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LiteGait Forums > Trainers > Training Reports 2019 > Harborview Medical Center 4/30/2019

Harborview Medical Center 4/30/2019
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jennyhrc
Instructor
 

Joined: Sun Jul 12th, 2015
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Posts: 17
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Mana: 
 Posted: Thu May 2nd, 2019 04:18 am
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Presentation:
Power point or hand outs, target group PT’s, OT’s etc. What major questions or concerns did they have regarding information given?
All participants had completed the one hour training prior to training day. The hospital actually has an older version of the LG, and had been using it somewhat regularly with their patients. They didn’t think they needed the training as they all have experience with it. No questions presented at the beginning of the session.

How many attended? 9 physical therapists and 2 physical therapy interns.

Did you mention to join the free LiteGait user forum and to become a fan of LiteGait on Facebook to your group or individually to any of the attendees? Yes, I mentioned most of the resources that Mobility Research offers including its Facebook page and technical support.
Although maybe this could be reinforced more, because I didn’t get a chance to wrap up with the entire group since the group split up for the patient demonstration portion of the training and did not all come together at the end of the training ( I only got to tell one therapist about it).

Harness/LiteGait Equipment Training:
Were all of the training elements completed or was something left out? What factors contributed to elements not being covered: i.e. time ran short, no patients or not enough patients. This information is helpful as we make our clinical support follow ups & to understand the evaluations better.
All therapists were present during the first hour. The group then split up into two groups with 4 therapists stayed for the second hour of training, and another group of three therapists returned at the third hour of the training.
All the training elements were completed. I briefly discussed the content in the one hour webinar that they watched (gait qualities, More Better concept, protocols ). Harness demonstration and components of LG took the majority of the time. The last patient canceled so I used the extra time at the end and showed one therapist how to don harness in supine.
Patient Training:
What types of patients participated and how did they respond? What handling techniques were used? (weight shifting, breaking tone etc.)
The training was done in a therapy gym that is not actually used for therapy treatment.
1) 1st patient – atraumatic brain injury: The patient had low endurance, but had been able to walk with handheld assist and/or walker. Two therapists were able to perform hardness donning using modified standing technique. However, the patient was only able to tolerate about 1.5 minutes of ambulation in LG before requesting to stop. The therapists also did not want to continue as the therapists report that the patient reported increased headache today and “seemed off”. The therapists recommended a seated rest break though pt declined. Vitals were taken, therapists reporting the patient has a slight increase in heart rate compare to normal.
2) 2nd patient – R CVA with dense L hemiparesis: The patient was able to tolerate harness donning in standing while holding onto the handle bar with two therapists, with one of the therapists providing a posterior blocking force to involved LE. I also showed them how they could use towels to prevent putting pressure on the foley catheter when tightening the groin piece. The patient needed total A with advancing LLE and required max cuing for hip and knee extension during L stance phase. One of the therapists reports that she feels it is difficult to assist LLE swing. I recommended using a pillow case so the therapist has something to grab onto to help assist swing, but the therapist did not try it. We used the Q-strap to facilitate hip extension, which helped mildly as hip extension was significantly limited by weakness. I recommended working L stance phase in LG by having the patient performing foot taps with RLE, which appeared to have some success even though the patient still required total A to stabilize LLE (but patient was able to get hip extension and knee extension with manual assist). I also showed the therapists and the patient how they can use BiSym as visual feedback during training. When the patient needed a break, I recommended an “active rest break” by having the patient sit on a Swiss ball, which the patient was able to try and balance and practice upright seated posture with support of LG. Lastly, I recommended gait training without the use of AFO to allow the patient to be able to get into a trailing limb position on the involved side (the therapists were saying it was difficult to achieve that). The therapists said they will give it a try next session.
3) 3rd patient – R CVA with mild L neglect and L hemiparesis: The patient is getting ready to be discharged tomorrow and has been ambulating with a FWW. He practiced gait over treadmill progressing from forward walking to more dynamic walking with the use of flexible yoke and then side stepping with the freedom yoke (and practiced turning with freedome yoke as an “active rest break”). Then the patient did overground gait training with the therapist on gaiter stool (without assisting forward propulsion of the LG). The patient enjoyed the session, he didn’t think he could push the LG with the therapist behind him, but he was surprised he did it at the end of the session. The patient was able to practiced turning with no BUE support, which was new to him as he relies on his BUE for balance for most standing activities.

Problems or Concerns Encountered with patients:

- one of the arms on the gaiter stools does not lock properly (it tightens, but you can keep turning without a hard stop vs the other side has a hard stop)
- the tablet mount does not swivel (really tight), so the tablet does not have different viewing angles
- the therapists were wondering if you could download other apps on the tablet and use the app simultaneously with the BiSym app (for example, they were wondering if there was a metronome app on the tablet, and can it be used during gait training while BiSym is running) – my answer was no because if you want Bisym to run, you have to click on the app.. but potentially a good idea to build into BiSym?
- they were wondering if the Chime sound can be used when the patient DOES NOT achieve the goal (so more like a negative feedback instead of a positive feedback where the chime sounds when the patient does achieve the set goal)

Champions:
Who is the best person to f/u regarding clinical support? Sara Sullivan
Who is the best person to f/u regarding sales needs? Sara Sullivan

Recommendations:
What do we need to do for these customers?
They seem like they already have a good understanding of LG use as they already have an older version that they’ve been using in their gym. Maybe follow up to see if they would like to upgrade their Gait keeper, and potentially get the Gait Sens with their new LG.
Sara Sullivan said they would like more info on the Q-pads when I mentioned it to her.
Please follow up with the above problems and questions were encountered during the training session. Thank you!


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