LiteGait Training Report
Training Date: 5/24/19 8-10:30 (2.5 hours)
Facility: Smith Ranch Nursing Rehabilitation Center San Rafael, CA
Facility: Skilled Nursing
Did they listen to the lecture online? If yes, did they give you feedback?
Yes, they did listen to the lecture online and they had no questions
How many attended: 13 participants; 2 PTA, 5 PT, 5 OTR/L, 1 COTA
Did you mention MoReIce clinical support, LiteGait social media, Presenter series webinars – especially free tips and tricks every quarter, free LiteGait user forum and Facebook Page? Yes, I encouraged the staff to sign up to read and post questions and also discussed online webinars and journal clubs for continuing education credits. I also let them know they could ask for clinical support whenever needed as there is a PT on staff who can answer questions.
Harness/LiteGait Equipment Training: I reviewed the parts of the LiteGait I-360 model with respect to the casters (brakes on 1 side and unidirectional on the other side); the handlebars and removing it along with tightening the knobs – educated to not overtighten the knobs to not strip the screw; how to charge the unit – plug into wall; the hand controls with respect to moving both actuators up and down; the FlexAble and how is it used for patients walking at faster speeds versus a patient that requires more stability; the straps and how it connects into the harness and how to tighten and loosen them; the yoke that has the sensors on the right and left side that would feed into information on the Bisym scale (however their scale was not working)
I demonstrated correct harness placement in standing with staff discussing the differences in the harness they have in comparison to the new version of harnesses with the elastic bands on the side. Their old harness has the fabric on the sides and needs to be sized according to the patient’s girth. We did this by folding the harness in half and loosening/tightening straps before applying it to the patient. Also educated that it could be wrapped around in sitting and then adjusted in a standing position (noted that this detailed sizing does not need to be performed on the new harnesses). They only had 1 pseudo groin piece which were straps clipped to the front and back that they had been using without any padding. Again, reinforced that the new groin pieces have variable sizes and also are fully padded and wipeable. I positioned the harness on a staff member and discussed bottom strap should be fitted at the level of the greater trochanter and the importance of tightening the groin piece and bottom 2 straps (2 finger width accommodation) to ensure good fit and prevent harness from riding up on the individual. One therapist was set up in the LiteGait and did overground walking. We also adjusted the straps to demonstrate how the LiteGait can assist with posture correction.
Supine Demo of harness placement: performed this on a staff member as none of the patients were appropriate for a supine placement. Educated staff via rolling and checking the harness both front and back by checking the buckle alignment; can use bridging technique to center harness; cues to get the groin strap on from the beginning to minimize rolling.
Patient Trainings: There were 2 adult patients that were set up in the LiteGait for this training.
Patient #1: 69-year-old male, history of multiple sclerosis, history UTI, confusion.
Current function: SBA 100-300 feet with hinged knee brace RLE for stabilization to avoid hyperextension. Noticeable shuffling with decreased heel strike and decreased stride. Poor FWW placement. Cues to always keep AD close
Harness application: Harness placed in standing with patient using the LiteGait for support.
Patient walked forwards and backwards direction to work on cues to facilitate better heel strike, longer step length.
Discussion of where to stand to facilitate his lower extremities using a stool behind the patient or using a gaiter stool.
Patient #2: 77-year-old male, had a fall from bed and unable to get up; increasing weakness; Parkinson’s Disease x 12 years and bilateral knee pain due to arthritis; dyskinesia, lacks 15-20 degrees of passive knee extension in both knees
Current function: SBA to walk 150 feet with 4ww
Harness application: Harness placed in standing position
Patient was used as a demo for transfers on/off the mat table given extra questions from staff. Patient sitting at edge of mat table and demonstrated how to position mat table height and also height of LiteGait to facilitate sit to stand transfers for someone who is more dependent to someone who can assist with the stand of about 25-50%.
Patient was set up in standing by the staff and given his high functioning min to no weight was unloaded; he walked overground forwards, backwards, practice turns; and then was assisted onto their treadmill – the GaitKeeper.
Demonstrated the use of the FlexAble as he was able to walk at 0.8 mph with good tolerance, verbal and visual cues to kick to foam pad to increase step length; and tactile cues to keep feet apart due to scissoring gait pattern.
Problems or Concerns Encountered with Patients: There were no issues with patients; some challenges with using the LiteGait under the mat table and bed due to items under the mat table. We discussed how to best orient the patient to use the LiteGait. The LiteGait harness were the older versions and they groin piece were 2 straps without padding. Educated them with how to use what they have but highly encouraged them to get newer harnesses and groin pieces that would be easier to use, set up, clean, and be more comfortable for the patient.
Champions: There was no specific champion today but everyone participated well with the 2 patients and had hands on experience with harness application and use of the LiteGait system.
Recommendations: I suggested signing up for webinars and clinical applications and how to post questions on litegait.org if needed. I suggested they get at least 2 adult harnesses (or narrow harness and bariatric depending on their patient population and size), several groin pieces for adults, and also consider the FreeDome as it can be well used for PT and OT while keeping patients safe, allowing more mobility in different directions.
What was the BEST question/remark/feedback you got during this training? The staff found the hands-on training very helpful and noticed good changes with some of the patients they worked with today. Overall, they learned quite a bit on how this equipment will be helpful for a variety of their patients.