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BWST Lecture. KIN 436B Spring 2008. Transfer. Place chair at angle to table Secure Chair Transfer Client Provide assistance as necessary. Stretching. Hamstrings Glutes Adductors Calves Foot ROM Ankle. Locating A nterior S uperior I liac S pine. Palpate ASIS
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BWST Lecture KIN 436B Spring 2008
Transfer • Place chair at angle to table • Secure Chair • Transfer Client • Provide assistance as necessary
Stretching • Hamstrings • Glutes • Adductors • Calves • Foot • ROM • Ankle
Locating Anterior Superior Iliac Spine • Palpate ASIS • Adjust harness location as necessary • Strap/Secure harness across ASIS
Leg Straps • Ask client to make any adjustments as necessary (esp. male clients) • Give client privacy • Start low then slide up • Fasten and adjust
Chest Strap • Secure chest straps • Use towel or sweater if client is between sizes • Tighten accordingly • Allow about 1 inch of play between harness and client
Harness/ Transfer • Ensure harness secure • Sit client up • Place client’s feet off table to allow for breathing • Transfer Client back to chair (2 person)
Preparing for Treadmill • Roll client up ramp and onto treadmill • Have person in front to guide front wheels • Secure chair • Have leg trainers remove leg rests/prepare to lock knees • Have front person assist with yolk/karibiners
Connecting BWS Device To Client • Front Trainer brings down yolk • Hip Trainer (Captain) connects karabiners with clip opening to the rear (front to back)
Standing/Sitting Procedure • 4 trainers in contact while sitting/standing • Hip trainer (captain), 2 leg trainers, front trainer • Leg trainers position feet on ground • Front trainer grabs waist loop and guides • “Captain” confirms everyone is ready • “Captain” signals computer operator to lift • Team allows MACHINE to lift client, NOT hip/front trainers
“SafetyFIRSTSafetyLAST” • Once standing, front trainer confirms 3 other trainers have control prior to attaching/removing safety karabiner • Safety is FIRST thing attached after client initially stands, LAST thing removed prior to sitting.
Safety Attachment • Attach karabiner to closest loop • ATTN: do NOT lock in the event of emergency drop
Bungee Cords • Once chair removed, attach front bungee cords to anterior hip loop on opposing side (cross) • Repeat process for rear bungee cords • Wrap around post if necessary to correct posture
Alignment • Leg trainers position client’s legs directly beneath to support weight • 4 landmarks • Shoulder • Hip • Knee • Ankle
Leg Trainer Positioning • Leg trainer sits partially on treadmill • Seat/foot rest/back rest adjusted for comfort • Keep limb close to body • Use arms, not back (Don’t row a boat!)
One, Two, Step • Captain calls weight shift to one side • Trainer on same side holds stance • Opposing leg trainer positions leg in terminal stance, pre-swing • Captain chooses speed (usually 0.8mph) to start • Treadmill controller starts treadmill and confirms by repeating command
Stance • Hand closest to treadmill applies pressure on patellar tendon • Other hand applies pressure on Achilles Tendon
Swing – Overview • Closest (top) hand applies pressure on middle hamstring • Bottom hand hooks foot to prevent foot drag
Swing – Top Hand • Pulls on middle hamstring throughout swing • NO pressure on patellar tendon
Swing – Bottom Hand • Bottom hand uses thumb to lift foot • Guides ankle placement at terminal swing
Successful Walking Tips • Training team coaches/provides feedback • Captain calls out adjustments to be made by leg trainers (i.e. L-side hold ext. longer) • Leg trainers communicate/alternate stepping • One trainer waits for opposing foot to perform prelim. stance prior to initiating swing • Both trainers adjust to each other (i.e. stride length, swing speed, etc.)
Training Complete!!! • Once training completed, turn off treadmill • Have front trainer enter • Reverse process with bungees, chair, safety, and ramp procedure
Additional Safety Precautions • Any part of training team can call a pause at any time during session • Commands by “captain” or leg trainers repeated by responding teammate for verification ex. Captain: Pause! Treadmill Controller: Pausing. • Client always faces uphill on ramp whether entering or leaving treadmill
BWST THE END