The final presentation I attended was “Harnessed Mobility: A New Paradigm to Expand Participation Across the Lifespan” give by Debbie Espy (again), Ann Reinthal, Andrina Sabet, Madalynn Wendland and Cole Galloway. I’d like to define the word ‘paradigm,’ because it seems to be a buzz word as of late. “Paradigm:” Thank you, Dictionary.com. I feel better now. So how does that word apply to this presentation? Herein, you shall find the basics of using a harness system to boost ability to participate in community based activities in all age groups.
Debbie first drew our attention to the notion that this presentation looks at using a harness system in an adaptive or restorative manner rather than a compensatory manner, which is a different way to think about a harness. They will be using the harness to facilitate and restore community function.
There are 3 types of harness systems:
non-body weight support– will catch a person if they fall, but does not relieve body weight during mobility
partial body weight support– allows some degree of partial body weight support during mobility; however, the degree changes as the person’s center of mass moves up/down during normal gait cycle
dynamic body weight support– can take 0-100% of body weight AND adjusts automatically as the person’s center of mass moves up/down during normal gait cycle making the % body weight supported more constant
Right now therapists are using harnesses in 4 modes of intervention, including:
balance training– stationary balance interventions with stationary harness system for safety measure, able to push limits more with harness there to prevent injury in fall
multi-directional— frame or track allowing movement in all horizontal directions, but stops falls. Examples: Enlighten
** This is not an exhaustive list of the harness systems out there, and the presenters stated that they had learned some of these companies have new products in different modes for show-and-tell at the conference. If you’re interested in a system, I would contact the above companies and then do a quick Google search to make sure there aren’t any missing major players. Finally, ask the companies for more info directly, which is why I’ve linked to them above. I am not endorsing any one or all of these companies.
Next, the presenters discussed using the harness in a reactive balance protocol, which we discussed in the last post. And then in a proactive balance protocol using Kinect Adventures games including Reflex Ridge (requiring ducks, jumps, weight shifts to avoid obstacles), 20,000 Leaks (player is in a leaky box underwater and must use hands, feet to stop leaks, kind of like Twister), and Kinect Sports Table Tennis (lots of trunk rotation), Target Kick (soccer game requiring alternating feet and aiming). The researchers modified the games to make them a little harder, for example, in Table Tennis, the participates were required to use their dominant hand only and take steps instead of being allowed to use both hands. They used the Rate of Perceived Stability scale which we talked about last post, but I’ll put here again, because it is that important.
And when things got too easy, they would bump up the game difficulty and/or increase the difficulty of the surface on which the participant was standing. After this intervention, a case study was done with 1 participant who reported more participation in his community as more mobile, such as walking to the mail box and moving around the room at social gatherings rather than sitting in one place and letting the people come to him.
So where do these harnesses meet the community and get people participating in those communities? The presenters discussed several very unique ideas.
With children, they put several harnesses in an exploratory type museum gallery that basically looks like a playground. Kids that normally can’t move around freely were able to do so with the assistance of a harness and really play with their siblings, parents and other kids. And as we all know, a kid’s occupation is play! And really this program wasn’t a huge cost: about $8K to initiate and about $1.2K annually to keep running. All of this was provided by grants and university student volunteers.
For adults, there were 2 different locales mentioned: a café job and a home setting. Currently, at in the University of Delaware, there is a café set-up with a harness system to where a person with limited mobility can do a job (make coffee, put pastries in to-go bags and be cashier) while under supervision of a therapist. The university is currently executing plans to apply this concept in what they are calling a Mobility Home: an entire house set-up with a harness system, so a person with limited mobility can go about their daily tasks walking with as much or as little assistance from a therapist as necessary.
I was just blown away by these ideas. Just absolutely flabbergasted and I LOVE IT!!!!!
What I took away from this is that harnessed mobility is only limited by my own imagination in where to put a harness system.