NEWLIFTWALKER.COM
FROM THE CREATOR OF THE ORIGINAL LIFTWALKER
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New LiftWalker inservice outline... included with every machine at time of delivery.
Intro to New LiftWalker, main components and purpose.
To give safe and comfortable time on your feet.
If shoulders and arms are weak, or there is a possibility of collapse, these go on your legs
This goes around your belly and under your forearms
If you have contractures or spasticity, these go on your ankles
It goes up and down like this
It spins like this, or tracks like this
When it's properly adjusted it's very comfortable and safe.
It's useful for the wheelchair bound with cerebral palsy, brain and spinal injuries, stroke, etc.
It's also to save your own back while making possible new therapeutic approaches.
Safety first...
anti tipping
anti fall-through
anti harness hang syndrome
anti pressure sores
anti fear of falling
back saving transfers
safe toileting
safe stander with gentle traction
Then comfort
95% of design work is applied to the parts that touch the body
pads everywhere, but firmness of posture
this is why you first apply on self and other normal adults who can speak.
First practice on self and other normal adults and children
the importance of learning liftwalker use with one's own body
by practicing with normal adults and children you can have exact verbal feedback as to what works and is comfortable
Adjustment of thigh prompts, Part 1
designed to position while patient is seated
thigh prompt pattern designed to adjust to a wide range of thigh sizes and shapes
left and right thigh prompts
connection point at hip socket
kneel before client and place their foot on your thigh, thus creating space underneath patients leg
slide thigh prompt under leg
position just rear of knee
place hip rotation point low below hip socket
wrap around thigh being careful to fit it snugly along the entire length of thigh. the object is to have as much of thigh muscle group in contact with prompt fabric with no loose spots
you will apply thoracic prompt at this time and return to completion of thigh prompt adjustment in part 2
*Application of thoracic prompt
after initial thigh prompt placement, and before standing, apply thoracic prompt
slowly move Freedom Walker to client while lowering thoracic prompt to just above lap
as you move the Freedom Walker rearward, open arm trays to get just outside of forearms
be sure front belly belt is loose so client and be moved as far forward forward in prompt as needed
place forearms in arm trays with elbows backed up to elbow pads
secure pads around forearms with velcro straps
have client lean forward and secure back belt. tighten so upper arms become as nearly vertical as possible. observe vertical-ness from sides and front.
ideally the small of the back will be in line with the backs of the elbows as viewed from the sides
secure the front belly belt snugly at this time, and take special care to not apply belt over or close to feeding tubes nor apply any pressure whatsoever to implanted med pumps.
Adjustment of thigh prompts, Part 2
place belt buckle into attachment hook below elbow
snug tight, usually to the shortest adjustment possible, but this is dependent on body ....tall lanky patients can have a longer belt adjustment
secure excess belt end by velcro-ing down to side of thigh promptyou can
double check all prompt connections and over all adjustment and advise client that he's about to stand up and have some fun
you can lift patient either from from or from side. From the side you can offer a hand behind the client's back to help them lean forward and assist you in standing them. If you stand in front advise client that they lean forward and get their torso over their feet.
while pulling the lift switch forward, and while the lift arm is going up, bring the client forward about 12 to 18 inches so that they are pushing directly down on the floor to help themselves and you get them to standing. If you observe yourself standing from a chair you will see that you have to move your torso forward the exact length of your femur to maintain balance while standing. Imitate this movement while helping client stand. It is very uncomfortable to do otherwise.
the body stretches out somewhat after standing and you will likely need to snug up the back belt just a little bit. Snug but not tight.
Thigh prompt adjustment, Part 2
after raising client to standing check posture and readjust thigh socket connection point if necessary. You can use the buttocks strap to help keep the connection point sufficiently at hip socket or rearward of this point.
check left and right prompts for evenness of upward pull, adjusting as needed, also considering the differences in leg strength and length.
check client posture at this point before attempting to walk and be sure that all has been done to place the client in the most safe and comfortable standing posture as possible.
initially ankle prompts were designed as anti scissoring devices
addition of weights to ankle prompts (internal stainless steel rods) serves as a gentle traction to relax and stretch contractures
they also serve as a stabilizing force to counter wildness of step
plus offering weight training and tempering of spastic gait
place ankle weights on ankle with most weights facing forward over top of foot.
place ankle weights so that cord extends directly from side of ankle to base frame.
If anti scissoring force is required to separate knees, shorten cords using the device attached to cord as illustrated.
If client fatigues at some point if may be helpful to remove the ankle weights. The stretching of legs sometimes lasts even when prompts are removed and then the client may find more steps possible with weight removed.
Miscellaneous prompts, accessories, and their use.
hyper extension strap (illustrate use)
anti "frogging" knee prompts (illustrate)
wrist wraps (illustrate)
toileting and transfer strap (illustrate, sort of)
pelvic positioner strap (illustrate)
buttocks strap (illustrate)
back pad for skin issues (illustrate)
Standing and refining posture
it will take time for the patient to stretch and straighten up
use lift switch liberally during this posturing process, as well as during walking
If required for posture correction, remove one prompt at a time and move connection point rearward. this will often help a client stand upright.
if the buttocks are extending backward and preventing good standing try using the pelvic positioner or buttocks prompt (as illustrated)
get client standing comfortably before proceeding to standing. (story of Erin could be helpful here)
having the hands grip the handle bars is not all importan if the client is using the thigh prompts. but hand grip is usually helpful to maintain posture and directional control of the machine. Use the wrist wraps to keep the forearms in position if necessary to keep arm placement and posture stable.
thigh prompts can be moved up and down on the leg and also raised in relation to the arm prompts to compensate or adjust for differences in leg length, leg shape, or postural issues.
If client scissors, adjust the length of the cord attached to ankle prompts using the small stainless steel spool hanging on the cord. (illustrate) Each winding of cord on the spool takes up two inches.
If leg contracture is so extreme that thigh prompts and ankle prompts do not suffice to separate the knees, a knee level anti scissoring prompt is available by special order. This accessory works easily every time.
Regarding infinite height adjustment....play with height adjustment continually to adjust for changes in client height due to stretching, relaxing, fatigue, and even a change in floor surface (carpet to tile), etc. Adjustments of height as small as an eighth of an inch make all the difference in the client's ability to make a good step.
Gait training....let's take a walk
Constantly evaluate posture, energy level and fatigue, sweating, heart rate, and attitude.....give a rest and or a drink as needed. Be nice.
Be aware of breath-holding. A lot of people concentrate so fiercely on taking steps that they forget to take regular breaths and are not aware of it. Remind them to breathe if necessary. Believe it or not, this helps.
Some kids will practically jump out of their chairs and take steps right off. But these children will have little wind capacity and will tire quickly. Just try and keep them at a moderate pace, especially at the first.
Most clients will need careful coaching of their stepping techniques.
I saw one PT go very slowly and let the child initiate her own steps. This took a lot of time and I don't usually have much time. But it can work.
I tend to favor techniques which fall generally under the category of patterning
Sit on a rolling stool behind the patient. Put their feet on your feet. walk slowly and deliberately around the room while they feel what the motion is like.
Get on the floor and take one foot in each of your hands and physically place each step. This can be hard on the knees so you might want to get some kneepads.
If the child hops, both feet at once, you will need to patiently hold one foot down while they take a step with the other. then alternate to the other foot, hold it down while they step with the other. and so forth. It doesn't usually take more that a few minutes before they get the idea. Usually after a few walking sessions they will fix the hopping problem.
You can stand behind client with your hands holding their upper arms, and with your feet or knees put their feet to inititate steps.
Whether standing or kneeling by client you can tickle their legs. This often works to initiate steps.
While crawling behind client and working with their steps, you can remove their shoes and socks and tickle their soles. This usually is very good to initiate steps. Often you'll get a very vigorous response.
One of my clients takes a cord and attaches it the the thigh prompts and while she guides from the front of the walker she pulls on the cord to help initiate steps.
One of my clients takes a cord and attaches it the the thigh prompts and while she guides from the front of the walker she pulls on the cord to help initiate steps.
If your student is doing very well and basically cruising along, you can relax a little bit. Engage the directional casters and get up front and hold the handle bars while adjusting height as necessary. Essentially you are just keeping direction.
If a student is mentally alert they will eventually learn to navigate on their own. Still, always be watchful for potential obstacles, especially drop offs like a sidewalk curb. This is the main way to tip over a LiftWalker. Sidewalks are not level. Always engage the directional casters or the student and machine will drift down toward the edge. You will need to keep hold of the handles when on sidewalks with a curb, or upon any uneven surface.
If the outward force of the thigh prompts causes an excessive abduction force, or frogging, get these d ring prompts and attach like this to pull the legs together. (illustrate)
Resting, sitting, transfers, toileting, standing, kneeling...
First steps require a tremendous effort. Offer rests often. If the student needs to sit and there are no chairs close by you can get down on one knee and lower the student to sit on your extended knee. Meanwhile send someone for a chair unless the rest is but a few minutes. While wearing the thigh prompts it is often sufficient to just stop walking and let the person stand. Lifting the student a little bit can take some weight off their feet.
For a seated transfer use this prompt like this. Attach to handle bars, thread underneath the legs just behind the knees, and buckle in. Make snug and then lift student a few inches before transferring laterally. (illustrate)
To toilet, secure back belt so it has no chance of getting into toilet, back student to the toilet, remove the thigh prompts, lower pants, and lower onto toilet. Secure position with front caster brakes. Then wait patiently.
especially for spinal rehab, lower client onto one knee or two knees. apply brakes until time to lift.
Care and maintenance
12 volt batteries and charger. Put charger where it will not be disturbed and can remain plugged in. Put the empty battery in the charger and it will charge in about an hour. And the charger is a smart charger, that is, when the battery is full it stops full charge mode and goes into trickle charge mode keeping the battery topped off with electrons. Leave the battery in the charger until needed and keep the charger plugged in. Make sure the power supply to that outlet doesn't go off at night or the battery can be damaged. When the lift performance becomes slow, remove the battery from the holder by squeezing the gray plastic thumb tabs and lifting. Exchange it for the battery in the charger and you're ready to go. Do not allow charger to be on a circuit where the power goes off at night. This will cause battery damage and greatly reduce battery life. If cared for these batteries should last a good five or ten years. Replacements available through our factory or go to some place like Home Depot. 12 volt Makita power tool battery. The factory says that the first four or five times the battery is used, drain it completely before charging. This, they say, gives it better capacity and longer life.
The electronics, especially a battery must not be allowed to get wet. No walking in the rain. Sorry.
The arm and chest pads are washable. The front vinyl pad can be wiped clean with soapy warm water and cloth. For arm pads remove the black foam and wash them both separately with soapy warm water. Ankle weights have stainless steel rods and will not rust. If they become soiled carefully remove and wash immersed in warm soapy water and drip dry in warm place.....or dry clean. Thigh prompts can be dry cleaned. You may have to tie off the buckles with a sock and rubber band. Or wash by hand and drip dry in very warm place. Keep buckles out of water.
Keep all velcro off floor and away from fuzzy cloth. Velcro can sometimes be de-linted with strong tape.
Clean stainless steel surfaces with moist cloth and mild disinfectant
Structural breakages are rare and only occur from some extraordinary stress or impact. If anything occurs please call the factory. I saw one of my machines the other day that appeared to have been backed over by a car. Don't do this. It's not covered by warranty.