The Second Step Gait Harness System II(GHSII) is a unique, all-in-one standing frame and walking frame, providing safety, ease of use, comfort, security, and great versatility. When donning the Gait Harness and supported within the GHSII, the user cannot fall.
GHS products help:
· improve balance
· increase stability
· improve muscle strength
· increase core & trunk control
· improve circulation
· promote bone & musculoskeletal health
· improve range of motion
· increase independence
· improve positive therapy outcomes
· support faster recoveries
Recovery focused therapy outcomes
Understanding Second Step Gait Harness System products and their applications to the life and health of any patient is due in part to the implicit design of the System, and then to the application of physical therapy principles and the fundamentals of physiology, biomechanics and neurology.
The Gait Harness System provides therapist and patient with the tool they need to accomplish a necessary step in the recovery process. No other system provides the same combination of therapeutic advantages, safety and ease of use.
The System also allows for a creative, responsive and innovative approach that considers the many physiologic, biomechanical, and biochemical factors, as well as the individual’s opinions, emotional and spiritual needs.
The Gait Harness System allows for a therapist to efficiently address the needs of patient from the acute to the chronic setting. Therapists have seen an undeniable need for the Gait Harness System, and a recovery focused ideology to be implemented throughout a patient’s continuum of care.
The safety of the Gait Harness System benefits users, caregivers, and practitioners alike. Many of those using the Gait Harness System also realize that greater savings can be realized from longer, recovery-focused care following the initial injury, rather than repeat care, which targets adaptations and accidents later in life.
Below browse publications regarding Second Step products.
PROGRESSION OF AMBULATION IN A PERSON WITH INCOMPLETE PARAPLEGIA USING AN OVERGROUND HARNESS SUPPORT FRAME
Camacho MA, House MJ, Shields RK. University of Iowa Hospitals and Clinics and the University of Iowa Graduate Program of Physical Therapy and Rehabilitation Science, poster presented at APTA CSM 2003
PURPOSE: This case report describes a novel over ground gait training system that was used to facilitate functional ambulation in a person with incomplete spinal cord injury.
SUBJECT: The subject was a 22-year old female who sustained an incomplete spinal cord injury eleven months prior to initiation of outpatient therapy. The spinal cord was injured at the fourth thoracic level and caused residual diminished strength, proprioception, light-touch senses below the level of injury and absent pain and temperature senses. The American Spinal Cord Injury Association (ASIA) functional score was graded as C. The subject was on a prescription medication to manage spasticity of the lower extremities. The patient also reported her gait had remained the same over the last several months.
METHODS: The subject received physical therapy services for an hour and a half 3 times per week for 6 weeks. The primary intervention was supported gait training provided by the Second Step ™ system, which consisted of a wheeled frame with harness support for over-ground walking. Other interventions included lower extremity stretching and strengthening exercises. Pre-treatment and post-treatment measures were (1) 50-foot walk speed (2) Sit to stand height from a high/low mat with use of standard walker and one hand support on walker, (3) level of assistance needed for gait, and (3) a modified Quality of Life SF-12 Questionnaire (Shields 2002).
ANALYSIS: The percentage change in walking speeds, ability to rise from a chair, level of assistance, and the modified SF-12 scores was calculated before and after 6 weeks of the supported walking program
RESULTS: The subject demonstrated a 62 % decrease in the 50-foot walk speed from 170-seconds to 65-seconds following the training with the over ground harness system and required 20 % less assistance. The subject’s ability to rise from a progressively lower seated position improved by 16% from 25 inches to 21 inches. The patient’s perception of health quality remained over this 6-week time.
CONCLUSION: This subject demonstrated improvement in gait velocity, assistance needed, and ability to rise from a seated position after using the Second Step ™ gait training device. However, the improved walking did not reach a threshold to cause an improved perception of health quality.
RELEVANCE: Use of a gait training device, such as the Second Step ™, provided an individual with incomplete spinal cord injury the opportunity to walk with partial support of body weight without utilizing the more expensive suspended treadmill systems. Over-ground walking with this device may be facilitating the use of Central Pattern Generators for improved reciprocal gait ability. The results of this study have important practical and economic implications for the therapist designing a rehabilitation program for individuals with SCI.
Dr. Richard K. Shields PT, PhD
Chair of the Department of Physical Therapy and Rehabilitation Sciences at the University of Iowa Carver College of Medicine; Researcher & Professor; Director of Human Movement Control/Performance Laboratory; Member of the Board of Trustees for the Foundation for Physical Therapy
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 PT, DPT
Lead Physical Therapist, Center for Spinal Cord Injury Recovery, Rehabilitation Institute of Michigan; Level Eleven Physical Therapy Clinics Founder; Clinic Director, Oakland Orthopaedic Physical Therapy Institute
An integral component of the care of residents or patients in long-term care facilities is the maintenance and restoration of functional activities. Ambulatory goals are a central component for most residents. In therapeutic or restorative gait programs, the challenge is to provide a safe and effective method for both resident and caregiver. Falls can be a devastating problem for the resident, caregiver and the risk management in a facility. Advances in ambulatory and support devices provide a safe and effective method for mobility of the resident that can make a significant impact on the overall health of residents, caregivers and the cost effectiveness of treatments in facilities.
Falls in nursing homes and long term-care facilities as noted by the National Center for Injury Prevention and Disease Control are a serious problem with approximately 50% of the 1.5 million residents nationwide falling at least once per year. These falls occur in part because the residents in our facilities are in need of our help. They are often older, frailer, more cognitively impaired than those living outside long-term care facilities. For these reasons, residents being transferred or ambulated, may “give way” suddenly, without warning and resulting in a fall unless we are properly positioned and ready for this event. In the Nursing Home Long Term Care June 2000, article on Improving Resident Transfers, Wood et al., point to improper training for manual lifting techniques with under arm holds as a major culprit for injuries. The training of the clinical/caregiver staff was addressed and the cost savings relating to proper training was discussed in detail. The most common causes of nursing home falls are weakness and gait problems, which accounts for 24% of the falls. Environmental hazards (wet floors, lighting etc.), medications, difficulty in transferring and foot care are some of the other causes.
Identifying predisposing factors and assessing resident-caregiver risk can assist in forecasting fall risk of the resident, the caregiver and the facility in regards to mobility and fall prevention.
Predisposing factors with falls as it relates to the resident may be weakness and gait problems, poor general health, impaired mental status possibly influenced by medications and their emotional status. Predisposing factors for falls as it relates to the caregiver may be improper training in both transfers and the use of transfer and ambulatory equipment, and physical factors such as a disparity between the size of the resident and the size of the caregivers. The facility’s predisposing factors include limitations of equipment used or provided that reduces the stresses during lifting and supporting residents. Environmental factors that can lead to falls are lighting, flooring and other design issues. The challenges encountered by caregivers while assisting residents with mobility and transfer activities are some of the most difficult challenges in long-term care facilities today, as the residents can suddenly “give way.” If a fall occurs, the mutual trust that is necessary for advancement in therapy programs is strained.
From a clinical perspective, the fall and mobility issues for residents should address those factors that can be influenced through implementation of products and services that will most effectively address the major causes of falls while maximizing the benefits of mobility for residents.
Researchers in the area of physical therapy and mobility are looking at new ways to address these areas and they have encouraging news. New technologies are emerging in the industry such as such as ambulator-gait harness systems have a significant impact with regards to clinical experiences. These systems provide for safe, effective and dynamic gait training programs that can be integrated into all ambulatory and transfer needs of the facility. One such system is the Second Step, Inc. Gait Harness System (GHS). The system is composed of a gait harness and ambulator. The gait harness designed to reduce the stresses/compressive forces on the lower back of the caregiver during gait training activities.
Dr. Robert Andres has written about the uses of gait harness systems. In a study he modeled a variety of situations using realistic postures with caregivers using gait harnesses. Other researchers also relate to finding safety solutions for Mobility and Fall Prevention as described in The Isernhagen Work Report, Fall 2000, the Ergo Focus identifies that the harness distributes the patient’s weight, allowing caregivers to manage residents more easily and safely. The gait harness also provides the caregiver a unique ability to control the lower half of the resident’s body during transfers providing substantially improved manual control and assist of the resident as needed. Through secure handholds built into the harness, caregivers can be sure to position themselves properly with both single and two-person assistive activities. The use of the gait harness in weight-bearing assistive programs addresses both mobility and safety issues effectively.
The following therapists’ clinical experiences identify resident mobility outcomes that address many of these key factors in fall prevention with gait training. According to Linda Horn, PT, NCS, the inpatient physical therapy coordinator for St. Agnes Healthcare, Baltimore, Maryland, a 407 bed Integrative Health Care Facility, once the resident is properly placed in the gait harness, they can be transferred into the ambulator for mobility activities. When the resident is properly secured in the GHS, the resident is completely supported without the need for the caregiver to hold onto the resident directly. This eliminates the risk of injury from the resident suddenly “giving way” and falling to the floor. Since the resident is in a stable and secure environment, mobility activities can be performed relatively hands free for the caregiver. Linda states “the resident’s confidence is then restored, which can be a huge barrier removed,” thus allowing the therapist to concentrate on fine-tuning the resident and addressing weakness and other gait deviations.
The clinical perspective from Healthsouth Rehabilitation in Tampa, FL, where patients whose diagnosis range from Traumatic Brain Injury (TBI) to post-operative total joint replacements have demonstrated functional advancement in weight-bearing activities at faster rates with a higher level of functional performance. Mutual trust between the resident and therapist while being held/supported with the GHS is enhanced and more productive therapy sessions can follow. The clinician can advance the therapy program by performing tasks that are above the current functional level of the resident and yet not increase the risk of injury to either the caregiver or resident.
Clinicians progressed another patient, who in five years of on again off again rehabilitation, failed to develop independent ambulatory capabilities for even short distances. The therapist integration of the GHS with this resident made tremendous progress and independence with ambulation for moderate distances of 200 to 300 feet through aggressive therapy in restorative gait training programs. The system allowed the therapist to use his hands to resist or assist the patient despite her difficulties relating to balance control. For example, the therapist stood a short distance behind the patient and resisted her lower extremities. Resistive tubing was utilized to provide resistance to the thigh to enhance motor recruitment and facilitate normal patterns of movement without the need to hold on to the resident. This allowed the resident to receive truly skilled hands-on care for more progressive therapy sessions by concentrating on specific areas such as neural programming and coordinate task in standing. The therapist noted an increase in resident motivation and confidence as therapy progressed. Simple task such as backward walking could be performed with the therapist focused on retraining the movements and assisting or resisting without fear of the resident falling. At Providence Benedictine nursing center, Mt. Angel, Oregon, Theresa Raudsepp, MSPT, reports that one of her residents with a brainstem CVA utilized the GHS during her stay. Emphasis was placed on symmetrical stride length and cadence with the goal of normalizing her gait. Another resident with a diagnosis of left hemiplegia and right total knee replacement was treated with a therapy program that included GHS. This allowed the caregiver to address both the complications of his hemiplegia while at the same time restoring the strength and function of his lower extremity in standing. The system provided the resident with a secure environment to ambulate. This enhanced his muscular recruitment and the resident soon overcame his foot drag.
At IHS of Braden River, Bradenton, Florida, a 208 bed SNF, clinicians indicate therapy time for a nursing home resident with TBI, was shortened by 6 weeks after the introduction of the GHS. This resident lacked enough motor control to ambulate safely in a walker without assistance. The resident was able to quickly gain self-control of her gait in part because she could not rely on someone else to support her and lean on the caregiver. She gained confidence quickly and was soon able to ambulate, perform higher-level coordinative activities such as catching and throwing a ball and build her endurance through walking in this system.
Liza Chuanico Bolle, RPT follows an integrative approach with their restorative gait training programs. Favorable intervention efforts are getting the results that caregivers are looking for with Mobility and Fall Prevention as it relates to gait training. One 200 lb. TBI resident previously ambulating using a rolling platform walker 200-300 feet for 30 minutes, required 2 caregivers assistance due to a tendency to lean to the right side with the right leg buckling under him. GHS has assisted the patient to assume a more upright and symmetrical position through arm supports and has cut ambulation time to 5 minutes. This reduced assistance to 1 person per resident and restorative aid feedback, the system provided a secure and stable environment allowing overall improvement in this program.
These programs benefit residents, caregivers and the facility. They reduce the risk of falling by restoring and maintaining resident muscle strength and control, improving range of motion, joint nutrition and function, improving circulation, maintaining bone density and increased alertness. In addition, residents have the psychological benefit of increased self-esteem from actively participating in their own care with a greater degree of independence. The entire health care team benefits from greater resident physiological improvements, which prevents falling injuries and a reduced risk of injury to caregivers since these systems provide a safe environment for the resident during ambulatory activities.
In summary, clinicians indicated very promising outcomes in relation to fall prevention and mobility. The challenges that nursing home facilities are confronted with in relation to complex and difficult areas are being met with very favorable intervention efforts. Researchers and therapists offer evidence that options exist that provides encouragement. Implementing effective systems and programs within the long-term care facility can prevent injuries that are fall related while increasing opportunities for your facility’s mobility outcomes.
Joseph Millen PT, MTC
Impact Health Clinic Founder & Owner, Palm Harbor FL
Andres RO. Resident transfer: Scientific testing begins. Nursing Homes/Long- Term Care Management 1998; 47-60.Baker SP, Harvey AH. Fall injuries in the elderly. Clinics in Geriatric Medicine 1985; 501-7.Bureau of Labor Statistics, US Department of Labor, Washington D.C. (1995, April). News (USDL-94-600)Ejaz FK, Jones JA, Rose MS. Falls among nursing home residents: An examination of incident reports before and after restraint reduction programs. Journal of the American Geriatric Society 1994; 42(9):960-4.Rubenstein LZ. Preventing Falls in the nursing home. Journal of the American Medical Association 1997;278(7):595-6Rubenstein LZ, Robbins AS, Schulman BL, Rosado J, Osterweil D, Josephson KR. Falls and instability in the elderly. Journal of the American Geriatric Society 1988;36:266-78.Tinetti ME, Speechly M. Prevention of falls among the elderly. New England Journal of Medicine 1989;320:1055-9.
Nursing Homes Magazine, February 2001, “Gait Training to Improve Resident Mobility” Read here
At Second Step, we have a passion to help clients preserve and build positive therapy outcomes and improve walking recoveries with our products, including thePractitioner’s Gait Harness System IIand theHome User’s Gait Harness System II.
We believe the GHSII provides greater versatility than any standing frame, walking frame, standing walker or gait trainer. See our Product Demonstration Gallery
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Now people can get the help they need to stand and walk again. Visit to find out more about the results oriented, clinically proven Second Step Ga
it Harness System (GHS) and NEW Gait Harness System II (GHSII).
Since 1989 the Second Step GHS has been the durable standard of excellence in commercial grade rehab standing frame and walking frame equipment.
The Second Step Gait Harness System is a unique, all-in-one standing frame and walking frame, providing ease of use, comfort, security, and great versatility.
The System provides new therapy opportunities to walk again, even for those who have not walked in years, helping people regain healthy functioning after stroke, brain injury, cerebellar degeneration, spinal cord injury, orthopedic, neurological, lower extremity amputation, Parkinson’s, Alzheimer’s, and other ambulation, gait and balance rehabilitation issues. The GHS is more than just a standing frame, walking frame, gait trainer or walker.
The GHS is used world-wide not only in outpatient and inpatient clinics, but also in the home, with both indoor and outdoor applications.
Discover how Second Step is “Helping People Walk Again” by keeping users, caregivers and practitioners safe, and simultaneously facilitating healthy, functional therapy outcomes.
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