Product Manual
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1. 15 STAGE 4 Knee Panel Fitting amp Additional Knee Extension Assist sold separately 5 AAA 4 gt 7 4 eat tye get ly j 19 Try the assembly on the child Ifa leg 20 Establish and mark the length 21 Attach the knee extension post if discrepancy is encountered the knee of upper side struts Add 7 8 to available to the knee plates Leave pad should be fitted to the lower marked length amp cut off with pipe the attachment to the foot plate until patella tendon and build up added to cutter the knee pad for the higher knee after the shims have been selected and installed in Step 23 16 STAGE 5 Alignment Finishing and Inspection 22 With the nyliners in place hold the knee pad joint assem bly together by hand and check in the standing and sitting positions It may be necessary to readjust some parts of the assembly Special attention should be paid to the fit of the knee pads as well as the width and height of the back panel Note Excessive looseness of the knee joints may be caused by not drawing the knee joints together before riveting in Step 15 After final check the Upper and Lower Side Struts must be riveted to the Knee Assembly Eight Upper side strut holes are provided in Knee Joints Drill through these holes with 1 8 drill bit into the Upper Side Struts and rivet Eight Lower Side Strut and Lower Knee Joint holes must be drilled using 1 8 drill bit and rivets Deburr holes Mak2. ParaPod SERVICE MANUAL Fillauer LLC TABLE OF CONTENTS Toe Erster Dora ee 4 DISS Dee er een 10 SEI OR Te ee era 5 Stage 1 Back Panel unennssnnssensenneusenene 10 DT ee er A 6 Stage 2 Foot Plate nensnunssensenennennnssensensnnensenenne 12 a 3 5 1 SO E E rapt scatterers 6 Stage 3 Knee Panel nennen 14 Propart eana O 8 Stage 4 Knee Panel and Extension Assist 16 Material Pie Para lON scaponsinsscbonstnecscsaneatennacn nentepeserwencdea s 8 Stage 5 Alignment Finishing and Inspection 17 Measurement Chart RUE REINER ED EN 9 Therapy Treatment a ial EEE ER 01s ease ou A wis E a TE REEL TETTERE TITTEN 18 THE FILLAUER PARAPOD The ParaPod comes in a kit form that can be sized and assembled easily for significantly less than conventional HKAFO s The kit provides an exoskeleton worn over clothing that consists of shoe clamps aluminum uprights foam knee blocks upper back and chest supports he aluminum uprights are sized at the knee and hip and cut to length Additional tubes can be cut to a longer length to accommodate growth SELECTION CRITERIA 5 Evaluate for deformities and contractures to determine if 1 When the child indicates a desire to stand up by pulling on furniture and other objects or is developmentally mature enough to stand a bracing program may commence The criteria used for ParaPod considerations are A The child does not have sufficient muscle power in the lowe
3. as shown in the photo the two halves of the back panel should be held at the above determined mark and the height on both sides should be checked A distance of two fingers between the lower border of the axilla and the top of each side is usually adequate Occasionally the sides have to be adjusted by cutting off material or adding extensions STAGE 1 Back Panel cont d 4 Remove the back panel from the child Drill using a 3 16 drill bit for the rivet holes while holding the two halves at the mark determined in step two Deburr holes 5 Rivet the back panels together using four 3 16 solid rivets 6 Cut off any extra back panel lining and glue the lining in place using contact cement 11 STAGE 2 Foot Plate 7 Measure the center distance between 8 Using the measurement from Step 7 9 Bolt the lower side struts in place see the Upper Hip Joints with handles less 1 4 mark the footplate and place Step 23 for more details positioned laterally the carriage bolts in the plate Make sure that the square shoulder on the bolts fit the slots in the plate 12 STAGE 2 Foot Plate cont d 10 Check if shims will be required 11 Put the plastic shoe retainers on the 12 With the plastic retainers on the child under the foot sockets to ensure child with the shoe strap buckle on again mark the feet position onto proper load bearing the medial side Mark the length of the footplate to establi
4. applied at the feet knees hips upper torso to provide standing simulation with significantly less energy cost to the patient The standing position offers the patient with an alternative position to sitting which offers numerous psychological and physiologic benefits The child with lower extremity neuromotor dysfunction has better self esteem because they are equal to their peers and can also begin upright balance and mobility training Physiologically a vertical position provides the combined benefits of alternative tissue loading increased bone deposition better bowel function fewer urinary tract infections and reduction hip and knee flexion contractures 18 The ParaPod comes in a kit form that can be sized and assembled easily for significantly less than conventional HKAFO s The kit provides an exoskeleton worn over clothing that consists of shoe clamps aluminum uprights foam knee blocks upper back and chest supports The aluminum uprights are sized at the knee and hip and cut to length Additional tubes can be cut to a longer length to accommodate growth The ParaPod is intended for upright standing and some swivel mobility but does not have the structural stability for long term dynamic swing to or swing thru gait To unlock the hip and knee joints the child should extend the trunk and lean against the back plate The side handles are pulled up and internally rotated to align the joints so they are free to flex To move from
5. balance Skin tolerance and circulatory function should be observed and the knees hips and torso as well as shoe fitting during more active period such as playtime The child should learn to play at a table then become confident standing away from a supportive object Independent balance should be encouraged in a variety of programmed activities and positions so the child can learn to stabilize themselves with trunk positioning Playing catch with a large ball is very instructive for sudden movements and positioning As the child learns to stand they should learn to fall forward and catch themselves if they begin to fall 2 4 and 6 benches can be introduced to allow the child to learn to lower and rise to a standing position from various positions Developmentally a two year old can begin independence of action in donning The earliest gait pattern is a pivot or swivel pattern using stable objects such as furniture For parallel support walkers are introduced to allow movement from place to place and pivot pattern is encouraged at first A two year old can usually master a swing to or swing through gait after establishing confidence with swivel walking Children must rely on upper extremity strength for independence which must be developed early to increase optimal function Push ups from 2 4 and 6 benches can be used for strengthening and to increase the ability to rise from the floor As upper extremity strength improves th
6. e any needed final adjustments Stand the child upright in the ParaPod and by pushing back wards determine if the child can lean backwards approximately 10 without falling Now repeat this leaning forward You can now adjust the shim as shown above to give the same amount of leaning forward and backwards This will assist the child in achieving a better degree of balance and self assurance while reducing the fear of falling 23 In order to provide a simple method for the Orthotist to change the position of the child s center of gravity relative to the base please note the following feature in the Lower Strut Attachment Bracket 1 The lower surface of the bracket is machined with 1 1 2 taper 2 A loose shim is included which has a 1 1 2 taper This allows the struts to be assembled in five different positions as shown in the following illustration 17 THERAPY TREATMENT The ParaPod from Fillauer is an important training tool in the overall rehabilitation goal of independent vertical standing and mobility Used as a training aid the ParaPod facilitates the transition from the seated position to upright stance and encourages the independent balance necessary for bimanular activities The child can then practice hands free balance control with the head and arms to work with and exploration necessary for normal cognitive development and participation with peers The Parapod uses multiple three point pressure systems
7. e child should demonstrate independent locking and unlocking activities Most children find that locking the device on the floor makes it easier to rise from the floor As ability increases the child can learn swing through gait and more outdoor activities can be encouraged on rough ground curbs or stairs need for independence at school The child should be developing the upper extremity strength and coordination with the trunk for gait training and symmetry for in preparation for RGO orthotic wear 19 F llauer LLC 2710 Amnicola Highway Chattanooga TN 37406 800 251 6398 www fillauercom Hosmer 561 Division Street Campbell CA 95008 800 827 0070 www hosmer com CENTRI Kung Hans Vag 2 192 68 Sollentuna Sweden 46 8 505 332 OO www centri se MO44 03 09
8. g Normal Age Range 2 to 6 yrs CONTENTS The Fillauer ParaPod 021018 5 Knee S A 021126 1 RH Back Panel S A 021120 Knee Plate 021153 Chest Strap 021194 Center Knee Plate 021151 Back Strap Buckle not shown 021187 6 Knee Socket Foam 021176 2 L H Back Panel S A 021121 7 Foot Plate S A 021100 Chest Strap Buckle 021186 Foot Plate 021156 Elastic Back Strap 021191 Rubber Protector 021159 Back Panel Liner 021179 8 Front Panel 021138 3 Shoe Plate S A 021104 9 Knee Joint S A 021109 Shoe Strap 021188 10 Hip Joint S A 021112 Shoe Strap Buckle 021185 11 Upper Side Strut S A 021115 4 Lower Side Strut S A 021106 Handle 021172 Lower Upright 021141 Upper Side Strut 021144 12 Knee Ext Assist Post S A 021129 optional purchased separately R H Back Panel S A 021120 L H Back Panel S A 021121 Shoe Plate S A 021104 Lower Side Strut S A 021106 A 021141 Knee S A 021126 Knee Socket Foam 021176 6 Foot Plate S A Upper Side Strut with Handles S A 021100 021115 021172 021144 Knee Ext Assist Post S A Front Panel optional purchased separately 021138 021129 12 Knee Joint S A Hip Joint S A 021109 021112 a 4 PREPARATION Material Preparation 1 The following tools are required to fit and assemble the ParaPod a pipe cutter b pop riveter c contact cement d 1 2 reamer e 1 2 countersink f adjustable wrench g tape mea
9. r extremities and trunk to ambulate and stand without crutches B The child has either gone through the Standing Brace stage or is physically and mentally ready to move into the ParaPod directly C The child is of such size that comfortable sitting can only be accomplished by flexing knees and hips Evaluate upper extremity coordination and strength to deter mine if the child can utilize crutches or walkers effectively Evaluate the condition of the feet and determine if there is room for custom shoes special padding and plantar flexion wedges Check the condition of the skin bones and joints for good weight bearing capabilities A physical therapy program may be required to prepare the child for weight bearing activi ties device modification may be required Check the legs pelvis and spine for severe deformities Orthopedic surgery and physical therapy can be of great assistance Evaluate the skin condition while checking for sores and hypersensitive areas around the chest panels front panel area sacral area buttock support and patellar tendon and knees knee pads Protruding myelomeningocele and spinal deformities should be evaluated to determine if there is enough clear area over the sacrum to have a good buttocks support panel and if a body jacket can be used if necessary Maximum Height to Axilla 33 in 83 cm Maximum Chest Circumference 26 in 66 cm Maximum Weight of Patient 55 Ib 25 k
10. sh the location the shoes plus 1 2 and trim off excess rotation and build ups Drill and rivet plastic In case of extremely small the retainers to the foot plate using shoes the shoe strap buckle should be 3 16 pop rivets moved back 13 STAGE 3 Knee Panel 13 Holding the knee pad bar over the 14 With a pipe cutter cut off the side 15 patella tendon mark the length of struts to equal lengths Sometimes it the lower side struts is necessary to ream out the side strut with a 1 2 reamer if the lower knee joint does not enter the side strut Holding two halves of the knee pad bars with a clamp drill and rivet them together using the supplied plate and four 3 16 pop rivets in the outer holes Deburr holes fully 14 STAGE 3 Knee Panel cont d Knee Panel 16 Position and mark the foam knee pad Cut it out to fit the inside of the knee plates HTL Foam Knee Pad F IF HI 17 With the child s feet strapped to the foot plate and the foam pad in place mark the location of the knee cut outs t is advisable to spread the knee laterally somewhat to ensure that knock kneeing is not encour aged It is very easy to ruin the knee pads by cutting too large or deep Start with small cut outs and adjust if necessary 18 Cut out the foam as marked in Step 17 It is important that the angle of the cut is made to approximate the sloping of the patella and tendon
11. sure h knife 1 slotted screwdriver j pencil k felt pen I portable drill with 1 8 amp 3 16 drill bits 2 Ensure the child has adequate footwear and check for fit and comfort Slightly loose shoes are recommended for best results 3 The semi assembled ParaPod kit as it is supplied is shown on the right Width and height adjustments can be made during patient s fitting 4 Hardware Kit Includes e 16 xs 1 8 pop rivets e 8 x s 3 16 pop rivets e 4x s 3 16 solid rivets Measurement Chart Refer to this chart and complete all measurements With the patient sitting the panels are over lapped and the width is marked posterior C Circumference Mid Patellar Mid Heel FEN Diameter Distance Distance Length MLI Ai Bed to Patellar VAN N Tendon Heel with Shoes Axilla i Patellar Tendon Date Patient Orthotist Therapist Hip Dislocation Hip Flexion Contracture Hip Abduction Adduction Knee Flexion Contracture Knee Valgum Varum Knee Hyperextension Ankle Valgus Varus External Rotation Scoliosis LLD Comments ASSEMBLY STAGE 1 Back Panel 1 With the child lying face down hold 2 With the child sitting the back panel the two halves of the back panel is again checked for width a new together and mark the width mark is inscribed and the final width is determined half way between the two marks 10 3 With the child sitting and the arms held
12. the seated to standing position the child can utilize the telescoping pole as an aid to pull to a standing position The standing pole has an elastic cord within it to retract when finished The hip and knee joints will externally rotate with the proximal elastic band automatically pulling them outward The child should be instructed to extend the trunk and make sure both handles move to the lateral position for standing safety The ParaPod is most successful when introduced early in development when the child becomes frustrated by the inability to pull to a standing position at approximately age two to three Early parental involvement is crucial for encouragement and acceptance of the standing balance program Initially donning and doffing of ParaPod may prove challenging and will only be successful if the parents are committed to its functional developmental goals without being overprotective All functions of the ParaPod should be properly demonstrated to the parents to insure proper operation As the child becomes more independent with the parapod the parents should also be instructed how to inspect skin condition and all load bearing areas to avoid complications The ParaPod should be worn at first for short periods and the child should demonstrate satisfactory head and trunk control to maintain balance The child should demonstrate motor ability in the prone and supine position using mat activities as well as demonstrate independent sitting
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