What disability types can benefit from using the Spartan?
At its core, the Spartan is a means of facilitating and controlling an individual’s gait kinematics in their lower extremities. So, it can really benefit anyone whose ability to walk normally has been impaired. However, its design was inspired and informed by the neurological rehab space. It works best for those who have severe neurological impairment and need a good amount of assistance to ambulate or gait train. Included in this population (but not limited to) are: spinal cord injury, traumatic brain injury, stroke, multiple sclerosis, cerebral palsy, transverse myelitis, amyotrophic lateral sclerosis, Guillain-Barre syndrome, muscular dystrophy, and motor neuron disease.
What support system is best for me so that I use the Spartan safely and without the risk of falling?
- Ask yourself: While I am in the middle of gait training with the Spartan, what would happen if the device vanished into midair?
- If the answer is “I would fall” or “I would get hurt,” then you need to bolster your support system.
- The support system you use with the Spartan serves two purposes: (1) it helps you shift your weight and trunk to mimic normal walking, which in turn allows you to reduce your reliance on any compensatory techniques you may employ, and makes smoother the lower-extremity kinematics (properly weight shifting does wonders for a quick and painless swing-through); and (2) it should be your safety net and prevent you from falling or otherwise harming yourself during the activity.
- For some people, a cane or two will suffice. These will be the high-functioning individuals who can basically walk unassisted.
- For some, a standard walker will work. These individuals should be able to advance the walker on their own, and should have excellent upper-extremity strength and trunk control.
- For most Spartan users, the support system will be a platform walker on wheels. If you have the upper extremity strength to support your whole bodyweight by pushing into the platform, and can hold this for several seconds (or however long it would take for your operator to grab your wheelchair and position it behind you), then the platform walker is all you need.
- If you cannot do that, you will need a mechanism to support your weight if your legs ceased doing so. Many platform walkers have the ad-on option of a pelvic harness that can do this. Two more expensive but equally effective options are a ceiling track & harness system, and a mobile bodyweight support harnessing system.
How does the operator calibrate the Spartan to the user’s height?
- Affix the thigh and ankle cuffs.
- Straighten one leg (or both if they are different lengths).
- Grab the handle and start rotating the device “upward” so that the handle gets closer to the user’s face & chest. Note the point at which the joint in the drop-arms becomes fully extended (the ankle will get a tug and the device will not rotate any further). This position is what you must reach during gait training for the foot/ankle to begin swing-through. That is how far upward you will need to rotate the handle before you begin pulling the foot through.
- If it is too early/low, move the slide hinge closer to the thigh cuff.
- If it is too late/high, move the slide hinge closer to the handle.
- If, while gait training with the Spartan, you notice that the user’s legs seem to be straight-legged stepping (their knees aren’t breaking, or are flexing very little during swing-through), the slide-hinge should be moved closer to the thigh cuff. If this stiff-leg problem is caused by spasticity or muscle tone, disregard this suggestion.
How tight should the straps be?
The thigh straps need to be tighter than the ankle straps, because the thigh straps have the potential to slip down over the kneecap. Make the straps quite snug. You don’t want to pinch skin or reduce circulation enough to cause discoloration of the skin, but if the straps are loose the device will not function as expected and the cuffs will shift around and irritate the skin.
- What is the right way to use the elastic bands and shoe sleeve (collectively the foot and ankle components)?
- The desired gait pattern calls for the foot to be pulled “up” into dorsiflexion during swing-through so that the user’s toes don’t drag on the floor.
- If the user cannot perform this motion on their own, or if their foot and ankle tend to rest in some non-neutral position because of muscle tightness, tone, or spasticity, then you should apply the shoe sleeve and some of the elastic bands to bias the foot to be where you want it during swing-through.
- If dorsiflexion is needed: apply elastic bands to the shoe sleeve toward the toes, centered on the foot.
- If the user tends to invert their foot (sole faces medially): apply elastic bands to the shoe sleeve on the outside (side of the littlest toe) of the foot.
- If the user tends to evert their foot (sole faces laterally): apply elastic bands to the shoe sleeve on the inside (side of the biggest toe) of the foot.
- If the user tends to rotate their foot outward (duck footed): use the elastic bands with the plastic components that are nearly ‘L’ shaped, displacing the elastic bands from the drop-arm so that the angle of the pull on the foot has a larger than normal horizontal component. Place them on the inside of the drop arm, and affix them to the shoe sleeve on the inside (side of the biggest toe).
- If the user tends to rotate their feet internally (pigeon-toed): use the elastic bands with the plastic components that are nearly ‘L’ shaped, displacing the elastic bands from the drop-arm so that the angle of the pull on the foot has a larger than normal horizontal component. Place them on the outside of the drop arm, and affix them to the shoe sleeve on the outside (side of the littlest toe).
Something broke, how can I get it fixed?
If your device is still covered by the warranty, send it in and we will repair or replace it. Otherwise, parts and peripherals may be purchased.
Am I doing it right? Gait training seems like a complicated activity and I am not sure if what I am doing is correct.
Go to our Videos page to see if you are gait training properly. It is indeed a complicated activity, and words will probably not help as much as video. Also, if you film yourself using the device and email the video to firstname.lastname@example.org we will respond soon with an analysis of your technique, and any tips or advice which may help.
(Note: if the video file is large, it may be a good idea to upload it to Youtube and send a link. Links to videos on Dropbox, Vimeo, Google Drive, etc. are all acceptable.)
If I have been neurologically disabled for a long time and don’t anticipate recovering any time soon, is it still beneficial to use the Spartan?
Absolutely. As long as it is safe for you to gait train with the Spartan, it is massively beneficial for many reasons. If you unsure about whether it is safe for you to use, ask your doctor if your body can withstand the forces of walking with an assistive device such as the Spartan.
For people with little biological potential for recovery, gait training with the Spartan is an excellent way to mitigate or eliminate the physiological and psychological risks associated with having a sedentary lifestyle. Countless studies suggest that even moderate amounts of exercise can vastly decrease one’s chances of a myriad of metabolic and cardiac disease states.
But using the Spartan offers more than just an elevated heart rate. It is more than exercise. It is weight bearing and cyclical movement in someone who doesn’t normally get it. Regular gait training has been proven to benefit:
- Bone-mineral density
- Systemic circulation
- Digestive health
- Skin integrity
- Range of motion and strength
- Trunk stability and strength
- Spasticity management
- Bowel and bladder regularity
- Subjective feeling of wellbeing
I have a degenerative disease (MS, ALS, CP). Is gait training still useful?
Yes. As long as it is safe for you to gait train with the Spartan, it is beneficial. If you unsure about whether it is safe for you to use, ask your doctor if your body can withstand the forces of walking with an assistive device such as the Spartan.
For you, gait training may be useful for two reasons. First, it may slow down the progression of your loss of ability. Second, it will help you for the same reasons it is useful to anyone with a sedentary lifestyle (see the FAQ “If I have been neurologically disabled for a long time and don’t anticipate recovering any time soon, is it still beneficial to use the Spartan?”).
The straps irritate my skin. How can I fix this?
Use gel or fabric pads between your skin and the straps. Loosen them a bit, and stop if the thigh cuff begins slipping down over your knee or if the cuffs begin moving and rotating too much during use.
The thigh cuff keeps slipping down over my knee. How can I stop this from happening?
Be sure to use the elastic band component of the thigh cuff. It should be under a good amount of tension. If this is not the issue, try tightening the straps more.
You may also place gel pads underneath the thigh cuff to offer a more pliable material for the straps to “squeeze.” Also consider placing a high-friction rubbery material underneath the cuff to prevent slip. Dycem non-slip self-adhesive material (50-1530B) works very well for this.
Will my shoes fit into the “universal” shoe sleeve?
The Spartan’s shoe sleeve is designed to fit any shoe between a woman’s size 6 and a man’s size 13. Variations between shoe brands may cause this window to be slightly inaccurate.
My foot drags on the floor during the swing-through phase. How can I prevent this?
See the FAQ “What is the right way to use the elastic bands and shoe sleeve (collectively the foot and ankle components)?”
My foot swings through at the same time my knee is pulled forward. I step with nearly straight legs. What am I doing wrong?
If you are sure it is not a result of muscle tightness, tone, or spasms, then the slide-hinge may be positioned incorrectly. While gait training with the Spartan, you notice that the user’s legs seem to be straight-legged stepping (their knees aren’t breaking, or are flexing very little during swing-through), the slide-hinge may need to be moved closer to the thigh cuff.
To troubleshoot further, see the FAQ “Am I doing it right? Gait training seems like a complicated activity and I am not sure if what I am doing is correct.”
Where can I get a platform walker on wheels?
Rifton and Wenzelite both make excellent platform walkers. Look for one with wheels and any necessary accessories (forearm straps, pelvic support pad, etc.). You may need to search for “gait trainers,” “safety rollers,” or “posture walkers” to find what you’re looking for.
My knees are hyperextended. Should I be concerned about this using the Spartan?
It depends. Knees can be hyperextended somewhat and still be strong and stable. If this is a concern you have, we strongly recommend you be evaluated by a physical therapist and get their opinion.
Be sure that your operator knows not to push excessively to extend the knees. If they can manage, have them avoid fully extending your knees altogether. It will require more strength and concentration, but ask them to stop pushing on the thigh when your knee is close to locking out and hold position there.
You may also use a stabilizing knee brace underneath the thigh cuff to further fortify the joint.