MANUAL THE EXERCISE WHEELCHAIR. Movement-Enabling Rehab Equipment

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Movement-Enabling Rehab Equipment MANUAL THE EXERCISE WHEELCHAIR Neurogym Technologies Inc. 2017 100-1050 Morrison Drive, Ottawa, ON, Canada neurogymtech.com

? FOR SERVICE OR PART INFORMATION CALL: + 1.877.523.4148 100-1050 Morrison Drive, Ottawa, Ontario, Canada, K2H 8K7

TABLE OF CONTENTS UNPACKING INSTRUCTIONS...04 PRODUCT OVERVIEW...04 SPECIFICATIONS...04 BENEFITS...04 LIST OF PRECAUTIONS FOR THE EXERCISE WHEELCHAIR...05 IDENTIFYING THE PARTS OF THE EXERCISE WHEELCHAIR... 06 INSTRUCTIONS FOR USE...08 MAINTENANCE...12 OTHER NEUROGYM TECHNOLOGIES PRODUCTS...13

UNPACKING INSTRUCTIONS The Exercise Wheelchair is shipped fully assembled on a 4 x4 skid. Remove the protective wrapping and it is ready to use. PRODUCT OVERVIEW The NeuroGym Exercise Wheelchair converts from a standard wheelchair into a variable resistance flexion and extension exercise machine for the trunk and lower extremities. By releasing a switch, the wheelchair seat, backrest or both can be enabled to allow for flexion and extension exercises of trunk, hips and knees. A special footrest apparatus, which is stored under the seat, pulls out smoothly for use in exercise and folds back up easily so that it does not interfere with standard use of the wheelchair. Visit www.neurogymtech.com to access Application notes and training videos SPECIFICATIONS US Patent No.: US 7,569,002 B2 MODEL # E-EW-A-1 Medline K4 Model MDS806500PLUS Seat width 20, seat depth 18, seat height 18 Seat to floor height range 15-20 ½ Max weight capacity 350 lbs Weighs 90 lbs BENEFITS Allows for effective functional strengthening of trunk and lower extremities critical antigravity muscles for stabilizing posture and enabling standing and transfers. Improved trunk strength also allows for improved ability to turn over in bed more independently. Can be used to improve endurance in weak, wheelchair-bound users Doubles as a comfortable wheelchair 04

! IMPORTANT Read all instructions and precautions prior to using the Exercise Wheelchair LIST OF PRECAUTIONS FOR THE EXERCISE WHEELCHAIR: 1. Always ensure the wheelchair brakes are securely engaged before using the chair for exercise. When pulling out the leg mechanism, make sure to grasp the end of the mechanism near the front of the seat (see pictures below do not reach under the seat to grab the inside of the leg mechanism). 2. When locking/unlocking the chair back/seat mechanism, do so by pressing the lever down or pulling it up from the end closest to the seat back cushion. 3. During exercise, user should keep hands on arm supports or resting on the lap away from moving parts. 4. Do not exceed full (180 degrees) trunk extension; it is recommended to gradually increase the exercise range until full extension is achieved. 5. Do not extend the neck past neutral during the extension phase. 6. The user may require assistance to pull out and set up the sliding leg mechanism; if user is attempting to do so independently, ensure user is securely fastened in chair with seatbelt. 7. Discontinue the exercise and consult a physician if sharp pain or discomfort is experienced. 8. Consult with a Registered Physical Therapist before using the Exercise Wheelchair with individuals who have a high degree of trunk and lower limb spasticity. 05

IDENTIFYING THE PARTS OF THE EXERCISE WHEELCHAIR: Exercise Wheelchair in Regular Mode Exercise Wheelchair in Exercise Mode Rear Bungee Cord Safety Wheels Sliding Leg Mechanism in Stored Position Slot for Attaching Carabiner 06

Chair Back / Seat Locking Lever Bungee Cord Caribiner Back Seat Cushion Seat Cushion Foot Plates Velcro Straps Sliding Leg Mechanism Wheelchair Brake 07

INSTRUCTIONS FOR USE A. GETTING STARTED 1. Ensure that the Exercise Wheelchair (WC) brakes are securely engaged. 2. Transfer user to the Exercise Wheelchair (WC) or, if already seated on the WC, remove legs from foot supports and rotate supports sideways (or remove foot supports). 3. Have user part knees slightly. Grasp sliding leg mechanism at front as shown below. Take care to grasp the front of the mechanism. Do not reach underneath/further under the chair. 4. Pull leg mechanism out fully until it rests on the ground in-front of the chair. 08

5. Grasp the posterior heel notch of the foot plate and slowly guide the collapsed arm of the leg mechanism from under the seat. Note that it may be necessary to tilt the foot plates slightly so they clear the under side of the seat. 6. Disconnect the carabiner, to which the bungee cords are attached, from the lower ring on the moving arm, and connect it to the slot at the front of the seat cushion. 09

7. Lift foot-plates with one hand and mount user s legs, one at a time, on the foot plates. Secure Velcro straps over the feet. 8. For leg exercises only, do not unlock the chair back/seat locking levers. The chair is now ready for performing isolated leg exercises. 9. To perform trunk exercises in addition to hip and knee flexion, the 2 chair back/seat locking levers located on the back of the chair behind the user s shoulders must be released. B. EXERCISING Ensure that the Exercise Wheelchair (WC) brakes are securely engaged. Simultaneously push legs forward (extension of knees and hips) and trunk back (extension). Begin with limited range movement to get a feel for the movement and resistance. Reverse direction by flexing the trunk and lower extremities. Ensure that the user attempts to return all the way to full sitting position. 10

If resistance for either trunk or legs is not satisfactory, change it by removing/adding bungees as needed to decrease/increase resistance. Make sure to secure the chairback/seat locking levers when changing the bungee cords. Always begin with slow movements and attempt to resume original sitting position with each flexion. Progress range and speed of movement as suggested by instructor/ trainer; remove hands from arm support as an additional step up in exercise progression. C. ADDITIONAL EXERCISE OPTIONS To target legs alone, secure both chair back/seat locking levers, then train one or both legs at the range, level of resistance and speed desired. To better enable hip flexion, add additional bungee cords. Trunk flexion/extension exercises can be performed alone without engaging the sliding leg mechanism. With the original wheelchair foot plates in place, the chair back/seat locking levers can be released and trunk flexion and extension exercises performed with the feet remaining on the original wheelchair footplates. In the absence of original footplates, a low stool can be placed in front of the user on which to rest the feet. To vary the pace or speed sensitivity of the exercise, music or biofeedback video games may be added (a sensor on the back rest would best detect the motion). To add a level of difficulty to trunk extension, an elastic band could be used to involve scapular retraction (via horizontal abduction of the arms). 11

D. TUCKING LEG MECHANISM BACK UNDER WHEELCHAIR Remove user s legs from Foot Plates and place on ground. Detach resistance bungee from notch at the front of the seat by unattaching the carabiner and reattach the carabiner to the loop on the moving arm. Collapse foot plates and lateral arm of sliding leg mechanism in the direction of the chair, then grasp the base from the ground and slowly slide it back onto track under the wheelchair. Note that the foot plates may need to be tilted slightly to fit under the chair. Caution: hold the sliding leg mechanism only as indicated. Do not reach under WC to adjust the position. If the apparatus does not slide smoothly, pull it back out to adjust the angle slightly, then try again. MAINTENANCE Use disinfectant wipes or spray to clean the exercise wheelchair after use. The metal frame and sliding leg mechanism should be kept clean and free from dust or dirt. Inspect bungees for signs of thinning or fraying. Replacement bungees are available from NeuroGym Technologies Inc. 12

OTHER NEUROGYM PRODUCTS SIT-TO-STAND TRAINER Actively assist the standing motion with support at the knee, trunk and arms to promote early mobility. The NeuroGym Sit-to-Stand Trainer uses a counter-weight mechanism to provide a safe and effective way to strengthen weight-bearing muscles and increase standing stability and endurance. PENDULUM STEPPER The NeuroGym Pendulum Stepper is a self-assisted trainer of reciprocal stepping designed to specifically target the antigravity muscles that are so important for maintaining balance and gait. Even in individuals with significant muscle weakness, it is designed to make improving the strength and endurance of the stepping motion simple and convenient. BUNGEE MOBILITY TRAINER The NeuroGym Bungee Mobility Trainer is a versatile body weight support mechanism enabling safe, intensive motor retraining. The unique patented design enables the re-training of gait and natural protective reactions by counteracting loss of stability as naturally as possible. Comparable to a pool environment in terms of support, the Bungee Mobility Trainer allows graduated weight bearing while normal protective reactions such as sidestepping are re-developed. The Bungee Mobility Trainer provides graduated support from underneath, rather than a harness mechanism that provides the support from above. Supporting the patient from above does not allow this natural graduated support, particularly upon loss of balance. The Bungee Mobility Trainerenables more realistic safe practice of gait, and most importantly, the protective reactions necessary to prevent falls. ANKLE TRAINER Strengthen paretic, sprained or post-surgical ankles by isolating and training targeted muscle groups through a complete range of motion. The NeuroGym Ankle Trainer is a lightweight, portable device with an axle and foot platform that can be locked into place. This unique design permits training in dorsiflexion, plantar flexion, inversion, eversion, internal and external rotation motions that are difficult to isolate and specifically strengthen. NEUROGYM TIMTRAINER The NeuroGym TIMTrainer creates an engaging and motivational environment for relearning motor abilities using a combination of camera-captured movement technology and NeuroGym s patented computer algorithms for movement training. The location of coloured sensors held by or attached to the user is recorded by the camera and interfaced with computer games. Desired movements such as reaching, standing up from a seated position, weight shifting or stepping can then control a computer game. The range, speed and general complexity of the game can be changed to allow for the user s ability and progress. Three games are included: Ski, Pong and Pinch. 13

? FOR SERVICE OR PART INFORMATION CALL: + 1.877.523.4148 100-1050 Morrison Drive, Ottawa, Ontario, Canada, K2H 8K7

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neurogymtech.com NeuroGym Technologies Inc. 2017 100-1050 Morrison Drive, Ottawa, Ontario, Canada, K2H 8K7 TF: 1.877.523.4148 16 NEUROGYM, NEUROGYMREHAB, NEUROGYMTECH, NEUROGYMFIT, and CLINIQUENEUROGYM are trademarks or registered trademarks of Neuromuscular Gain Inc.