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For Clinicians Who Care - Research, Publications & Case Studies
 
“The regaining of walking ability is one of the main goals of rehabilitation following stroke.”
Matjacic et al., rehabilitation researcher
Clinical evidence-based practice supports the Gait Harness System as a necessary adjunct to recovery

Find Out How Walking is Possible Again

Quick Facts……

  • The risk of falling increases with age.
  • Two-thirds of those who experience a fall will fall again within six months.
  • A decrease in bone density contributes to falls and resultant injuries.
  • Failure to exercise regularly results in poor muscle tone, decreased strength, and loss of bone mass and flexibility. All contribute to falls and the severity of injury due to falls.
  • At least one-third of all falls involve environmental hazards in the home.
  • Falls are the leading cause of death from injury among people 65 or over.
 
 
Research
Bruce H. Dobkin, MD, and Pamela W. Duncan PT, PhD, FAPTA, FAHA
Jeffrey M. Hausdorff MD, Galit Yogev, Shmuel Springer, Ely S. Simon, Nir Giladi, Division on Aging, Harvard Medical School
Stephanie Watson, Executive Editor, Harvard Women’s Health Watch (research by Jeffrey M. Hausdorff MD, Harvard Medical School, professor at Tel-Aviv Medical Center)
Pamela W. Duncan PhD, FAPTA, FAHA (see pages 29-31 for summary)
Balance, Balance Confidence, and Health-Related Quality of Life in Persons With Chronic Stroke After Body Weight-Supported Treadmill Training
Stephanie A. Combs, PT, PhD; Eric L. Dugan, PhD; Miranda Passmore, DPT; Cara Riesner, DPT; Dana Whipker, DPT; Elizabeth Yingling, DPT; Amy B. Curtis, PhD
Body-Weight-Supported Treadmill Rehabilitation after Stroke
Pamela W. Duncan , PT, PhD, FAPTA, FAHA; Katherine J. Sullivan, PT, PhD; Andrea L. Behrman, PT, PhD; Stanley P. Azen, PhD; Samuel S. Wu, PhD; Stephen E. Nadeau, MD; Bruce H Dobkin, MD; Dorian K. Rose, PT, PhD; Julie K. Tilson, DPT; Steven Cen, PhD; Sarah K. Kayden, BS for LEAPS Investigative Team
Preventing Falls in the Elderly
K.R. Tremblay Jr., and C.E. Barber
New Research Looks at Getting Stroke Patients Back on Their Feet
Pamela Duncan, PT, Duke University School of Medicine, Durham NC
Tracy H. Brown, PT; Julie Mount, PhD, PT; Bethany L. Rouland, PT; Katherine A. Kautz, MS, PT; Renee M. Barnes, PTA; Jihye Kim, MPT
Andrea I. Behrman, Mark G. Bouden, Preeti M. Nair
Gale Whiteneck, PhD, Michelle A. Meade, PhD, Marcel Dijkers, PhD, Denise G. Tate, PhD, Tamara Bushnik, PhD, Martin B. Forchheimer, MPP
Andrea L Behrman, Anna R Lawless-Dixon, Sandra B Davis, Mark G Bowden, Preeti Nair, Chetan Phadke, Elizabeth M Hannold, Prudence Plummer, Susan J Harkema
Daniel P. Ferris, Helen J. Huang, and Pei-Chun Kao
Shoshanna Vaynman and Fernando Gomez-Pinilla
Publications
 
Second Step Gait Harness System as Compared to Body Weight Support Systems
 
The Second Step Gait Harness System (GHS) ambulator has several distinctions that make it unique when compared to body weight support systems. 
First, the GHS does not directly off-load the individual’s weight. Weight reduction (if needed) is performed actively by the individual in the System.  Most individuals will not have home access to a body weight support treadmill training system, but may be able to implement an over-ground system that allows for the efficient reinforcement. I use the Gait Harness System, which does not directly offload weight, to accomplish this reinforcement (the individual offloads as needed or instructed).
 
Second, the harness used in the GHS directs supportive forces (or fall recovery forces) through a much larger surface area on both thighs.  Other over-head harnesses direct these forces through the sensitive pubic area, which often leads to decreased treatment time and intensity. 
 
Lastly, the GHS allows for reinforcement of newly learned gait patterns in a real world situation.  I have implemented this technique with several incomplete Spinal Cord Injury individuals and have had great success in regards to gait speed and distance.  This is a very beneficial and much needed adjunct treatment paradigm, and accentuates body weight support treadmill training.  Body weight support treadmill training, in general, has shown a benefit of retraining central pattern generation and the ensuing stepping pattern.  Body weight support treadmill training can be difficult and labor intensive.  For body weight support treadmill training to be effective, any progress made needs to be safely reinforced with over-ground training.
 
The GHS allows you to safely transfer and reinforce this progression to various land-based gait training activities.  Reinforcement of the various qualities of gait during land-based activities is a must for the activity to become functional.
William Thornton, MPT
Lead Physical Therapist
Center for Spinal Cord Injury Recovery
Rehabilitation Institute of Michigan 
Addressing Resident Mobility and Fall Prevention:  A Clinical Perspective with Gait Training by Joseph Millen, PT MTC
 
Case Studies
 
J.T. is a T11/12 incomplete 15 years post.  He sustained both an SCI and above knee amputation secondary to a MVA. When he started the program a little over a year ago at RIM, he had a wood prosthetic that was for static standing only.  He had not tried to walk in 15 years.  His therapist has progressed using the Gait Harness System (GHS) through 2 prosthetics/orthotics to a carbon fiber KAFO with stance control knee and friction knee prosthetic.  He has progressed to ambulation with a standard walker plus stand by assistance for safety.  He currently is up to 1500 feet in the GHS and 600 feet with a rolling walker.  The therapist chose this individual because of the complexity and the ease of application of the GHS with both a prosthetic and orthotic.
 
A.B. is a C6 complete who had been non ambulatory for over 10 years.  She walks in the GHS with carbon fiber KAFO’s.  She only requires assistance for guidance of the GHS.  This would require more that one person without the GHS.  
 
B.S. is a 6 foot 5 inch C5 ASIA B status post diving accident.  His therapist has progressed him from KAFO’s to AFO’s.  Additionally, the therapist has FES applied to the tib anterior and pernoneals that he activates via a trigger switch to break the extension spasticity.  The GHS frees up an individual to manually correct improper foot placement. The therapist reports the harness works very well with the braces. This particular individual also buckles on occasion.  Generally this happens when the patient accidentally activates the e-stim bilaterally.  The main point is that the GHS effectively prevents him from falling and there is no pain or skin irritation from the harness.  The therapist reports this client has tried numerous harnesses and said the GHS harness and the Crawl2@Walk crawling harness is by far the most comfortable.
 
E. is a T6 complete.  He now requires minimal assistance for guidance of the GHS.  He currently wears carbon fiber KAFO’s with stance control knees.  The Gait Harness works great with the braces. 
 
C.H. is a C6 complete. She is status post MVA in 2002, and nasal tissue stem cell surgery in 2005. She has therapy 3 x wk. In therapy, C.H. can walk 134 feet around a track with leg braces and the GHS, with help from her therapist.
 
L.B. is a C8 tetraplegic, ASIA A, status post MVA 10 years ago. She attends therapy 3 x wk, 3 hours per session. L.B. uses bilateral carbon fiber stance control KAFOs and a GHS. The two products work together to provide L.B. the opportunity to safely ambulate with a natural reciprocating gait pattern.  Since her accident, she has regained some movement and sensation below the level of her injury, much occurring since she started in the SCI program. L.B. has purchased a GHS to be used at home along with the braces.  Her husband assists her with a sit to stand into the GHS. Her home therapy program includes neuromuscular E-Stim of all major muscle groups below the lesion level every other day, and standing in the KAFOs and GHS to work on endurance, pre-gait and gait activities. 
 
A.F. is a T8 complete, status post MVA in 2002, and nasal tissue stem cell surgery in 2005. A.F. participated in a SCI program post stem cell surgery. Prior to surgery, she was using non-stance controlled leg braces. Therapy was 3 hours daily. She is currently using stance controlled KAFOs, which allow her legs to move independently within the GHS. The GHS forces her to place most of her 122 pounds on her legs instead of her arms. She is currently progressing by doing therapy at home, walking with the GHS daily.
 
55 y/o with SCI and LE paralysis went from walking 5 minutes moderate to maximal assistance in the parallel bars to 45 minutes in the GHS independently after 1 week.  After one month of therapy, he had improved lower extremity circulation and substantially reduced risk of having his legs amputated secondary to circulatory dysfunction. 
 
K.M. is a 35 y/o male who sustained a TBI as an 11 y/o child, status post MVA 24 years ago. He had been wheelchair bound for 22 years at the time he first began using the GHS in an adult day center program. K.M. began using the GHS 2 years ago, but required 4 person assist and walked just a few steps. He had moderate to severe tremors, and was barely able to stand. Therapy has typically been 2 x week.  One year later, he had decreased to a 2 person assist, and was able to routinely walk up to 200 feet in the GHS. This current year, he is down to just a 1 person assist with ambulation in the GHS, and is routinely walking 800 feet per therapy session. His initial focus in therapy was on distance and endurance. Now, he is also focusing on improving his technique and self correction of form. He is finding it easier to transfer into the GHS. K.M. is showing more stride confidence. He is now able to look at pictures in hallways while walking. Tremors are decreasing, and he is increasing control of his upper torso, head and neck while walking. He is taking less frequent rest stops and finding it easier to initiate initial stepping. Staff members encourage him to bring his shoulders backward, tilt hips and pelvis forward, and take smaller steps. His thigh muscle mass and strength have increased so much he now requires a larger gait harness. K.M.’s home caregiver reports he is much stronger and better able to assist her with transfers at home. After seeing his steady improvement, staff and other program participants are highly motivated to use GHS for a variety of gait and balance dysfunctions.
 
P.D. sustained a TBI 8 years ago and is a long-term resident.  He has very little trunk stability so needs to walk with some assistive device or he loses his balance.  He has developed bad habits over the last 8 years. When he walks, the therapist has been teaching him to ambulate within the GHS upright and to correct gait deviations.  His progress is much slower but he is able to walk with more control and stability within the system. 
 
S.B. sustained a TBI in June 2003.  This patient has been seen for a couple of weeks and already has progressed out of the GHS and now walks with a rolling walker.  He is now able to transfer and walk independently with the walker around the unit.  The therapist was able to work with his balance deficits and he was able to regain his balance very quickly. The therapist also has placed resistance tubing around the thigh cuffs for resistance training.  Second Step suggested beginning higher level balance training with ball toss and cone activities as a progression to patient’s program.
 
TBI/CVA patient with severe extensor tone and was totally dependent with standing and ADL’s. Patient has progressed to a level of min. to moderate assistance with sit to stand with bed mobility. The GHS has allowed the therapist to work on static strengthening/balance to foot placement with gait retraining and now the patient is walking 400’ with min-mod assistance. Both OT and PT working with this patient have stated that the GHS has made progress possible for this patient and without it progress would have been minimal.
 
60 y/o retired MD secondary to Parkinson’s Disease had substantial improvement in gait with reduced falls and improved gait pattern after 1 month of skilled therapy using the GHS.
 
55 y/o with SCI and LE paralysis went from walking 5 minutes moderate to maximal assistance in the parallel bars to 45 minutes in the GHS independently after 1 week.  After one month of therapy, he had improved lower extremity circulation and substantially reduced risk of having his legs amputated secondary to circulatory dysfunction.
 
25 y/o with TBI from overdose had significant improvement in overall balance and coordination patterns.  She had significant dyskinesia that made ambulation a high risk.  In the GHS she was low risk of injury to herself and to the treating therapist.
 
D.H., a bilateral amputee patient in the nursing home setting had substantially improved gait pattern with orthoses and shortened rehab stay while reducing the risk of falls while in the GHS.
 
65 y/o with a history of a CVA and bilateral TKA had return of functional gait and became independent with a cane after 2 months of rehab one hour per day, three days per week using the GHS and performing neuromuscular re-education activities.
 
A 34 y/o male who sustained a TBI in 1994.  Patient was at the Tampa VA for therapy from 1996-1997 and recently returned in 2003 for a re-evaluation and was trained in the GHS.  The family was educated in the proper set-up and application of the GHS and a request was made to have a unit shipped to Tennessee for patient to use in the home for continuity of care and continued functional training.  This patient uses GHS daily at home.
Contact us for current, detailed case study information specifically covering the following client populations
  • Traumatic Brain Injury
  • Spinal Cord Injury
  • Veteran's hospitals
  • Acute care setting
  • Sub-acute care setting
  • Out-patient & In-patient
  • Home care
  • MR/DD and Group homes
  • Pediatric
It's about WALKING AGAIN
No problem is too big…if the right people, with the right treatment, and the right System, go at it the right way
:: HOME USERS :: CLINICIANS :: VETERANS

 

 

 

 

 

 

….. renewed hope of recovery
“Your videos of brain injured folks, like my son, using the GHS brings tears to my eyes because it reminds us to never give up and to keep trying new things.”
Bonnie P., parent of user, Eugene OR
 
.....healthy opportunities for recovery
 “Just this morning the Gait Harness System was bringing some amazement and tears to staff members as a student used it successfully.”
David Cacciatore, Physical Therapist, Lane School, Houston TX

 

…..keeping therapists & patients safe
 “Patients cannot fall using the GHS as the harness is designed to support their full body weight if necessary.  No walker or cane can compare to the safety of this System.”
Nicole Prieto-Lewis, Director of the Gait and Balance Laboratory, Gainesville VA, Gainesville FL
 

Many clients have found Second Step, and learned about the Gait Harness System, because of their interest in one or more of the following:

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At Second Step, Inc. we specialize in helping people walk and stand again. Our product line includes:

second step gait harness system, gait harness system, adult harnesses, Gait Harness System II , pediatric harnesses

You may contact us at:

steffani@secondstepinc.com, secondstepinc.com, 541.337.5790, 941.545.7580,877.299.7837