Transfer Training Case study in ltc april 2012-1
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Transfer Training Case study in ltc april 2012-1
- 1. Neurogym Technologies St. Patrick’s Home – Ottawa Ontario Eric Heiden Msc. HK April 2012
- 2. Participants • 11 residents of a LTC facility – selected by restorative care staff based on the following criteria: – Able to transfer with supervision or assistance from 1 person – Able to understand and follow instructions • At the start of the training program each of the residents required some assistance to perform 5 consecutive sit to stand movements • Most common co-morbidities included Parkinson’s disease, multiple sclerosis, osteoarthritis, dementia
- 3. Methodology • 12 week case study • Training sessions 3x / week for 25-30 minutes • Assisted standing with the NeuroGym sit to stand trainer – Up to 50 repetitions in a session – Progressive reductions in weight assistance • Games-based biofeedback training – Began at week 5 – Progressive increase in game speed
- 4. Sit To Stand Trainer NOT A LIFT!
- 5. Average Time to Complete Repeated sit to stands
- 6. Weekly Trends During Training 5x sit to stand Average Time to Complete Repeated sit to stands (seconds) Average weight Assistance (lbs) Average Game Biofeedback training Score begins (week 5)
- 7. Progression of Support / Assistance Weight assistance, hand support and knee pad support •Counterweight provides assistance for moving the body off the seat •Hand support stabilizes the body and pulling against the bar helps move the body off the seat •Knee pad stabilizes the lower body and provides a fulcrum for moving the body forward and off the seat Hand support only •Body weight is lifted off the seat entirely by muscle force •Hand support stabilizes the body and pulling against the bar helps move the body off the seat •Legs are independently stabilized Independent •Lifting the body off the seat requires muscular force and speed – to develop enough angular momentum for lifting the body off the seat •The body is stabilized independently
- 8. Support / Assistance Required for 5x sit to stand Number of Participants
- 9. Changes in RAI MDS 2.0 Scores After Training
- 10. Conclusions • Enabled movement training with progressively reduced body weight support and biofeedback training, with progressively increased speed, improved the ability to perform repeated sit to stand movements measured by time to complete 3 and 5 consecutive sit to stands • 4 of 11 participants were able to perform 5 consecutive sit to stands without assistance at the end of the training program • 4 of 11 participants (not the same 4 as above) improved their ADL scores (measured by RAI MDS 2.0) after the training program • Training with body weight support and speed sensitive biofeedback improved the ability to stand from a chair, these improvements appear to be associated with positive outcomes on the RAI MDS 2.0
Hinweis der Redaktion
- (1:50) My name is Kara and I am with Webex. Thanks for attending the Neurogym Technology Webinar - A Paradigm Shift in ElderCare. I would like to start by making two introductions. Giving the presentation will be Kevin Mansfield who is the president and CEO of Neurogym Technologies. Also present for the webinar is Dr. Avi Nativ, the founder and CTO. Dr. Nativ is a registered physical therapist who holds a PhD in Kinesiology. He has been involved in rehabilitation for over 20 years, and continues to operate a clinical practice for neurologic physical therapy. Dr. Nativ will be available to answer any questions of a clinical or therapeutic nature. Kevin: Thank you Kara, and thanks to everyone for joining us on our first Webinar. We have been very encouraged by what we have seen in both Canada and the US in terms of a significant shift away from the traditional institutional model for long term care. This shift encompasses many aspects of life for seniors, one of which is physical mobility. The ability for someone to, at a miminum transfer more easily or in some cases regain the ability to walk. The science is very clear that this is attainable, and even moreso now with the available of equipment that can safely enable marginally mobile individuals to perform daily activites such as getting up our of a chair and walking. As Kara mentioned, you can type in your questions and we will attempt to answer them all in the last 5 minutes. Those questions we can't get to in the question period will be answered by email over the next day or so.
- (:52 - 14:00) Dr Nativ starting working on brain plasticty during is Phd. It was very clear from Dr. Nativ's, and others work, that brain plasticity could be initiated with the right kind of training. Patient initiated, speed sensitive and intense. He decided to do a Physical Therapy degree hoping to bring brain plasticity to the clinical environment. Unfortunately the equipment did not exist to safely allow people to move in the way needed to facilitate plasticity. Dr. Nativ then spent 15 years developing a line of enabling equipment for his neurological patients. The results were amazing. The equipment was able to help move the most difficult to move patients. Patients with spinal cord injury, stroke, Brain injury, MS or parkinsons to name a few. So the equipment was actually born in neurophysiotherapy.
- (:52 - 14:00) Dr Nativ starting working on brain plasticty during is Phd. It was very clear from Dr. Nativ's, and others work, that brain plasticity could be initiated with the right kind of training. Patient initiated, speed sensitive and intense. He decided to do a Physical Therapy degree hoping to bring brain plasticity to the clinical environment. Unfortunately the equipment did not exist to safely allow people to move in the way needed to facilitate plasticity. Dr. Nativ then spent 15 years developing a line of enabling equipment for his neurological patients. The results were amazing. The equipment was able to help move the most difficult to move patients. Patients with spinal cord injury, stroke, Brain injury, MS or parkinsons to name a few. So the equipment was actually born in neurophysiotherapy.
- (2:23 - 17:33) This is one of our more popular products - The Sit-to-Stand Trainer. The machine works specifically on retraining the sit-to-stand skill. Not a sit-to-stand assist, but a training tool to improve specific muscles and coordination used when attempting to stand. As an individual gets stronger, we reduce the amount of weight assist on the weight stack. Even if someone cannot fully stand up due to range for motion issues at the knees, transfers can be targeted by only standing 30 to 45 degrees. (Clip 1:20) After the clip. Talk about the time and resources required to set up the training. Talk about the castors and even performing the training in the individual's room. Talk about Fred and the mirrors Talk about the Scottish lady sobbing