Introduction
The patient is a 72-year-old male hospitalised with a GI bleed and acute blood loss anaemia. His medical history includes CHF with left ventricular dysfunction, left ventricular ischemic cardiomyopathy, EF = 30%, atrial fibrillation, CAD, HTN, COPD, continuous O2 @ 2L/min, PVD, diabetes, peripheral neuropathy, chronic venous stasis, chronic kidney disease (stage III) and morbid obesity.
Prior to hospitalisation, the patient was Modified Independent with transfers and ambulation > 500 feet on a variety of surfaces using a Rollator Walker. However, upon admission to this rehab facility, the patient required Moderate Assist for transfers and Max Assist for ambulation x 3 steps using Rollator Walker. His standing activity tolerance was less than one minute
Goals
- Modified Independence with sit-stand/bed-chair/toilet transfers
- Modified Independence with ambulation > 500 feet on even/uneven surfaces with RW
- Return home with family assistance PRN
History
- Significant functional decline after initial hospitalisation.
- Classified as a possible Hospice candidate.
- Demonstrated hypotensive episodes with position changes.
- O2 saturation level < 90% with standing, frequent rest periods required. O2 saturation recovery above 90% required 1.5 minutes.
- Initiated core strengthening program to improve balance and trunk control to facilitate safe transfers.
- Gradual increase in repetitions and resistance with patient supine, seated, and standing.
- Educated patient on energy conservation techniques.
- Second hospitalisation for anaemia and C-diff 4 weeks after facility admission.
- Initiated use of AlterG Anti-Gravity Treadmill™ 9 weeks after patient’s initial admission to this rehab facility.
- Used AlterG Anti-Gravity Treadmill x 4 weeks.
Results
This patient received PT services 5x/week over the course of 100 days. He demonstrated progress with transfer ability and core strength using conventional
treatment methods, but had limited improvement with standing activity tolerance and gait distance.
With the combination of conventional treatment and the AlterG Anti-Gravity Treadmill, the patient was able to return home with his family at a SBA level for transfers and ambulation > 500 feet on even and uneven surfaces using a Rollator Walker.
When use of the AlterG Anti-Gravity Treadmill was initiated, the patient:
- Ambulated 80 feet on even surfaces with frequent rest periods using Rollator Walker
- Required Mod Assist of 2 to step into the cockpit of the AlterG
- O2 saturation levels often dropped below 90%
After 4 weeks of combined treatment methods, patient:
- Ambulated > 500 feet with Rollator Walker
- Required only SBA to enter/exit the treadmill
- O2 saturation level consistently above 90%
To summarise, the AlterG Anti-Gravity Treadmill was incorporated into this treatment program to improve the patient’s standing tolerance and gait distance. He could not walk without frequent rest periods due to his cardiopulmonary deficits.
The AlterG AntiGravity Treadmill allowed the patient to incrementally increase his body weight, leading to improvement in endurance and greater distances ambulated on even and uneven surfaces. In addition, the cameras and TV monitor provided the necessary visual input to improve the patient’s step length and base of support during ambulation.
The AlterG was a vital component of this patient’s treatment plan and recovery. Use of the Anti-Gravity Treadmill, combined with conventional treatment methods, allowed the patient to achieve his ultimate goal – to return home.
To learn more or contact us about the AlterG treadmills and our relevant services, visit our page at AlterG.
More Information
Glenda Hill, MSR PT
