LiteGait Training Report
Training Date: 02/14/2019 11-2 pm (3 hours)
Facility: Santa Rosa Post-Acute
Facility: Skilled Nursing
Did they listen to the lecture online? If yes, did they give you feedback?
No, they did not get the lecture recording before the in person/hands on training.
How many attended: 5 participants; 2 PTA, 2 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-400E model with respect to the casters (brakes on 1 side and unidirectional on the other side); how to move the LiteGait on and off the treadmill (pushing brake side towards steer side to prevent casters from hitting the treadmill); 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; the hand controls with respect to moving both actuators up and down; the integrated FreeDome and its variable uses for standing balance, turns, and walking in different directions; 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 to indicate how much weight is being unloaded; and finally the Bisym scale tablet – all aspects reviewed with inputting of patient weight, difference between weightbearing and support, and biofeedback system of knowing what the green and fuschia color indicates with respect to weight unloaded, and then how to capture the data for email or printing. I also reviewed the different harness sizes and groin piece sizes and reviewed the Q-straps during patient demos.
I demonstrated correct harness placement in standing with staff discussing need to open up the harness fully to assess how large and small it goes. I suggested placing the harness on sitting to get it on the patient and then have them stand to complete the adjustment and tightening straps at landmarks. 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.
Patient Trainings: There were 2 adult patients that were set up in the LiteGait for this training.
Patient #1: Female, unknown age, short stature and heavier set, she had custom rigid leather boots and her legs were positioned in increased ER bilaterally.
Current function: Difficulty standing and doing sit to stands but is better once she is in standing
Harness application: Harness placed in supine on mat table with education on correct harness placement for the staff. Staff educated to have her roll and center the harness both front and back by checking the buckles; can use bridging technique to center harness; cues to get the groin strap on from the beginning to minimize rolling.
Assisted patient to sitting position on the table and used the harness straps (posterior ones) to assist her with sitting balance.
Assisted to standing position with cues to push up – and given her weakness with standing raised the mat table and lowered the LiteGait to keep yoke close to patient’s head as she was being lifted in the equipment; once in standing weight unloaded was decreased.
Uses the visual biofeedback on the Bisym scale to work on pushing through legs to decrease use of LiteGait support.
She performed several mini squats initially for strengthening and limb loading followed by taking 3 feet of steps, very short, and cues for therapist to assist with weight shifting to facilitate stepping - also suggested having her wear a sock or boot over toes to help slide her feet as she progresses with stepping pattern and foot clearance.
Patient #2: Female, unknown age, morbidly obese who had a left CVA that resulted in right side weakness and presents with movement throughout right hemibody.
Current function: She had not trialed standing yet with the therapy staff.
Harness application: Harness placed in supine in her air mattress on her bed. Cues to double check the alignment and cross check of buckles. Given air mattress and challenge she sat up with difficulty and was sliding down as she laid back. We laid her back with the legs up and paused the air mattress function to create a more stable support, then assisted to sitting.
She was connected to the LiteGait and was quickly buckled in for stability and then safely assisted to standing. Weight was reduced once she was standing so she could practice taking more weight through her legs. Used the Bisym scale for visual biofeedback to increase limb loading and decrease use of the LiteGait for support.
She took 5 steps forward (for the first time in several months) without facilitation and then sat back in her wheelchair due to fatigue. Vitals remained normal.
Problems or Concerns Encountered with Patients: There was were some challenges with using the LiteGait under the mat table and bed due to items under the mat table and also adjusting bed to get LiteGait underneath. Staff were educated and problem solving was done with a patient in a bariatric air mattress with alternating pressure to safely connect patient into the LiteGait system and assist with sit to stands.
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 might be interested in leg straps for those that can’t tolerate the groin piece.
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 more involved and their low-level patients. The feel it will work best for this population since that is where the challenge is in getting patients up and moving.