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UN--WEIGH MOBILITY TRAINER

UN
IMI 3204, IMI 3207

(General Information & Working Manual)

INDIA MEDICO INSTRUMENTS


S-46, Badli Industrial Estate Phase-1, Delhi 110042 (India)
Office : 2-3 Gurwalon Ki Dharamshala, Angoori Bagh, Delhi 110006
Email. : www.indiamedico.com

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INTRODUCTION

PARTIAL WEIGHT BEARING GAIT THERAPY AND BALANCE TRAINING (1)


The loss of the ability to ambulate can be one of the most debilitating aspects of many
Neurological and musculoskeletal disorders. Any of the three main components of locomotion
- posture, balance and coordination - can be affected by a variety of neurological or
musculoskeletal pathologies resulting in the disruption of an individuals ability to walk
Normally. Partial Weight Bearing Gait Therapy (PWBGT) has shown great promise in helping a
wide Variety of impaired patients as they relearn walking function. It is an appropriate modality
to use whenever gait therapy is prescribed for patients who are unable to support their own
body weight or lack the upper body strength to support themselves during assisted ambulation.
In addition to aiding gait pattern regeneration, partial weight bearing therapy allows patients to
perform cardiovascular workouts in conjunction with a treadmill, enhance balance and improve
posture. Partial Weight Bearing Gait Therapy makes use of a patient suspension system, such
as the IMI Un-weighing Trainer, to reduce the amount of weight born by a patient and provide
proper upright posture. The suspension system is used to remove a pre-determined portion of
the weight load from the patients legs and redistribute it to the patients trunk and upper thighs,
thus freeing up the arms and legs.

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INTRODUCTION
PARTIAL WEIGHT BEARING GAIT THERAPY AND BALANCE TRAINING (2)
With the patient supported by the suspension system, horizontal movement is provided by
setting the treadmill to a slow speed. The constant rate of movement provided by the treadmill
provides rhythmic input to reinforce coordinated, reciprocal movement of the legs. The therapist
can provide further assistance, especially with severely involved patients, by manually placing
the patients feet and/or assisting the patient in weight shifting. Once the patient begins to gain a
feel for the proper coordinated movement pattern the Treadmill speed and/or the amount of
weight borne by the patient can be gradually increased to better simulate natural walking
conditions. The increase in weight bearing and treadmill speed also helps the patient to relearn
dynamic balance. Having achieved preset goals on the treadmill, the patient can be progressed
to ambulating over ground with the aid of the suspension system. Ultimately, it is hoped the
patient will be able to ambulate over ground independently or with an assistive device. PWBG
Therapy sessions typically last 30 minutes to an hour and are scheduled three to four times per
week. Each hour of the session can be divided into three or four periods of activity followed by a
rest period. Activity periods can be as short as three minutes with five minutes of rest but should
not exceed 15 minutes if the patient is supported or partially supported by the suspension
system. Each period should end at its predetermined time, especially if the patients gait
deteriorates or the patient or therapist feels fatigued. Because the repetition of coordinated
walking patterns is the most essential element to the success of this therapy, be sure to provide
consistent training without interruptions or breaks.

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INTRODUCTION
PARTIAL WEIGHT BEARING GAIT THERAPY AND BALANCE TRAINING (3)

Patients are evaluated over a Two-week period and are expected to make some gains in
their ability to coordinate movement during treadmill walking in this time frame. Continue the
program for Eight to 12 weeks if sufficient progress is demonstrated. Continue for up to an
additional Four weeks for cases showing slower improvement. For acute patients who show
little on no progress after the first Two weeks of therapy, time may be better spent on
different learning activities. The Un-weighing System can be used in the recovery of balance
and posture for patients with compromised posture or balance mechanisms. Toss the
patient a ball to catch or provide perturbation manually to challenge their balance. The
suspension system will prevent the patient from falling while providing proprioceptive cues.
The amount of support can be reduced as the patient progresses.
NOTE : Extreme caution should be taken to assure the stability of autonomic reflexes
(in acute stages) as well as bone and muscle integrity (in chronic cases).

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UN--WEIGH MOBIILITY TRAINER IMI 3204
UN

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ASSEMBLING THE UNWEIGHING SYSTEM
NOTE : At least two people are required to complete the following procedure. Ensure that the Un-weighing
system will be assembled on a level surface. Ensure that there is enough room to move easily
around the Un-weighing system frame during installation. After final assembly the Unit will be like
this drawing/photo. (see page 5)
Tools: Spanners & Screw Driver are provided with the unit for assembly.
1. Using a knife slice open the Bundles & open Boxes and remove the packing.
2. Support legs with wheels should be bolted to Base Frame (with matching Numbers & printed name facing
you) making it to look-like a Horseshoe.
3. Bolt the chrome-plated Support Pillars Base Plate on the top of Base Frame with positioning/adjustment
holes on the outer side.
4. Now slide down first Handle Bar bracket, second Steering Handle bracket & last Suspension Bracket
(large one). The Locking Pins of Brackets should match with Holes in the Support Pillar.
5. Fix digital Panel on Suspension Bracket.
6. Fix with Straps UPS in SS tray provided on the Base Frame, the out-put sockets should face Support
Pillar.
7. Insert patient support handles into the handrail receiving tubes so that they face in toward the center of the
unit.
8. Snap a black finishing cap into each of the bolts fixed.
9. To attach the harness, open the harness attachment clips, attach the harness and snap the clips back
together to secure.
NOTE : 1. Un-weighing System uses a special harness to support the patient. It is vital that the harness fits
properly on the patient.
2. Never leave a patient unattended on this device. Check all cables, harnesses and fittings
before each use.

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BENEFITS OF DYNAMIC UN-
UN-WEIGHING THERAPY

Partial Weight-Bearing Therapy, also known as Un-weighing, is a concept of

rehabilitation that uses an external device to support a percentage of the patients body

weight, allowing them to perform a variety of therapeutic activities in an upright and safe

environment.

Typically used with Neurological Pathologies, the patients body weight is supported

between 20-40% to assist with developing proper gait patterns and improvements in

cardiovascular and muscular endurance with less physical demand.

The ability to initiate exercise early in the rehabilitation process can benefit the patient

by allowing development of neural pathways through muscular patterning.

Research has shown the benefits of Un-weighing to occur in a variety of physiological

ways.

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PHYSIOLOGICAL BENEFITS

Symmetrical Loading of the Lower extremities - This assists with equal weight
distribution over the base of support. Equal weight distribution in turn provides the proper
biomechanics to correct step length deficits and time distribution between limbs.

Reduction of Muscular Splinting - Parasympathetic tones typically associated with


neurological pathologies can be reduced through partial-weight therapy.
Minimizing parasympathetic stimuli helps to reduce muscular tension in turn allowing
for increased range of motion and focus on motor control exercises.

Reduction of Cardiovascular and Metabolic Demands - Relieving graded portions of


body weight allow the patient to exercise with less stress to the cardiopulmonary system,
this is beneficial for extremely deconditioned patients as it allows them to initiate exercise
without increasing cardiopulmonary demand. VO2 levels are maintained better at 40% un-
weighing than at 0%, the patient can then also exercise for a longer period of time. This
application can be beneficial for cardiac and pulmonary rehabilitation, as well as obese
patients as exercise can be prolonged to enhance conditioning.

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OTHER BENEFITS
Acute Injury and Post Surgical Un-weighing can also provide a safe environment to
start acute therapy following injury or surgical procedures. This is especially true with
patients suffering from low back pain, whether its acute or chronic. Un-weighing provides
an environment around the injured joint with reduced gravitational effects, this can be
coupled with exercise to enhance joint stability. Vertical traction is accomplished to provide
patient relief. This same approach can be taken with other orthopedic injuries. By using
the Un-weighing System you can be assured that your patient is working in a dynamic
environment unloaded to physician specifications. Since the weight of the patient is
supported, there is increased safety for them and the clinician, should a fall occur.
Balance Training - The Un-weighing System provides a safe environment during balance
training. Securing your patient in the Un-weighing System will eliminate the risk for falling
during balance training. The somatosensory input provided by the harness provides
proprioceptive feedback in regards to location of the trunk over the base of support and will
allow your patient to work with more confidence during rehabilitation.
Digital Display of Un-weighing Load - The digital display incorporated on the Un-
weighing System provides feedback in regards to the amount of weight being relieved
from the patient. This is beneficial as it allows for consistency between treatments thus
providing a therapeutic environment to improved gait mechanics and neurological
patterning.

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POSITIONING THE UN-
UN-WEIGHING SYSTEM FOR
USE WITH TREADMILL

1. Roll the un-weighing system into


position so the display faces
toward the front or back of the
treadmill deck. The treadmill
control panel should be easily
accessible.

2. The patient should be placed in the


center of the treadmill belt and
closer to the front than the back.

3. Lock all four locking casters.

4. Adjust un-weighing as needed.

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DETERMINATION OF BODY WEIGHT
SUPPORT

1. Heel / Ground contact during ambulation is lost in patients when weight relief is

in excess of 40% body weight.

2. Chose a level of weight relief in which the patient achieved heel/ground contact

bilaterally for ten consecutive steps.

3. When determining body weight support, keep in mind the patient's pathology

level of involvement and comfort. A patient who is considerably challenged

may require a greater percentage of weight relief.

4. The digital panel shows the Total Body-weight of the Patient in Green window

and the Red window shows the Body weight being lifted.

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USING THE SUPPORT HARNESS
1. Two Harnesses are supplied with the system. (Small harness for thin patients & Large for fat
patients)
2. To assure patient compliance and successful rehabilitation, the Support Harness must be
properly adjusted to provide a comfortable environment for your patients. There are Two
harnesses to accommodates a wide variety of patient sizes and shapes.
3. The Velcro straps are easily adjusted while the harness is on the patient and allow for quick
removal once therapy is completed.
4. The harnesses can accommodate patients with torso sizes measuring from 24" to 50".
Follow the directions below to ensure a proper and safe fit.
CAUTION:
A snug fit is necessary to provide safe un-weighing and improved patient compliance.
It is necessary to ensure that the straps do not lay over pressure points or where friction
may occur.
These areas may include, but are not limited to, under arms, between legs, and at the edges
of the harness.
For purposes of hygiene and comfort, it is recommended that the patient wear clothing
under the contact areas of the harness at all times.

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PUTTING THE HARNESS ON THE PATIENT
NOTE: You can perform the following procedure with the patient in a supine, seated or standing position.

1. Undo the Buckle straps on the front of the harness. (The front of the harness is the side with the
red button on the seat belt buckle).
2. Place the patients arms through the shoulder straps on each side of the harness.
3. Place the middle torso strap over the iliac crest. Make necessary adjustments to the vest using
the Velcro straps in the front and back to provide an equal and snug fit.
NOTE: The buckles should align up along the middle of the patient's body on both the
front and back.
4. Place the leg straps between the legs and adjust fit to patient comfort.
5. Ensure that the shoulder straps have been adjusted to equal length on both the right and left
side.
6. Attach "O" rings to Cross-Bar hooks and check that the cross bar is now two to three inches
above the patients head. Readjust the length of the shoulder straps and ensure the straps
equally snug on both sides.
7. When the treatment session is completed, open the buckles release the patient. The harness is
now ready for the next patient.
CAUTION: The between leg straps must be used with the harness for heavy un-weighing load.
The leg straps are as important for weight distribution as is the main body of the harness.
The buckles should align with the middle of the patients body on both the front and back.

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ANTERIOR VIEW POSTERIOR VIEW
Fixing of Harness
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ANTERIOR VIEW POSTERIOR VIEW

Fixing of Harness LATERAL VIEW

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ADJUSTING THE
HE HARNESS

1. Torso Straps : Adjust for the circumference of the patients chest.


Placement : The middle torso strap should be placed over the iliac crest and equally
distributed between the right and left sides.
Adjustment : Using the Velcro straps, secure the harness snugly around the patients torso.
The torso straps can be adjusted from the front or back of the harness.
2. Between Leg Straps: Allows for weight distribution through the legs.
Adjustment : Using the Velcro strap, secure the harness snugly between the Legs.
3. Shoulder Straps : Allow for harness height adjustment while patient is secured to the Un-
weighing System. Should the patient need additional support on one side
the strap can be shortened to provide additional unilateral support.
Placement : Adjustment of the shoulder straps should allow the cross bar of the Un-
weighing System to be positioned approximately two to three inches above
the patients head before the un-weighing load is applied.
Adjustment : The shoulder straps can be lengthened or shortened using the end of the strap
located near the seat belt buckle. With Remote Switch adjust the Suspension
bracket with cross bar to patient height.
NOTE : Be aware of incontinence concerns. Use of the un-weighing harness can put pressure
on the patients abdominal area, including the bladder. Should a harness become
soiled, it can be hand-washed in a sanitizing detergent, then air-dried.
NOTE : Patient set-up should be conducted over the desired walking surface (i.e, treadmill or
floor) as moving from the floor to the treadmill will require the set up procedure be
repeated.

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ATTACHING A PATIENT TO THE
UN--WEIGHING SYSTEM
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1. Turn ON the Load Monitor display on the Right side of the unit.
2. Press TARE button, all the readings in Red & Green window gets 0.
3. Press Peak Hold button, Holds Red indicator will glow.
4. Press UP button (Remote/Hand held switch) to lift up the Patient from
ground to have patients actual body weight in Kilograms.
& it will be displayed in GREEN window.
5. Press Store/Reset button to store the actual body weight in memory.
6. Press Peak Hold button, Holds Red indicator will goes OFF.
7. Press DOWN button (Remote/Hand held switch) and Check the display to
see how much weight have been on the patients legs.
Calculate the weight removed and press switch until the display
shows the desired level.
8. Ensure the patient is comfortable and that the vest is properly fitted.
Be sure the shoulder straps do not rub against the patients ears.
Make sure the bar does not hit the patients head.

The Un-weighing System is now ready for use.

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FREE WHEELING
1. The Un-weighing System can be
used over the floor or with other
exercise devices.
2. Be aware of the adjustments
required when moving from one
device to another.
3. For example, when stepping down
from a treadmill, the step-up height
of the treadmill must be taken into
account.
4. This is accomplished by Pressing
DOWN switch of remote switch and
lowers the patient.
5. The opposite is true when going
from the floor to the treadmill.
6. When traveling across the floor
there is no need to spin the entire
un-weighing system around when
the patient runs out of floor space.
Simply turn the patient and head in
the opposite direction.

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PHOTOGRAPHS OF SYSTEM IN USE

Vertical Support for Walking

Sit to Stand Exercises


(Adjusting Suspension Bracket)

Controls Weight Bearing

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MAINTENANCE AND SAFETY
INSPECTION
INSPECTION
Although the IMI Un-weighing System is designed for trouble-free operation, simple daily and
monthly inspections should be made of the hooks & straps to assure patient safety.
A more comprehensive inspection should be performed every six months to the lifting assembly
to ensure proper operation and safe applications.
Cleaning
As needed, wipe down the frame with a solution of warm water and mild detergent.
Hand-wash patient support vest in a sanitizing detergent & Air dry.
Daily
a. Inspect the Harness Straps and Snap hooks.
b. Use Remote Switch to Lift or Lower the Suspension Cross Bar to check its smooth working.
c. Inspect Harness Spreader Bar and clips for signs of wear. Make sure to release clips and lock
them into place to ensure they are functioning properly.
Monthly
a, Inspect the four casters for uneven wear. Ensure they are attached firmly to the Un-weighing
System.
b, Check that the wheels lock and unlock properly.
c, Inspect the upper pulley and suspension bracket adjusting rope for any signs of wear, which may
include fraying, cuts, or kinks in the rope.

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