back.
4. Place the leg straps between the legs and adjust fit to patient comfort.
5. Ensure that the shoulder straps have been adjusted to equal length on both the right and left side.
6. Attach "O" rings to Cross-Bar hooks and check that the cross bar is now two to three inches above the patient’s head. Readjust the length of the shoulder straps and ensure the straps equally snug on both sides.
7. When the treatment session is completed, open the buckles release the patient. The harness is now ready for the next patient.
CAUTION: The between leg straps must be used with the harness for heavy un-weighing load.
The leg straps are as important for weight distribution as is the main body of the harness.
The buckles should align with the middle of the patient’s body on both the front and back.
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ANTERIOR VIEW POSTERIOR VIEW
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POSTERIOR VIEW
LATERAL VIEW
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ANTERIOR VIEW
Fixing of Harness
ADJUSTING THE HARNESSHE HARNESS
1. Torso Straps : Adjust for the circumference of the patient’s chest.
Placement : The middle torso strap should be placed over the iliac crest and equally distributed between the right and left sides.
Adjustment : Using the Velcro straps, secure the harness snugly around the patient’s torso. The torso straps can be adjusted from the front or back of the harness.
2. Between Leg Straps: Allows for weight distribution through the legs.
Adjustment : Using the Velcro strap, secure the harness snugly between the Legs.
3. Shoulder Straps : Allow for harness height adjustment while patient is secured to the Un- weighing System. Should the patient need additional support on one side
the strap can be shortened to provide additional unilateral support.
Placement : Adjustment of the shoulder straps should allow the cross bar of the Un- weighing System to be positioned approximately two to three inches above the patient’s head before the un-weighing load is applied.
Adjustment : The shoulder straps can be lengthened or shortened using the end of the strap located near the seat belt buckle. With Remote Switch adjust the Suspension bracket with cross bar to patient height.
NOTE : Be aware of incontinence concerns. Use of the un-weighing harness can put pressure on the patient’s abdominal area, including the bladder. Should a harness become
soiled, it can be hand-washed in a sanitizing detergent, then air-dried.
NOTE : Patient set-up should be conducted over the desired walking surface (i.e, treadmill or floor) as moving from the floor to the treadmill will require the set up procedure be repeated.
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ATTACHING A PATIENT TO THE ATTACHING A PATIENT TO THE UN-WEIGHING SYSTEMUN-WEIGHING SYSTEM
1. Turn “ON” the Load Monitor display on the Right side of the unit. 2. Press “TARE” button, all the readings in Red & Green window gets “0”. 3. Press “Peak” Hold button, Hold’s Red indicator will glow.4. Press “UP” button (Remote/Hand held switch) to lift up the Patient from ground to have patient’s actual body weight in Kilograms. & it will be displayed in “GREEN” window.5. Press “Store/Reset” button to store the actual body weight in memory.6. Press “Peak” Hold button, Hold’s Red indicator will goes OFF.7. Press “DOWN” button (Remote/Hand held switch) and Check the display to see how much weight have been on the patient’s legs. Calculate the weight removed and press switch until the display shows the desired level. 8. Ensure the patient is comfortable and that the vest is properly fitted. Be sure the shoulder straps do not rub against the patient’s ears. Make sure the bar does not hit the patient’s head.
The Un-weighing System is now ready for use.
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FREE WHEELINGFREE WHEELING
1. The Un-weighing System can be used over the floor or with other exercise devices.
2. Be aware of the adjustments required when moving from one device to another.
3. For example, when stepping down from a treadmill, the step-up height of the treadmill must be taken into account.
4. This is accomplished by Pressing DOWN switch of remote switch and lowers the patient.
5. The opposite is true when going from the floor to the treadmill.
6. When traveling across the floor there is no need to spin the entire un-weighing system around when the patient runs out of floor space. Simply turn the patient and head in the opposite direction.
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PHOTOGRAPHS OF SYSTEM IN USEPHOTOGRAPHS OF SYSTEM IN USE
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Vertical Support for Walking
Controls Weight Bearing
Sit to Stand Exercises(Adjusting Suspension Bracket)
MAINTENANCE AND SAFETY MAINTENANCE AND SAFETY INSPECTIONINSPECTION
INSPECTION Although the IMI Un-weighing System is designed for trouble-free operation, simple daily and
monthly inspections should be made of the hooks & straps to assure patient safety. A more comprehensive inspection should be performed every six months to the lifting assembly
to ensure proper operation and safe applications.
Cleaning
• As needed, wipe down the frame with a solution of warm water and mild detergent.
• Hand-wash patient support vest in a sanitizing detergent & Air dry.
Daily
a. Inspect the Harness Straps and Snap hooks.
b. Use Remote Switch to Lift or Lower the Suspension Cross Bar to check its smooth working.
c. Inspect Harness Spreader Bar and clips for signs of wear. Make sure to release clips and lock
them into place to ensure they are functioning properly.
Monthly
a, Inspect the four casters for uneven wear. Ensure they are attached firmly to the Un-weighing
System.
b, Check that the wheels lock and unlock properly.
c, Inspect the upper pulley and suspension bracket adjusting rope for any signs of wear, which may
include fraying, cuts, or kinks in the rope.
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