|Joined: ||Mon Sep 17th, 2012|
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|Mana: || Posted: Thu Feb 2nd, 2017 09:49 am||
|LiteGait Training Report
Training Date: 1/31/2017
Facility: Avalon Place , Monroe, LA
Did they listen to the lecture online? If yes, did they give you feedback?
None of them said they had listened to the online lecture. Not sure if they even were told about it. The Lite Gait accessories all remained in the box. I took everything out of the plastic bags. The key to lock/unlock bisym IPAD was missing. Dana was going to ask Maintenance about the missing key, as Maintenance assembled the Lite Gait.
Attendees: 7 (3 PT/1 OT/2 COTA/1 SLP
Did you mention: LiteGait social media- FaceBook, Twitter;USER Forum LiteGait.org, Presenter Series webinars - especially TIPS & TRICKS every quarter? Yes. All the above plus Mobility Research. That pt stories can be seen on facebook.
Harness/LiteGait Equipment Training: Reviewed the Parts of the LiteGait: The flexible freedom yoke vs the rigid yoke during gait training and with standing balance, The overhead straps (how to independently adjust, loosen/tighten to correct postural alignment, clipping them into the yoke and the harness),The actuator (using both buttons to increase speed up or down and a single button to fine tune or go slower rising or lower pt), the handle bars (demonstrated how to raise/lower, tighten to just finger tightness, changing positions and removing bars, emphasizing the handle bars are for balance and not wt bearing), The battery pack for actuator and, charging requirements,emergency down button and battery read out bar, Discussed locking casters and directional casters. I showed the following accessories: harness extender, small adult hardness, quadruped harness, small groin strap and thigh straps. Wt limit discussed and pointed out that it was listed on actuator.
Harness instruction included top/bottom ,front/back, groin piece sizing, using the 1/2 girth test to size to patient, thigh cuff if groin piece was contraindicated. discussed placement of harness using greater trochanter for landmark and order of tightening straps with 2 finger test, and cleaning harness and straps. Discussed application of harness in standing and in supine. Discussed learning on easy patients initially and progressing to more difficult/lower functioning patients. We discussed pt candidates, contraindications, precautions and protocols and provided a handout of all these.
Therapists practiced harness application on 1 therapist which also included a demonstration of how the Lite Gait can be used for static and dynamic standing balance activities: facing all directions, LE strengthening, coordination activities, balance reaction time, UE strengthening, eye hand coordination activities, leisure activities, ie. Golfing, sitting balance on the EOM or EOB and help with sit to stand. I encouraged all the therapists to don harness so they could get the feel of a good fitting harness and that more practice would increase their comfort level and success rate. I demonstrated the Bisym and staff loved the biofeed back of the Bisym, especially the green/purple cues provided. Bisym could not be mounted on the LiteGait as the PEG on the IPAD was pressed in, preventing the Bisym from locking onto the LiteGait. The key to Bisym was missing. For that reason we did not try to use it during any tmt times. I did not want to tape it or allow it to hang.
Patient 1: Mrs R was a 78 y/o female with h/o multiple TIAs and general debility. Pt presented with a stooped slow gait with CGA with RW. Pt was very anxious and fearful of the Lite Gait. Pt stood for harness application. All anxiety completely disappeared when she sat and started swinging in Lite Gait. Great 1st time application of harness by staff. Protocol A was followed on Gait Keeper and mobile control panel demonstrated with mph, minutes and speed discussed. Pt ambulated TWO 3 min sessions with pt completely surprised with the distance she walked. Staff very surprised that pt automatically corrected her gait as speed increased and her comfortable gait speed was hit. With a slight speed higher than her comfort level she required very minimal assist to increase stride, by facilitating knee flexion and using Q straps at B anterior pelvis. I reiterated more and better gait with the Lite Gait. Pt was very eager to use Lite Gait again.
Patient 2 – Mrs M was a 77yo female 3 yr s/p CVA with L hemiparesis with recent decline and general debility. Pt presents ambulating 60’ min/mod assist with R hemiwalker with R midline shift and uneven stance and wearing a L AFO. Pt was doubtful that she would like the Lite Gait and fearfull of falling. Staff donned harness with pt in standing. Staff told pt to try to sit and pt finally believed she was safe. 1st gait session was with L AFO per pt request, Q strap used L ant and lateral L hip to increase forward L pelvis and L wt shifting. L BWS provided and Pt was able to ambulate with mod assist facilitating L LE advancement at foot and knee at 2 mph for 3 min with reciprocal gait but stance and swing abnormal due to rigid L AFO and increased tone in L hamstring. 2nd gait session of 3 min without L AFO. I also stabilized her L hip to block the lateral sway and her tone decreased with pt able to exhibit improved reciprocal gait with mod assist with L LE advance and verbal cues for L/R steps and pts gait pattern normalized, surprising staff and patient. Pt was very pleased and sad she was being d/cd the following day.
Pt 3: Mrs N was a 68 yo Pt with DX of Acute respiratory Failure with general debility, tracheostomy, and PEG tube. Pt was max assist 1-2 sit to stand, ambulated 60’ at her best with min assist with RW at extremely slow cadence. Staff practiced supine harness application with using towels to protect pts PEG site, followed by using the Lite Gait to demonstrate sitting balance activities and sit to stand. Pt was able to feel her quads actively engage with sit to stand and started crying, she was so excited. She wanted to keep practicing sit to stand. We used protocol B on Gait keeper with pt ambulating a total of 198’ @ 1 mph in 2.38 minutes. Pt was able to maintain her comfortable gait speed without assist for 35 seconds and then received min assist at post knees to facilitate B knee flexion , swing phase and increased stride. Pt used pre-agreed “ tapping sign” on Gait Keeper handle bars to let us know when she fatigued. Pt was beaming. She was super excited and staff was clapping and cheering. She wanted to schedule her tmt for the rest of the week. : )
Pt 4 declined so we spent extra time with the other pts.
Problems or Concerns Encountered with patients:
(If you encountered a difficult situation or patient, please post this information in the clinical support section of LiteGait.org as well as here in this training report.)
What was the BEST question/remark/feedback you got during this training?
“I think we will use this thing now” Staff totally agreed that they could see improvement within each pt tmt session. They also wanted to get CEUa for the training session. They typed an itinerary of the in-service and were going to send it to Louisiana board.
Who is the best person to f/u regarding clinical support?
Dana Stephenson OTR and Cassie Edwards PT
Who is the best person to f/u regarding sales needs?
What do we need to do for these customers?
Make sure they get a replacement key for bisym.
Wishlist: Small adult harness, harness extender
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