JULIAN WALKABOUT Use r s Manual TM 1 TABLE OF CONTENTS Preface Design Goals Precautions Program Recommendations P Components Assembly Adjustment Overview Fitting Instructions Measure the Child Sit Bar, Hip & Upper Trunk Supports Upper Body Pitch Column Height Spring Tension Swivel Caster Lock Adjustable Length Base Headrest Options Hand Holds & Arm Troughs Clear Tray Assembly Double Sit Bar Abduction Skirt Operating Precautions Maintenance Technical Data 3 3 3 4 4-5 6-8 9 10-15 10 10-11 11 12 13 14 14 14 15-17 15 16 17 17 18 19 19 2 PREFACE This booklet provides the information required for the set up and use of the Julian WalkaboutTM. The benefits of using this system can be profound, not only in terms of gait development, but also in terms of increasing the child s independence, self confidence and social interaction. DESIGN GOALS The WalkaboutTM is designed to give a child the potential for hands-free, self-initiated movement while providing lateral support and assisted lift. This spring-assisted lift allows for graduated weight relief as the child develops skill and standing tolerance. The adjustable pitch of the column, along with the pelvic and trunk supports, can be utilized to direct weight shift and assist with stepping. PRECAUTIONS 1. This stander should be used under the prescription of the child s physician and under the direction of the child s therapist. Often, ankle support is required prior to utilization of this equipment. 2. Never leave the child unattended! Maintain adult supervision at all times. 3. This stander is designed for use on level surfaces only. 4. Do not use for transportation. 5. Adjust the frame length to suit conditions of use. A short base used during play or out-of-doors can be unstable. 6. Periodically check and tighten all loose fasteners. Loose fasteners can cause the WalkaboutTM to be inoperable. 3 PROGRAM RECOMMENDATIONS Initially, many children use the WalkaboutTM as a stationary stander to develop standing tolerance and to develop hip and knee extension. Remember that spasticity has nothing to do with strength. A child with weak hip flexors may utilize their adductors to assist (this is not a good thing!) This situation can become more severe if the child has limited dorsiflexion. Try activities such as kicking or marching. Arrange obstacle courses to develop motor planning skills. Whenever possible, integrate the child while in the WalkaboutTM into peer appropriate activities: soccer, T ball, family chores , ice-skating, etc. COMPONENTS Refer to figure 1. 1. Pelvic support 2. Trunk support 3. Head rest 4. Front column 5. Spring stop assembly 6. Crank 7. Rear column 8. Tube adjustment clamps 9. Column brace 10. Base frame 11. Sit bar 12. Swivel Lock 13. Step Brakes 4 3 4 5 6 2 7 1 8 9 10 12 11 Figure 1 13 5 ASSEMBLY Tools Required: 3/16 allen wrench (included in pouch) 5/32 allen wrench (included in pouch) 1/4 allen wrench (included in pouch) Tape measure Adjustment Levers: Refer to figure 2. The adjustment levers can be ratcheted so the handle can rotate without affecting the tightness of the screw. 1. Pull out on black knob. Rotate the handle so it is not obstructed. 2. Release the black knob, and let Figure 2 the handle slide back and lock with the screw. 3. Continue tightening/loosening the screw by rotating the handle. Ball Lock Pins: Refer to figure 3. 1. Hold the head of the pin between your index and middle fingers. 2. Press in on the button (1) with your thumb while extracting or inserting the pin. Figure 3 6 1 Assembly Instructions: Column Adjustment Tube: Refer to figure 4 1. Place the base assembly on the floor. 2. Loosen the four allen screws on the tube adjustment clamps (1). 3. Slide the column adjustment tube (2) through the tube clamps. 4. Tighten all four allen screws on the tube clamps. Anti-Tipper: Refer to figure 5 1. Remove the ball lock pin (1) from the column adjustment tube. 2. Adjust the anti-tipper wheels so they are 1 to 2 from the ground 3. Reinsert the ball lock pin. Spring Stop Assembly: Refer to figure 6 1. Remove the ball lock pin (1) and attach the bottom end of the spring stop assembly (2). 2. Reinsert the ball lock pin, to secure it into place. 2 1 Figure 4 1 Figure 5 11 2 Figure 6 7 Column: Refer to figure 7 1. Loosen the T-nut (1) and remove the ball lock pin (2). 2. Slide the rear column into the column adjustment tube. 3. Replace the ball lock pin and tighten the T-nut to lock the column assembly in place. (Keep reading for further instructions on fine tuning.) 1 2 Figure 7 8 ADJUSTMENT OVERVIEW Proper adjustment of the WalkaboutTM will significantly improve the child s success. The therapist is encouraged to try various adjustment combinations. If the child demonstrates primarily reflexive movements and postures, adjustments should be made to increase the amount of assistance that the stander provides. As the child s skill improves, adjustments should be made to decrease the amount of assistance. Adjustments: Column Tilt (Pitch): Affects the child s orientation in space and can affect posture and tone. Column Height: Affects the degree of assistance that the stander provides (in addition to spring tension) Pelvic and Trunk Supports: Provide precise proximal stability. These components also provide some of the fine tuning for trunk alignment and control. Spring Tension: Spring support can be increased or decreased by turning crank (refer to Components section for location). Note: See the following pages for fitting instructions. 9 FITTING INSTRUCTIONS Figure 8 Measure the Child: 1. Trunk width: ___ 2. Hip width: ___ 3. Inseam to 1 below his/her axilla: ___ 1 10 Sit Bar, Pelvic & Trunk 43 2 Supports: Refer to figure 8. 1. Loosen the two allen screws (1) on the back of the trunk bars. Adjust the width of the trunk bars to accommodate the child s 5 chest (use measurement #1 above). Make sure the bars are symmetrical on both sides. 2. Trunk support height and angle can be 7 adjusted via the allen screws on the back of the trunk bar bracket (2). 3. Trunk bar depth can be adjusted by the allen screw on each arm (3). 4. Loosen the four (two on each side) al- 6 len screws (4) on the back of the pelvic support and adjust to accommodate the child s hip width (use measurement #2 above). 5. Sit bar height: Loosen the adjustment lever (5) and slide the the sit bar along the front column. Initially place the sit bar as high as possible on the column. 6. Pelvic support height: Loosen the two allen screws (6) on the top and bottom of the pelvic pad. Place the pelvic support assembly as close to the sit bar as possible without preventing hip flexion. If this support is too high or too low, it will not provide the stability required for the child to step forward. Tighten both screws. 7. Trunk pad height: Repeat step #4, but with the allen screws above and below the trunk pad (7). Pitch: Refer to figure 9 & 10. The child s shoulders should be positioned slightly in front of his/her lower body and feet (in most situations) with the pitch of the column at approximately 85 degrees to the floor. Occasionally the column will be positioned in a more upright, or more prone position, 1 to improve the child s gait pattern or to diminish primitive reflex patterning. When more pitch is needed, the rear column can be tilted forward. Loosen the two allen screws on the upper Figure 9 tube clamp assembly (fig.9.1). Raise the upper clamp assembly and frame brace while tilting the column forward (fig 10).When the desired angle is achieved tighten the allen screws to secure the column. Note: lowering the upper tube clamp Figure 10 assembly will tilt the column back upright. 11 Column Height: Refer to figure 11. After setting the pitch and the sit bar-to-trunk support distance, set the column height. 3 2 1. Measure the inseam: 1 Determine the child s inseam height: ____ a) If the child requires support at the upper trunk to stand, measure from the floor to 2 Figure 11 inches above the inseam. b) If the child requires only hip support to stand, measure from the floor to the inseam. 2. Adjust the Column Height: a) Loosen the T-nut (1) and then remove the ball lock pin on the rear column adjustment tube. b) Slide the rear column (2) up/down so that the sit bar height is the same as the inseam height determined above. c) Replace the ball lock pin and tighten the T-nut to secure the rear column in place. d) For more precise adjustments, rotate the crank (3) clockwise to raise the column assembly or counterclockwise to lower the column assembly. 12 Spring Tension: Refer to figures 12. The sit bar, pelvic support, and trunk support assist in lifting the child into standing. The amount of lift is controlled by the degree of spring tension. 1. Spring rate adjustment: The spring rate is the amount of force required to compress the spring a given amount. By sliding the black tubular spring stop (1) down, the spring becomes stiffer. To adjust, depress the silver slide lock button (2) and hold it in to release the spring stop. 2. Slide the spring stop up/down to adjust the spring assistance. Release the slide lock button to lock the spring stop in the desired position. 3. For additional spring adjustment, rotate the crank (3) clockwise (CW) to increase the spring tension or counterclockwise (CCW) to decrease the spring tension. Note: this 3 1 adjustment 2 can also be used to affect the height of the front column. Figure 12 13 Adjustable Length Base: 1 Refer to figure 13 & 14. To extend the base of the WalkaboutTM simply pull up on the Figure 13 ring (13.1) and slide out the extension tube to the desired length. Both sides should be set to the same length. Caution: Adjust Figure 14 the length to suit the conditions of use. Extend the legs for play or for outdoor use. The WalkaboutTM may become unstable if the legs are too short for the conditions of use. Swivel Lock: Refer to figure 15 The swivel lock (1) can be screwed down to lock the wheel into position, or alternatively, screwed back up to allow the wheel to swivel. Headrest: Refer to figure 16. To adjust the height of the headrest (1), loosen the allen screws (2) in the clamp on the back of the column. Slide the headrest up/down until it is in the desired position. Retighten the allen screws. 14 1 Figure 15 1 2 Figure 16 OPTIONS Handholds with arm troughs: Refer to Figure 17 & 18 1. Mounting: Hand holds 1 with arm troughs are mounted off the back of the sit bar (3). It is easiest 3 to mount with the sitbar 2 removed from the Figure 17 column. 2. Width: The width is adjusted by removing the ball lock pins (1) on the cross bar and sliding the tubes inwards or outwards. 3. Height: The height can be adjusted by loosening the clamps (2) and moving the hand hold posts up or down. Tighten the clamp again when adjusted to fit. 4. Reattach the sitbar (figure 18). 15 Clear Tray Assembly: Refer to figure 19 Mounting: The tray mounting arms attach to the back of the sitbar, just like the hand holds. Please refer to the previous page for instructions. 1 Figure 19 Adjustments: 1. Width & Height: Refer to the Handholds instructions on the previous page. 2. Depth: Pull the ring on the spring clamps (1), located underneath the tray. Slide the tray along the tray bar to the desired depth. Release the ring and ensure the tray locks into place. 3. Removing the tray: The tray must be removed to place the child in or take the child from the Walkabout. This is done by pulling the rings on the spring clamps (1) and lifting the tray off the support bars. 16 Double Sit Bar: Refer to figure 20 1. Remove the current seat. 2. Slide the sit bar onto the front column. Secure at the desired height with the adjustment lever. Figure 20 Abduction Skirt: Refer to figure 21 1. Remove the current seat. 2. Slide the sit bar onto the front column. Secure at the desired height with the adjustment lever. Figure 21 17 OPERATING PRECAUTIONS 1. Do not exceed the load limit shown on the name plate and in this manual. 2. The rear anti-tipper wheels need to be at least 1/2 (2.5cm) off the floor. If they are contacting the floor, the user cannot turn the device. 3. Adjust the height of the seat prior to putting the user in the device. 4. Adjust the spring tension after loading. 5. If the rear column tilts forward spontaneously you need to adjust the angle and TIGHTEN the clamp screws. 6. Check periodically for loose screws, and tighten when necessary. 7. This device is NOT to be used as a transportation device especially in motor vehicles. 8. Never make any tilt adjustments with the child in the WalkaboutTM. MAINTENANCE 1. Keep the WalkaboutTM clean. Wipe down all metal and upholstered parts with a damp cloth and dry. 2. Check weekly for frayed straps and velcro in need of replacement. For the child s safety, discontinue use of the stander until worn velcro and straps are replaced. 18 TECHNICAL DATA Specifications: Physical Unit Weight: Weight Limi ...