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Kline Gallan; SNF
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jennyhrc
Instructor
 

Joined: Sun Jul 12th, 2015
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Mana: 
 Posted: Sun Feb 10th, 2019 12:44 am
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LiteGait Training Report
Training Date: January 31st, 2019
Facility:  Kline Galland  
Name and type:  SNF, LTC

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 just completed the one hour training prior to training day. They did not have any questions re: the one hour training and felt comfortable with the content. Therapists that were present reported no experience with body weight supported devices.    

How many attended? Full staff (therapy aides, PT, OT and SLP) and one of their physiatrists.   

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 all the resources that Mobility Research offers including its Facebook page, webinars (paid and unpaid), and technical support.
I also mentioned the opportunity to become a Super User and briefly discussed the process.

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 the training elements were completed. I briefly discussed the content in the one hour webinar they have watched (gait qualities, More Better concept, protocols and precautions/contraindications). Harness demonstration and components of LG took the majority of the time. The therapists also wanted to see how to don harness in supine so no time was left to formally let the therapists practice donning harnesses. However, most therapists got to practice harness donning while I helped with two therapists with donning harnesses during first patient demo.  
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. The facility did not purchase a treadmill and they do not have a treadmill onsite. I discussed the benefits of using LG with treadmill training vs over ground. The facility got a GK mini for trial, and all patients performed gait training with use of GK mini.  
 
1)      RM 57 year old with MS and L ankle fracture (WBAT in CAM boot) – She currently walks with min A with FWW x 10 feet. I guided the therapists on donning harness with pt in standing holding onto the handle bars. The pt was able to ambulate on the GK mini for about 5 minutes without taking rest breaks. She ambulated at a lower speed 0.3 mi/hour, and she had difficulty with L foot clearance and weight shifting toward the L side during L stance. I showed the therapist how to assist with advance her limbs to help with swing phase. I also showed the therapists how to use Q straps to achieve more upright posture. The pt was able to use Bisym to help lower the % weight bearing supported by LG. the pt was happy that she got to try LG as she felt she is supported during gait training.
2)      UB with L femoral PT graft on 9/12/2018 with R AKA, ambulates with prosthesis – she currently ambulates with FWW with SBA/CGA, her goal is to be able to ambulate without use of AD. Therapists donned the harness in standing with pt holding on to the handle bars. The pt required assistance to step on and off the GK mini. The pt performed ambulation at 0.2 mi/hour as she gets used to walking over treadmill. She had trouble advancing her prosthetic limb and had multiple LOBs. She responded well to verbal cues to e nsure proper foot clearance and larger step lengths bilaterally. The pt  felt safe in the LG and felt that once she gets used to how it works, she would be able to practice ambulating without use of UE support.
3)      NY 91 year old with dementia, admitted for fall s/p ORIF – I also the therapists how they can use the LG for weight shift training before gait training. The pt was able to perform ambulation over GK mini for a couple of minutes before requesting to rest. I recommended that the pt could perform “active rest break” by having the pt sit on a Swiss ball. Though the facility did not have the appropriate size swiss ball. We ended having to unbuckled the straps to allow the pt to return to the wheelchair for rest breaks (pt did not want to continue secondary to reporting fatigue).
4)      RJ 74 year old with CVA – The primary therapists were interested in using the crawling hardness after I mentioned it to them during the first hour. The therapists wanted to use the crawling harness to get the pt in quadruped position to allow for some weight bearing through her involved UE as she has increased flexor tone. It took five therapists to get her in the proper position (we did this on the mat), with bolster and wedges for adequate support as needed. Initially she was very anxious though the therapists did a good job in comforting her and redirecting her. She was able to stay in quadruped for 5-8 minutes. The therapists felt that the crawling harness was beneficial in getting her into quadruped, however, they agreed that maybe she would benefit from a lower position prior to setting her up in the crawling harness as she was anxious and required increased amount of assistance from therapists to attain the appropriate position.

Problems or Concerns Encountered with patients:
- one therapists asked if the walker on the GKmini can be used while the pt is in LG… the therapist wanted to use the walker with someone that may require a platform walker – even though it’s not recommended to use walker with pt in LG (since pt should be able to just use the handle bar), but seemed like a good thought if the pt is unable to weight bear through wrists
- for pt that are short, the therapists were unable to leave the straps buckled in and had to unbuckle the straps for seated rest breaks (otherwise, I recommended a higher seat surfaces if available)
- could not get the GaitSens to syn/connect with Bisym
- still hard to steer and position the total brakes (toward and away from treadmill) so that the therapists could just use their feet to unlock or lock the brakes as needed

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

Recommendations:
What do we need to do for these customers?
- Watson mentioned a dent to the Gait Keeper mini (quite a big dent) and he was not sure if it affected the integrityof the Gait Keeper mini. He mentioned he has spoke to MR and someone is aware?
- Please follow up to see if they need help with use of Gait Sens. This was demonstrated during training but without a patient data (ran out of time). I also could not get it connected with BiSym. I discussed the use and purpose of it, as well as the objective measures Gait Sens provides.
- One of the therapists asked about what happens to LG if it runs out of battery in the middle of usesage, ie, can the patient still be lowered? I was not able to answer this questions confidently…
- Please follow up with Watson regarding potential purchase of GKmini as the therapists seemed to be interested after learning its use
- It seems like some therapists are interested in the leg straps and crawling harnesses – please follow up
-Check- in with the facility in a few months to see if they have any questions/concerns re: use of LG as Watson was worried that LG will not get used with time. I mentioned to Watson that he could also request for a refresher session in the future to ensure proper use of LG.
 


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