|Moderated by: shanna, Azadeh|
|LiteGait Training Report
Training Date: January 12, 2018
Facility: Stillwater Medical Center Total Health
Name and type: Inpatient rehabilitation
Lecture completed online without any questions.
Talked about obtaining more information from MoReICE clinical support, LiteGait social media, Presenter Series webinars - especially free TIPS & TRICKS every quarter.
How many attended: 5 Physical Therapists, 2 Physical Therapist Assistants, 1 Physical Therapy Student and 1 Physical Therapy technician. Will be emailing the attendance sheet.
Harness/LiteGait device Training:
All training elements covered including harnessing patient in supine.
Addt’l Equipment Covered: Facility had both GaitSens and BiSym scale. No questions.
Patient 1: Patient is a 63 y/o male, with a recent Right CVA (12/26/17) with Left side hemiparesis. Reduced force production throughout Left upper extremity and lower extremity with soleus, glut med and extensor digit longus more affected on lower extremit, and wrist stabilizers and extensors more affected on upper extremity. Good sitting balance, impaired standing balance; difficulty loading on Left lower extremity. Left side inattention. Patient is a Total Assistance for 26 feet ambulation with body weight support system, requiring facilitation for swing and stance phase on Left lower extremity. Patient harnessed in standing with two person support. Worked on off treadmill facilitation of knee extension with use of straps, with weight shifts attention to posture; repeated 15-20 repetitions. Treadmill training with manual facilitation of the left lower extremity as well as use of hip flexion and dorsiflexion and step length facilitation with use of theratubing. Went through 3-4 therapists facilitating gait (fatiguing therapists due to the effort required for left lower extremity function). Unfortunately therapist reset the treadmill post training losing all the data. Attention to the GaitSens data (kept requiring to be re-synced) and BiSym scale (turning off too fast even though set to maximum before turning off).
Patient 2: Patient is a 68 y/o female without history of falls. Her more recent fall was on 12/25/17, sustaining a Left femoral neck fracture and Left proximal humeral fracture. Patient underwent ORIF on upper extremity with non weight bearing status, and surgical repair with endoprosthesis on Left lower extremity with weight bearing as tolerated and hip precautions. Patient has had difficulty loading and tolerating weight bearing on Left, and is currently Standby assisted to ambulate 62 feet with hemi walker; however, it takes over 10 minutes to cover this distance. Harnessed in standing, left upper extremity in sling; patient had telemetry (cautioned against compression of the electrodes, worked through use of padding to limit compression (similar explanation for ostomies, feeding tubes and catheters). Ambulated 1100 feet 9.54minutes with 3 rest periods. Able to work on facilitation of the lower extremities with minor manual facilitation especially hip extension to toe off, and mostly with the use of theratubing to allow longer step length, increased hip flexion and heel strike.
Patient 3: 65 y/o African American, 2 years post Right basal ganglia CVA with L sided hemiplegia (12-10-15). Ambulatory with carbon fiber AFO (occasionally) and quad cane (almost broken at one of the feet) at times. Patient reports there has not been any change in function of Left upper extremity since CVA with increased tone into typical CVA posturing. Unable to perform any bilateral integration task. Uses dominant Right upper extremity for all activities. Requires extra time, but is independent with dressing in pullover clothing. Needs supervision assistance for safety with showering. Independent with bed transfers. Patient states he has been cleared to drive and has been driving himself within town where he needs to go. Presents in a facility transport chair. Harnessed in standing. Manual facilitation of the left lower extremity attention to weight shifting; worked on off treadmill activities of weight shifting stepping up onto a 5 inch step (15-20 reps fast and slow speeds) and then back onto the treadmill with improved weight shifting during gait. Worked on treadmill till patient fatigued. 16.52 minutes with a distance of 2245feet. Suggested alternative treatment for the tight left upper extremity and was able to extend elbow to full extension and fingers to neutral extension post application.
Walked therapists through alternative facilitation of the weak limbs with the use of E-stim as well as the use of kinesiotape.
Problems or Concerns Encountered with patients:
No problems encountered that we were not able to correct during training.
What was the BEST question/remark/feedback you got during this training?
Patient remark “This is definitely worth the while, when can we do this again. I have no doubt that this will help me walk better”
Candace Lynch for both sales and patient advocacy
Please send information on hip attachments. Will wait for further GaitSens training to figure out why the it kept needing to be re-synced to the treadmill. Will need to problem solve if the BiSym scale can stay on for the duration as well as goal set for one limb only. Please send paperwork necessary to applying for continuing education credits.