RT300 Supine Patient Setup Guide

This document provides setup instructions and troubleshooting strategies for the RT300 Supine

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1. Bike Kit Materials: Please have the following equipment before entering the patient’s room.

• 2 x Pillowcase • 1 x Cotton bed sheet • 1 x Socks • 1 x Plastic bag

2. Attach SpO2 sensor to the patient’s earlobe. i. Check that the pulse oximeter is powered on and there is adequate battery to complete session ii. Observe HR and SpO2 data is visible on the bike’s tablet before proceeding

Upon session completion, ensure nothing is lodged between the sensor before storing and check that the device is powered off.

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3. Lower bed side-panels and remove panel at foot of the bed

4. Bed adjusted so torso is positioned at ~45° incline (≥30° is appropriate)

5. Bed sheet draped across the groin to minimize exposure 6. Wires/lines moved into safe position for cycling

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7. Pivot the lower leg hanger (located between the pedals and leg rests) into cycling position.

Storage/Transport position Cycling position

8. Align both Kevlar cables (joining the leg rests and arm) into their respective groove, between the pulleys, located on the bike’s lower leg hanger.

Lower Leg Hanger

Lower Leg Hanger

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9. Before moving the bike over the foot of the bed: i. Connect the bike’s power cable to nearest power source and turn the bike’s power switch to on

ii. Grab the handles (two people) located on each side of the bike and pull/push to lengthen/narrow the base to allow enough space to move the bike over the foot of the bed, if needed.

iii. Adjust the height of the bike using the “Height” up/down switch to create enough clearance to safely move the bike over the patient’s feet.

10. Slide the bike over the foot of the bed until the patient’s heels are positioned beneath

the metal restraint devices

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11. Positioning the bike and patient for cycling i. Patient’s hips and shoulders should lie parallel and flat in the bed. The patient’s hips,

shoulders and the base of the bike should run parallel with one another. ii. Imagine a straight line through the bike’s lower leg hanger to the head of the bed. Align the

bike through the centre-line of the patient with the body symetrical on each side of the arm.

12. Lock one wheel on each side of the bike

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13. Place the patient’s lower leg and foot onto the leg rest and pedal. Insert a rolled up pillowcase between the leg and leg rest.

14. Secure leg straps and foot straps.

15. Assessing ROM and leg position:

Slowly guide the legs through the cycling movement and examine the following through the range of motion (ROM):

i. No obvious discomfort ii. Heels remain on the pedals and legs remain secured to lower-leg rests iii. Lower-leg rests do not make contact with hamstrings iv. Knee angle ranges from 90° (flexion) -160° (extension) v. Hip flexion is <90° throughout movement

ROM and leg position

i. Legs should have a maximum knee angle of 160° to prevent hyperextension (Heels remain on pedal)

ii. Lower leg should be parallel with floor when it is in the 12 o’clock position (adjust height of bike, if necessary)

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Guidelines for achieving proper patient positioning. i. Excessive knee extension: Ideal knee range 90° (flexion) - 160° (extension) • Push base of bike towards the head of the bed/towards the patient • Tighten the Kevlar wires using the lock on the lower leg hanger to straighten and secure the

legs into the lower leg rests ii. Excessive hip/knee flexion: ideal hip flexion should be < 90° throughout ROM • Pull bike towards the foot of the bed.

iii. Excessive knee abduction: (not all may apply) • Lengthen the lower-leg rests • Push the bike towards the patient/head of the bed • Tighten the Kevlar wires using the lock on the lower leg hanger to straighten and secure the

legs into the lower leg rests iv. Tibia/Lower leg not parallel with floor in 12 o’clock position: • Raise/Lower the bike’s elevation

v. Lower-leg rests contacting the hamstrings • Shorten the lower-leg rests

Knee ~ 160°

3

3 o’clock position 12

Knee ~ 135°

12 o’clock position

Lower Leg =

Parallel with Floor

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16. Adjusting the length of the lower-leg rests: If knee extension, knee abduction and hip flexion are ideal but the lower-leg rests continue to contact the patient’s hamstrings throughout the ROM, adjust the position of the calf shells along the calf support metal bar.

17. Remove slack in Kevlar wires

18. Securing the bike to the bed i. Lock all 4 wheels ii. Secure and tighten (use red lever and dial on metal restraints) both metal safety-belt hooks to

an immobile part of the bed.

No Slack Slack

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19. Final Setup

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