EQUIPMENT FOR LB THERAPY

The harness

If a patient can already walk on the treadmill without body weight support and is capable of independent walking, the harness is uncritical and any model can be used to serve as (necessary) safety belt. (For safety reasons it is generally not allowed to walk on the Laufband without harness). The only problem then to consider is that the harness does not hinder the patient when walking, e.g. forces him into sitting position or blocks hip extension.

With patients who need much body weight support, the harness and its proper fit are of most critical importance. With these patients considerable amounts of weight support have to be applied especially when the patient is not capable of independent upright standing. Then the harness has to be mounted while the patient is sitting in the wheel chair. We have developed a harness which meets these requirements and will be described here in some detail. A film showing the principles of mounting the harness on differently disabled patients is included in the CD accompanying the manual (HARNESS).

Fig.2 The harness.
One important feature is the distribution of body weight onto several supporting points. Some weight is carried by the pelvis part (A in Fig. 2) which is put at the lower edge of gluteus maximus (care has to be taken that the patient does not sit in the harness). Most of the weight is carried by the leg straps (E); it is important to pull them as deep down as possible and towards you before fixing them at the buckles: Obviously, straps running too steep cause pain and may jeopardize male genitals. Genitals need to be clearly free, and this needs to be positively confirmed by the patient (cave reduced sensibility) and the therapist. For further descriptions see film on the accompanying CD.The distance between pelvis and chest part is adjustable (B and C in Fig.2), thisway patients with a range of different body proportions can be accommodated. Also, it can be changed even under load (due to special buckles which have been developed for the parachutes of US army) e.g. to relieve hyperlordosis by tilting of the pelvis. However, too large distance causes a reduction in support for the pelvis/trunk and might allow too high mobility in the lumbar region.

Mounting of the harness is described in detail in the included film.