biodex 945-480 Installation & Operation Manual page 5

CONTENTS
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 car-
diovascular 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
Biodex Offset Unweighing System, to reduce the amount of weight born by a patient and pro-
vide proper upright posture. The suspension system is used to remove a pre-determined portion
of the weight load from the patient's legs and redistribute it to the patient's trunk and upper
thighs, thus freeing up the arms and legs.
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).
With the patient supported by the suspension system, horizontal movement is provided by set-
ting 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 patient's feet and/or assisting the patient in weight shifting.
Once the patient begins to gain a feel for the proper coordinated movement pattern the tread-
mill speed and/or the amount of weight borne by the patient can be gradually increased to bet-
ter 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.
PWB 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 suspen-
sion system. Each period should end at its predetermined time, especially if the patient's gait
deteriorates or the patient or therapist feels fatigued. Because the repetition of coordinated walk-
ing patterns is the most essential element to the success of this therapy, be sure to provide con-
sistent training without interruptions or breaks.
Patients are evaluated over a two-week period and are expected to make some gains in their abil-
ity 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 Biodex Offset Unweighing 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.
— 5 — PARTIAL WEIGHT BEARING