Worry free unweighted activities Exercise in an upright, controlled and safe position Comfortable, more normal rib and diaphragm interaction

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PneuVest Instructions Includes gait instructions Key Benefits Gait correction Patent 7063678 B1 Worry free unweighted activities Exercise in an upright, controlled and safe position Comfortable, more normal rib and diaphragm interaction Unisex design fits both male and female equally well

Distributed by Pneumex, Inc. Pneumex, Pneumex, PneuGait Foot Strap, PneuMAP, PneuBack Chair, PneuWeight and PneuVest are trademarks of Pneumex Inc. Copyright 2003 Pneumex All rights reserved Visit our web site at www.pneumex.com Pneumex, Inc. 2605 North Boyer Ave. Sandpoint, ID 83864 Phone 208 265 4105 Fax 208 265 9651 E mail pneumex@pneumex.com Rev 014 Revised Feb 26, 2014 2

Index Vest Types... 4 Putting on the Vest... 5 Vectors Vest... 6 Setting the Vector Straps... 7 Sports Vest... 8 Putting Vest on Wheelchair Patient... 9 Safety Requirements... 12 Specifications... 12 Maintenance... 12 Included Items... 13 Ischial Tuberosity Strap... 14 Jo Straps... 15 Gait Straps and Leg Cuffs... 16 External Rotation... 16 Internal Rotation... 16 Varus... 17 Valgus... 17 Over Striding... 17 Attaching to Unweighting bar... 18 Vest Problems... 18 Hold Down... 19 Warranty... 20 3

Vest types PneuVest Vectors Vectors has a sports bra type front and adjustable buckles on the back to assist with corrections. Back 4 Ischial Tuberosity Belt

PneuVest Sports Sports has a sports bra type front and no buckles on the back. Back 5 Ischial Tuberosity Belt

Included with your vest are these items: Gait Straps come attached to the vest and are used to correct gait problems; they Velcro to the leg cuff. For applications where the Ischial Tuberosity Belt may need to be held down a little more, you can attach the Jo Strap Gait Straps Leg-Cuffs Jo-Straps 6

Putting on the Vectors or SportsVest Before putting any vest on, make sure patient is wearing appropriate clothing; bulky, loose fitting and slick clothing will tend to allow vest to ride up. When putting on the vest, remember that a tight fit provides greater support and feels more comfortable when unweighted. Avoid pressure under the arms. Always fasten the straps in the order given in these instructions. In the following steps the terms left and right refer to the left and right of the person wearing the vest. All straps should be fully extended and adjusted later to fit. We have found in putting on any of the vest styles, it is easiest to first do the following: Hang it on the unweighting system. Pull cable assembly out to approximately the right position for the person being unweighted. Have them face the back of the treadmill and back into the vest. Put their right arm through the right side of the vest and the left arm through the left side of the vest. Front of vest is then secured by velcroing right over left, then pulling wings to non elastic tension. Velcro right over left (vest should be positioned so that snaps in front are centered side to side). 7

Putting on the Vectors or Sports Vest This is our standard vest. It has the most versatility and range of sizes and has lumbar adjustment straps. By choosing different vectors you can position lumbar straps to maximize or minimize lumbar lordotic. Hang it on the unweighting system. Pull cable out to approximately the right position for the person being unweighted. Have them face the back of the treadmill and back into the vest. Put their right arm through the right side of the vest and the left arm through the left side of the vest. Position vest by adjusting bottom of vest just below ASIS. Secure front of vest by velcroing right over left, then pull wings to non elastic tension. Velcro right over left (vest should be positioned so that buckles in front are centered side to side). If you are putting on a Vectors Vest have the patient turn 180º see next page for strapping instructions. The Sport Vest has no adjustment capabilities on the back. The straps are set and cannot be changed. 8

Setting the Vector Straps Position lumbar straps to maximize or minimize lumbar lordotic. Bottom position will enhance lumbar lordotic. Top position will minimize. (flatten) lumbar lordotic curvature. Center position will maintain normal lordosis. Allows for unweighting left SI. Minimizes low right impingement. Allows for unweighting right SI. Minimizes low left impingement. 9

Put on the Ischial Tuberosity Belt Starting on one side snap the forward buckle on the Ischial Tuberosity Belt into the forward buckle on the PneuVest. Wrap the Butt Strap around the side and the back of patient. Adjust strap so it falls right at the gluteus fold, continue to wrap around patient, snap the corresponding forward buckle on the Ischial Tuberosity Belt into the forward buckle on the PneuVest. The grey colored vertical adjusting straps can be tightened to assure a secure vest along with maximum comfort (strap should be across the hip joint, not too high or too low) allowing for normal gait. Buckle the large buckle in the front snug to approximately equal length, left and right (snug, not tight). Snap the smaller colored buckle into the corresponding front buckle. Pull loops to tighten. Attach remaining grey strap buckle on the Butt Strap to the PneuVest as shown. Tighten all buckles to comfort level. Use the strap length that allow the straps to be centered as much as possible. 10 Ischial Tuberosity Belt

Using the Jo Straps For applications where the Ischial Tuberosity Belt may need to be held down a little more, you can attach the Jo Strap as shown. Put on the leg cuffs and loop the Jo Strap around the Ischial Tuberosity Belt through the D ring and attach to the Velcro on the cuff. By adjusting this strap you can keep the Ischial Tuberosity Belt in desired position. Ischial Butt Strap Jo-Strap Leg Cuff See page 18 for unweighting. 11

Gait Control Straps The Gait Control Straps are buckled to the back of the PneuVest. These elastic Velcro straps offer gait enhancement abilities never before obtained with traditional treatment. Put one leg cuff on each thigh adjusting as necessary for patient comfort. Attach buckle end to vest and attach Velcro end as shown to help internal /external foot rotation, stride length and hip rotation. External Rotation For a person who is externally rotated, attach the gait strap (the elasticized band attached to the vest) on the Velcro section of the vest on the opposite hip, come across the gluteus maximus, between the legs and around the externally rotated leg and then, under tension, attach the gait strap to the leg band of the vest. It is helpful to place the foot in internal rotation when adjusting the band. Internal Rotation For a person who is internally rotated, attach the gait strap (the elasticized band attached to the vest) on the Velcro section of the vest on the opposite hip, come across the gluteus maximus behind and around the internally rotated leg and, under tension, attach the gait strap to the leg band of the vest. It is helpful to place the foot in external rotation when adjusting the band. 12

Varus For a person with a varus condition, attach the gait strap (the elasticized band attached to the vest) to the opposite D ring on the back of the vest, across the gluteus maximus, between the legs and around the front of the leg opposite the attach point and, under tension, attach the gait strap to the leg band of the vest. (Note with done concurrently). Valgus For a person with a Valgus condition, attach the gait strap (the elasticized band attached to the vest) to the opposite D ring on the back of the vest. Bring it across the gluteus maximus, around the back of the leg opposite the attach point and, under tension, attach the gait strap to the leg band of the vest. (Note with Valgus usually both sides will be done concurrently). Over striding For a person with excessive forward foot strike (over striding), while they are running/walking attach the gait strap (the elasticized band attached to the vest) through the D ring on the back of the vest, down the gluteus maximus and, under tension, attach the gait strap to the leg band on the vest (on the same side as the D ring). 13

Attaching the Vest to the Unweighting Bar Each shoulder strap on the vest has a D ring that attaches to the unweighting bar. Adjust the upright posture of the person being unweighted by moving the D ring back or forth on the straps: Warning: Before unweighting anyone, be sure the waist belt is snug and that the safety snaps are closed completely. Vest Problems If the vest rides up under the arms, reweight and pull the vest down. Have the person tighten the abdominal muscles, then retighten. If the straps do not seem long enough for comfort, try using the Chain Extenders (CE). These extenders can be use as one or two links if desired IMPORTANT: After unweighting, ask whether the subject feels comfortable. Be sure that the vest is not wedged into the underarms and that it does not restrict breathing. Readjust the vest as necessary. On the back of the vest are two elastic Velcro straps. These straps are used for gait control adjustments and DO NOT need to be attached in order for the vest to be used for unweighting purposes. See page 17 14

Safety Requirements Read this entire manual before using the PneuVest. Do not unweight until you are sure the vest is properly secured. Before each use, inspect the vest for damage. Do not use if the integrity is questionable. Specifications Size Waist Size Vest Color Child <16 to 18 Lt Blue Youth 18 to 22 Berry Small 22 to 32 Red Medium 32 to 44 Blue Large 44 to 55 Yellow XLarge 55 to > 67 Purple Maintenance Cleaning When needed, machine wash the vest on gentle cycle using regular detergent and cold water. Hang to dry. Disinfection Use procedures established for your facility. The vest can be washed with a mixture of water and disinfectant such as Lysol or equivalent. Do not use bleach on the vest or the color will fade. 15

Putting PneuVest on Wheelchair Patient Put vest on patient in chair. Tuck Vest back down as low as possible in the back. Fig 1 Fig 1 With an assistant standing behind the wheelchair, have them loop their arms under patient s armpits and lift up to help the patient tighten abs before tightening the waist belt. The clinician can then secure the first Velcro straps as low as possible making sure that the vest fits on women like a sports bra.. Fig 2 Fig 2 16

The assistant can then release patient for a moment and the clinician can repeat tightening the vest even more with the wings. Fig 3 Fig 3 To complete the lift you will need to get the Ischial Tuberosity Belt on the patient. Wrap the ITB around the patient Buckle the large and small Hip Buckles black and colored loosely in front. Fig 5 Wheel patient onto treadmill with a ramp, or position directly below the cable assembly and hook the vest to the spreader bar. Fig 5 17

Lift the patient up with the unweighting just enough to get ITB under their gluteal fold and do up side buckles. Fig 6 Fig 6 Lower patient back into chair, tighten the front Hip buckles and undo and reposition vest before reshaping as tight as possible. You can now lift the patient. Always check for fit if the vest rides up lower patient and retighten. It is recommended that you do interval training sitting them back down for short rests and to retighten the vest. * If the patient has an abdominal tub the Tie down strap is used allowing vest to be loosely strapped or unstrapped if necessary. 18

19

Your Warranty If a product purchased from Pneumex does not operate properly, Pneumex will repair or replace it at no charge, for up to one year from the date shipped. In the course of repair or replacement, Pneumex may send you written recommendations on how to prevent a problem from occurring again. Pneumex reserves the right to withdraw this warranty if recommendations are not followed. The customer is responsible for freight charges both to and from Pneumex in all cases. This warranty does not apply to compressors which are covered by the compressor manufacturers. This warranty is exclusive and is in lieu of all other warranties whether written, oral or implied, including the warranty of fitness for any particular purpose. Pneumex liability is in all cases limited to the replacement price of its product. Pneumex shall not be liable for any other damages, whether indirect, consequential, or incidental arising from the sale or use of its products. Pneumex sales personnel may modify this warranty, but only by signing a specific written description of any modifications. Pneumex 2605 Boyer Ave Sandpoint, ID 83864 pneumex@pneumex.com www.pneumex.com 800 447 5792 Pneumex Equipment 20 Pneumex Treatment Protocols