Facilitating Stepping in Inpatient Rehabilitation
| August 2018
We have used Rifton products in our facility for the last two years with our adult neuro patients, primarily with stroke, brain injury, and brain tumor resection, though they have also been useful with patients with incomplete spinal cord injury and demyelinating diseases.
Patients who might not be able to safely walk over ground or even in the parallel bars can often get up quickly into the Rifton E-Pacer or TRAM and begin walking farther and sooner. The trunk support and elbow support help to get a patient into an upright position, and the harness system and wide base of support eliminate the fear of falling, making patients feel confident as they re-learn to walk. Through trial and error, we found that a therapist using a strap around the knee as well as a strap attached to the patient's shoelaces can effectively facilitate a normal gait pattern.
Alternatively, we sometimes use a long strip of blue theraband to create lift assist for a patient’s hemiparetic limb. The theraband lift assist is useful to allow patients to move the limb freely and successfully on their own, without the therapist facilitating the movement for them. To accomplish this, the strip of blue theraband is attached at the patient's shoelaces, then criss-crossed behind the knee, wrapped around to the front, then criss-crossed at the anterior hip, and then tied around the back of our patient's waist. This is helpful if a patient has some strength in ankle dorsiflexion, knee flexion, and hip flexion, but not enough to allow them to complete swing phase independently. As a patient gets stronger, the amount of assist from the band can be gradually reduced.
I love the Rifton products because they are easy to use, easy to train other staff members to use, and the learning curve is low for most patients. Set-up time and take-down time are very quick in comparison to other forms of unweighted gait, and the devices are affordable. We have had countless patients return to walking independently at home and in the community thanks to the Rifton products! This is truly valuable technology.
