Journal of neuroengineering and rehabilitation, 11(1), 145.
Department of Engineering and Information Technology, Institute for Rehabilitation and Performance Technology, University of Applied Sciences, Bern, Switzerland
Early start of therapy with the h/p/cosmos locomotion treadmill system with body weight support. h/p/cosmos has equipped the system with an ergonomic wheelchair ramp. Furthermore the handrails contain telescopic extensions which can be pulled out 55 cm (21.65“) to give additional support to the patients. They can assist and hold the handrails in many cases even during entering the treadmill on the ramp. And most patients are happy to help if we give them such tools.
Those who want to learn to walk ... must walk! Therefore, functional training on a treadmill is a key component of a neurological treatment facility. At the same time locomotion in practice is not always easy to implement. It starts when a wheelchair patient begins their therapy.
Getting onto the treadmill deck can be a challenge already. Therefore h/p/cosmos has equipped the system with an ergonomic wheelchair ramp. Furthermore the handrails contain telescopic extensions which can be pulled out 55 cm (21.65“) to give additional support to the patients. They can assist and hold the handrails in many cases even during entering the treadmill on the ramp. And most patients are happy to help if we give them such tools.
Then they can stand up directly out of the wheelchair with support from the h/p/cosmos airwalk® vest and un-weighting system holding on to the individually adjusted handrails. Thus, the therapy can start successfully without much effort.
In neurological rehabilitation it is important for the patient to start exercising as early as possible. Therefore an individual and optimal un-weighting system is crucial for the patient. The h/p/cosmos airwalk un-weighting system supports a natural gait pattern. The single-point suspension allows dynamic up and down movement when walking and at the same time allows freedom in movement and body rotations where wanted. Additional fi xation straps for further stabilization may be utilized if desired and if recommended for the patient. The un-weighting, depending on the progress of therapy, can be adjusted electronically between 1 kg and 75 kg (2.2 and 165 lbs). The treadmill itself starts at 0.1 km/h speed and is driven by a very powerful 3.3 kW (4.5 HP) drive motor. Even heavy patients at low speeds can exercise smoothly without juddering.
The remote control for electronically re-adjustment of un-weighting has magnet holder and can be positioned on either side for the seated therapists. This is really important during therapy! With the h/p/cosmos system therapists can perform frequently required re-adjustments of parameters from seating position.
Due to an un-ergonomic working position and the diffi culty of manipulating the patient’s legs the therapist may find it difficult or even impossible to work with normal treadmills in manual locomotion therapy. Especially after several consequential sessions the therapists experience fatigue and often pain in shoulders and in the back. These problems can get worse when working with spastic patients. It may even lead to an early termination of the therapy. Therefore h/p/cosmos has developed a very sophisticated and ergonomic solution, which cares for the therapist fi rst. We understand that only motivated and healthy therapists can serve the patient‘s needs best.
The simple to adjust rotating therapist seats – with excellent lumbar support – and corresponding foot supports on both sides of the treadmill allow the therapist to sit comfortably and fi rmly positioning themselves optimally.
For locomotion therapy the specially designed seats are positioned very close to the center of the deck, so the posture of the therapist is optimized. Very wide running surfaces would lead to further problems, therefore h/p/cosmos recommends the 50 cm (19.68“) wide deck for this application and not the 65 cm deck of the h/p/cosmos quasar® med. No obstructive bars from un-weighting frames or other obstacles give the therapist un-interrupted access to the patient‘s legs. The arch design of the h/p/cosmos airwalk se 135 perfectly supports that. This is also important for lateral motion analysis.
Altering the speed, changing the elevation and stopping - the therapist must always have access to these functions. Frequently standing up of the therapists during locomotion therapy for re-adjustment of un-weighting, speed and elevation parameter would interrupt the manual motion support to the patient‘s legs. It would mean confusion and burden to patient and therapist and would make the therapy much less attractive and effective. Therefore this shall be avoided.
To simplify this, the additional keyboard and the additional stop can be placed by therapist quickly and easily in the desired position. Both controls come with a fl exible magnetic attachment and additional velcro strap for secure mounting and fast changing of positions either on the handrails (facing up or down) or on the vertical telescope pillars or even on the nearby tubes of the arch shaped unweighting system frame.
Among other potential uses in therapy, especially for patients with weakness of the dorsifl exors, the possibility of walking downhill with a suffi cient gradient is a big help. By using the reverse belt rotation the incline of the treadmill can be used as a downhill gradient up to 15% in this system. With the single point suspension un-weighting system the patient just turns round on the treadmill in no time. By simply turning a key switch, the running belt moves in the opposite direction. The automatic belt centring aligns the running belt during reverse and downhill operation on the h/p/cosmos locomotion® treadmill.
The results of the treatment course should be well documented. This is not just important for patients and families, but also for the participating doctors and insurance companies. Good documentation must be readily available and easy to interpret.
As soon as the therapy session has finished and the stop button is pressed the h/p/cosmos satellite printer, which is connected directly to the treadmill, prints the comprehensive documentation. This allows an easy and quick understanding regarding documentation of treatment progress without signifi cant expenditure of time. All relevant exercise results and data such as duration, speed, elevation, distance, heart rate, fitness index, date, time and even treadmill serial number for traceability are included in the printout, even without using any PC or software. Just write the patient’s name and remarks by hand.
These application included:
h/p/cosmos additional keyboard
6 keys with wire connection; works parallel to user terminal keys - without mounts
Unweighting rope 7m-Ø8mm (replacement) for [cos30017-01]
rope (replacement) for h/p/cosmos airwalk® se; to be replaced every 12 months or at the first sign of wear
Vest Large f. h/p/cosmos airwalk green
Vest Small f. h/p/cosmos airwalk red
Vest XSmall f. h/p/cosmos airwalk white
Wheelchair ramp L: 1.25 m for treadmill locomotion 150/50
wheelchair ramp (L: 125 cm x W: 80 cm) for h/p/cosmos locomotion 150/50(D)E med
3rd interface RS232 com3 coscom® 115,200 bps
additional RS232 port for ECG, EEG, PC, or UserTerminal with increased data speed
Connection cable RS232 10 m
RS232, 10 m (Sub-D 9-pin male/female), USB-Adapter optionally available (cos12769-01)
Potential equalization cable 5 m (with 2 POAG-plugs)
potential equalization cable for medical devices
h/p/cosmos satellite PC med
medical PC, 19" LCD Monitor, COL Laser printer, potential isolation, h/p/cosmos PC table with 4 wheels
robowalk® expander B 150/50
im hinteren Bereich - für alle h/p/cosmos Laufbänder mit Lauffläche 150/50 cm
unweighting system dynamic up to ca.120 kg with fall-stop-prevention & automatic running-belt-stopp, compressor required
robowalk® expander front airwalk® ap
for the front area - for all h/p/cosmos treadmills with optional h/p/cosmos airwalk® ap
|Zwischensumme netto||61.929,00 €|
|MwSt. 19%||11.766,51 €|
|Gesamtbetrag (brutto inkl. MwSt.)||73.695,51 €|