Akces-Med NOOK User manual

NOOK™
USER MANUAL
POSITIONING CHAIR

R
35°C
5°C
70%
45%
CAUTION! Manufacturer takes responsibility for proper usage
of the device only when the product was purchased from
qualified Akces-Med employee or at specialized medical store!
CAUTION! AKCES-MED Ltd. reserve the right to introduce
technical and trading changes in the content of the instruction
without warning.
Medical product first class according to the Regulation
93/42/EWG of European Parliament and Council
regarding medical products. For this product the
producer issued relevant declaration of conformity.
Akces-Med. Sp. z o.o. Company introduced quality
management system ISO 13485 regarding
production, sales and service. The system is certified
by Det Norske Veritas.

NOOK
CONTENTS
1. ..............................................................................................5
2. .................................................................................................................5
5. Description how to use chair................................................................................................8
5.1 The adjustment of chest support..……....................................................................8
5.2 The adjustment of removable abductor .............................................................9
5.3 The adjustment of pelvic belt ..............................................................................9
5.4 The adjustment of chest belt……...................................................................……10
6.
6.2 Headrest........................….......…………......................................................................12
6.3 Head supporting belt............................…........…….......………..................…………….13
6.4 Soft cover for tray.….............…................................................................................13
6.5 Headrest cotton cover.................................…........……………..................…………….13
8. Safety rules...............................…..….…...............................................................................18
9. Maintenance and cleaning................................................................................................21
10. Labelling.............................................................................................................................23
The purpose of user manual
Indications for use
3. General characteristics of chair.........................................................................................6
3.1. Standard equipment.................................................................................................6
3.2. Additional equipment...............................................................................................6
7. The use of chair....................................................................................................................14
7.1. Preparation of the patient.....................................................................................14
7.2. How to use chair.....................................................................................................15
7.3. Sitting position........................................................................................................16
4. Size table.................................................................................................................................7
Additional equipment......…...........................................................................…..................11
6.1 Tray...........................…...…………................................................................................11
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It is a corner rehabilitation chair which helps children and young people to adopt
the correct sitting position with upright legs. It is worth saying that this position
enforces the correct alignment of hips. It is recommended as the first therap-
eutic chair.
Ergonomic pelottes and abduction block with pelvic belt not only make the
patient feel secure but also control the correct posture. Additionally, a vast array
of adjustment is beneficial due to the fact that children grow fast.
There are 2 sizes and therefore it is perfect for children as well as young people
who are from 6 months to 12 years. This device is both light and small thanks to
which you can easily move the chair into different places.
Please read this instruction carefully. You will find information concerning our
product and you will find out how to use this device safely as well as effectively.
If you have any questions or remarks, do not hesitate to contact with us:
Medical consultant: mobile [phone]
Akces-MED Sp. z o.o.: ph. [phone]
e-mail:
Thank you for purchasing our product!
[e-mail]
NOOK
INTRODUCTION
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CAUTION! Before using the product, user is obliged to
familiarize himself/herself with user manual. Remember
that complying with guidelines is highly important. It assures
safety and extends durability as well as aesthetics of the

NOOK
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The present user manual contains basic information which is essential for
proper usage, preparation, maintenance, cleaning and guarantee conditions
NOOK™ static standing frame.
User manual should be kept in easily accessible place. It is designed for people
who look after the disabled, and for both doctors as well as physiotherapists
who operate the device.
Remember that complying with guidelines is highly important. It assures safety
and extends durability as well as aesthetics of the device.
THE PURPOSE OF USER MANUAL
SEINDICATIONS FOR U
The device is recommended for people in the following cases:
nCerebral palsy – various types and forms.
nBrain and spinal cord injuries with lower limbs paralysis and weakness,
balance and motor coordination disorders with different etiology.
nDemyelinating disease (e.g. multiple sclerosis - SM).
nMeningocele.
nMuscles diseases with weakness and paralysis (dystrophy, myasthenia
gravis, myositis).
nGenetic disorders.
nDegeneration and neurological diseases.
nOther condition connected with muscles weakness, paralysis and
musculoskeletal disorders.
nAfter head and spinal cord injuries and spine trauma with paralysis and
paresis.
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CAUTION! Before using the product, user is obliged to
familiarize himself/herself with user manual.

NOOK
GENERAL CHARACTERISTICS OF CHAIR
3.1. Standard equipment
1. Base
2. Sit
3. Removable abductor
4. Pelvic support
5. Pelvic belt
6. Chest support
7. Chest belt
3.2 Additional equipment
2
3
5
67
4
11
Tray
NKK_423 Castors with brakes
Adjustable headrest
Head supporting belt
Headrest cotton cover
Extended headrest
Soft cover for tray
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NKK_003 NKK_102 NKK_104
NKK_123
HexagonPro© Bodymap Headrest™
NKK_340 NKK_403
NKK_410 NKK_423

NOOK
SIZE TABLE
4
7
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Symbol
Measurement
Unit
Size 2***
Universal size
W Indicative user height* [cm] < 160 < 160
A
Seat width
[cm]
56
56
L
Seat depth
[cm] 32 29 – 33,5
C
Backrest height
[cm]
47 – 58
35 – 46
E
Pelvic supports width
[cm] 30 44
E1
Chest supports width
[cm]
30
29
L1
Seat depth to the abduction block
[cm] 14 – 24 13,5 – 18
Maximum user weight
[kg]
35
35
Unit
Size 2
Universal size
Width [cm] 56 56
Length
[cm]
62
62
Height** [cm] 52 52
Weight
[cm]
8
8
PRODUCT DIMENSIONS AND WEIGHT
SIZE TABLE
Note: Measurement tolerance range is +/- 1 cm / ½ in.
*The value cannot be main factor for selection of product size.
*** Size 2 - Available while stocks last
Note: Measurement tolerance range is +/- 1 cm / ½ in.
Note: Approximate values, depending on the product configuration.
**In case of mounted wheels dimension increases by 8 cm.

Before the use of the device you have to adjust it to the size of the user.
Therefore, you should take measurement of the patient. It is really necessary to
adjust the device in a way which is described in the further part of this chapter.
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8
5
CAUTION! Adjustment of the chair must be done only by
qualified staff!
Regarding the configuration of the device, it should be done with the aid of the
Allen key which is situated inside of removable abductor. When you will undo the
zipper (fig. 1), you will have an access to it.
5.1 The adjustment of chest support
In order to adjust support it is necessary to:
źLoosen knob with the aid of Allen key (fig.3) ,
źAdjust the height according to the measurement of the patient (fig.4),
źAfter obtaining the appropriate distance, screw the knob .
DESRIPTION HOW TO USE CHAIR
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fig. 1 fig. 2
fig. 3 fig. 4

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9
5.2 The adjustment of removable abductor
When you adjust distance it is necessary to:
ź Loosen knob with the aid of Allen key (fig.5),
ź Adjust the desired position (fig.6),
ź After obtaining the appropriate distance, screw the knob.
5.3
When you adjust the belt it is necessary to:
ź Detach Velcro in the belt,
ź Adjust the length of the belt to the patient,
ź After obtaining the appropriate length of the belt you should fasten the
belt by means of Velco (fig.7).
It is important to check if:
ź The belt doesn't press the child,
ź The belt doesn't unfasten because of pressure.
The adjustment of pelvic belt
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fig. 5 fig. 6
fig. 7

5.4
ź
ź,
ź
,
:
ź.
The adjustment of chest belt
In order to adjust the belt it is necessary to:
Detach Velcro from this belt,
Adjust length of the belt to the patient
After adjusting the appropriate length, it is important to fasten the belt
with the aid of Velcro.
You should check if
źThe belt does not press child,
The belt does not unfasten because of pressure
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fig. 8

6.1 Tray
Tray has to be mounted after placing the child in the chair. You have to insert the
tray under the removable abductor until safety pin will slam (fig.10). In order to
dismantle the tray it is necessary to pull away and hold the safety pin, after which
you have to take out the tray. Regarding the alignment of the tray (height, depth,
tilt angle), it is important to do it with the aid of Allen key by loosening as well as
screwing the suitable bolts.
Regarding the alignment of the tray - depth (fig.11, 12), height (fig.13, 14) it is
important to do it with the aid of Allen key by loosening as well as screwing the
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6
NKK_403
ADDITIONAL EQUIPMENT
1111
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fig. 9 fig.10
fig.11 fig.12

6.2 Headrest
Firstly, it is necessary to dismantle pillow of the pelvis pelotte. You should insert
headrest into slot (fig.15), screw it by means of bolt (fig.16) and mount the pillow
on Velcro.
Regarding the alignment of the head
rest (height, depth, tilt angle), it is
important to do it with the aid of Allen
key by loosening as well as screwing the
suitable bolts.
NOOK
NKK_104
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fig.13 fig.14
fig.15 fig.16
fig.17

Cover is made of cotton and it should be put on headrest. Regarding material, it
has some bands thanks to which material does not slip down.
NOOK
6.5 Headrest cotton cover
NKK_410
NKK_102
In order to mount the head supporting
belt, you should:
ź Fasten it to the side parts of the head
rest with the aid of Velcro
ź Adjust the length of the belts to the
patient
ź Pull it so as to check the correctness of
assembly.
6.3 Head supporting belt
6.4 Soft cover for tray
Please follow these steps so as to mount soft cover for tray:
ź Adhere 5 adhesive Velcro tapes (fig.19);
ź Put soft cover in a way that its edges cover tray edges (fig.20).
NKK_003
13
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fig.18
fig.19 fig.20

NOOK
THE USE OF CHAIR
7
CAUTION! NOOK™ has to be used with compliance to
guidelines included in this user manual. Remember to use the
product only with someone who is trained and
knowledgeable. Do not forget to prepare both product as well
as patient before using NOOK™!
7.1. Preparation of the patient
Before using the product, it is essential to make sure that:
§patient's outfit is light and comfortable sporty clothes are advisable;
§shoes should be comfortable and, moreover, they should stabilize
ankle;
§due to hygienic reason and to avoid abrasion it is advisable for the
patient to always wear clothes when using the device, skin must not be
naked especially in places of regular contact with upholstery;
§drains, bags, catheters etc. if applied, have to be secured to function
properly and not to disturb during using the product;
§if it is necessary for a patient to wear orthopedic supply (collar, corset,
orthesis, shoes) if it is recommended by doctor.
CAUTION! Outfit should protect patient's skin from direct
contact with upholstery as well as other parts of equipment.
CAUTION! Only doctor can make a decision concerning
using any kind of orthopedic supply!
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7.2. How to use chair
1. Before use it is necessary to:
§Unfold the device;
§Place the device on even ground;
§Make sure that all parts are serviceable, correctly mounted and stable;
§Block brakes (only in chair with castors);
§ Adjust the device to patient's measurements;
§Undo vest, trunk belts etc so as to place easily the patient is the device;
§Place patient in the device;
§Fasten all elements which stabilize patient e.g. vest, trunk belts, feet
stabilizing belts etc.;
§Mount additional equipment e.g. tray.
2. In case of patients who have problem with bladder, it is necessary to put
special cloth on seat. This cloth can be purchased in pharmacy or medical
shops.
Equipment works correctly only when the device is adjusted according
to patient's height as well as weight. Remember to take all these
measurements into account while purchasing the product. Correct
adjustment is the most important due to the fact that only then the
product is safe. It is forbidden to force child to keep specific position
because he/she will feel uncomfortable and it may lead to wrong
posture.
NOOK
CAUTION! Remember to makes sure that all belts and locking
and correctly adjusted and fastened. Check also if fastenings
from adjustable elements are firmly tightened.
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7.3. Sitting position
Clinical research shows that it is really beneficial for children to adopt sitting
position so as to stimulate psychomotor development. Moreover, adopting
sitting as well as standing position is advantageous for disabled due to the fact
that it has a positive influence on organs and systems. Furthermore, it often acts
as the stage of upright position and learning to walk:
§ the most significant cause of using chair is the stimulation of psychomotor
system;
§ it has an influence on patient's state of mind;
§ it has an influence on the development of muscles, joints and
musculoskeletal system;
§ it prevents from contractures or makes it easier to cure them; it improves
joint mobility;
§ it prevents from muscle atrophy (especially postural); it makes it easier to
take exercises for upper limbs while sitting position
§ it improves cardiovascular system;
§ it improves lung ventilation and prevents from pneumonia; it improves
intestinal peristalsis;
§ it prevents from urinary problems or makes it easier to cure it;
§ it prevents from bedsores or makes it easier to cure them;
§ passive sitting is usually only the stage of rehabilitation process
Taking the sitting position for the first time by the little patient usually happens
in the rehabilitation, neurology, neurosurgery or orthopaedic ward. Upright
standing is supervised by the doctor and physiotherapist due to the possibility
of occurrence such medical problems like: loss of consciousness, drop of blood
pressure etc. It is very important to adjust all parts of the device to the condition
of the child, taking into consideration contractures and deformations.
Taking the sitting position at home is supervised by qualified staff
(physiotherapists, nurse, trained members of the family).
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CAUTION! Incorrect adjustment of the device can lead to
side effects such as: fainting, body deformities, overloading
joints. It is highly advisable to adjust the device before every
use of a standing frame. This adjustment has to be done only
by a trained person or therapist. If any of these side effects
appear, it is highly important to stop the upright position
process, take out the patient from the device and lie him/her
down. If these undesirable side-effects still occur it is
necessary to contact doctor. If these side effects disappeared,
remember to inform doctor so as to make decision concerning
further upright position process.
CAUTION! Only doctor can make decision concerning the
use of rehabilitation chair!
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It is highly important to consult either doctor or physiotherapist in order to make
right decision concerning the choice of chair and its size. It is also essential to
familiarize with the guidelines described in user manual before using the device.
1. Before use it is necessary to:
§make sure that there are no damages or different faults which could
endanger patient's life; check if all parts are working and are correctly
mounted and, moreover, check if they are not broken;
§check if all screws, knobs and all glued, sewed or tapped parts are
tightened;
§check if brakes are operating correctly;
§check if buckles are operating correctly;
§always use safety belts, Velcro tapes should overlap min. 8cm;
§adjust the device according to patient's measurements and needs e.g. the
adjustment of pelottes , footplate etc.;
§make sure that all movable parts and knobs for adjustments are stable
and locked;
§secure patient with the aid of elements such as vest, foot stabilizing belts,
pelottes, abduction block, headrest. It is highly important to secure
patient because it safeguards him/her from falling out. If abduction
contracture occurs, it is recommended to use abduction block in order to
prevent ulcers between knees;
NOOK
SAFETY RULES
8
CAUTION! NOOK™ chair has to be used in compliance
with guidelines in this user manual.
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NOOK
2. It is forbidden to use chair for different purposes that it is intended to.
3. It is forbidden to use chair when it is damaged or any part is missing.
4. It is forbidden to leave the patient unattended.
5. Chair should be used only when there is someone who is trained and
knowledgeable.
6. It is forbidden to leave chair and the patient on unstable ground unattended,
even if the brake is engaged.
7.It is forbidden to either go up or down the stairs; it doesn't matter if the patient
is placed in the device or not.
8.It’s important to make sure that patient doesn’t stand on footer during either
getting into or getting out the chair.
9. It is important to engage brake during getting into and getting out the chair.
10.Make sure that all limbs are not close to spokes or other adjustable elements.
11.Although the device and the upholstery are made of fire-resistant materials,
please pay your attention when approaching to sources of fire or sources of
high temperature during using the device. Moreover, chair shouldn't be
stored in rooms with high humidity.
12.Secure chair during transportation in order to avoid any possible damages.
Manufacturer doesn't take responsibility for damages which appeared due to
improper preparation of the device during transportation.
CAUTION! Taking the sitting position for the first time by the
little patient usually happens in the rehabilitation, neurology,
neurosurgery or orthopaedic ward. Upright standing is
supervised by the doctor and physiotherapist due to the
possibility of occurrence such medical problems like: loss of
consciousness, drop of blood pressure etc. It is very important
to adjust all parts of the device to the condition of the child,
taking into consideration contractures and deformations.
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NOOK
CAUTION! The product contains small parts which children
may swallow.
CAUTION! It is forbidden to make any changes concerning
stroller 's structure due to the fact that it is dangerous and it
results in loosing warranty.
CAUTION! The weight of user should not be bigger than
maximal weight described on page 7 where you will find
information regarding this issue.
CAUTION! This device can be only used inside the buildings.
1) AKCES-MED Sp. z. o. o sells products free from manufacturing defects or faults.
2) Manufacturer gives the purchaser 24-month guarantee from the date of purchase. All
defects revealed during warranty period will be repaired free of charge.
3) All defects which appear after warranty period can be repaired only when the user will
pay for it. This rule doesn't apply to refunded products - user can ask National Health
Refund for refund.
4) Manufacturer claims that the product can be used for 36 months. User can use this
product after this period only when he/she will send the device to manufacturer so as
to service it. Next, manufacturer determines again how long the product can be used
and, moreover, the date of the next service will be determined.
5) If product is damaged, please contact our dealer or AKCES-MED customer service (ph.
17/864 04 70)
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