Akces-Med DALMATIAN User guide

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Rehabilitation Standing Frame
DALMATIAN
Use and Maintenance Instruction

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. Producer’s identification number in the
Registration Department of Healing Products, Medical Products and Biocide
Products:
PL/CA01 04088/W

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Taking an upright standing position by a disabled child plays a very
importantroleintheprocessofrehabilitation. Itstimulatesandimproveschild’s
psychodynamic divelopment. For a child that has lost the ability to stand up in
resultofanaccidentorillness,takinganuprightpositionispsychologicallyvery
important,aswellasforhis/herparents.
Standing frame DALMATIAN is a modern device designed for static
upright standing, used in process of active, everyday rehabilitation of children
with conditions that make independent sitting and standing impossible. Usage
of wood and bright colours makes this standing frame more a toy than a
rehabilitationdevice.
Itisauniversaldevice,designedtoplaceinsittingaswellasinstanding
position very flaccid children with muscle tone, as well as spastic children with
joint contracture. Thanks to this device the quality of life of child and family is
improved.
Please, read this instruction carefully. You will find here
information about our product and you will learn how to use it safely and
effectively.
In case of any questions, please contact our medical consultant (ph.
0048 508 382 509) or our office (ph. 0048 17 864 0470)
Thank you for purchasing this product.
Before first usage of the device it is necessary for the
user to read the manual. Please remember that
following the rules of this manual assures safety and
extends durability and esthetics of the product.

2R
9001
13485
CONTENT
1. Upright standing as relevant element of the process of
rehabilitation......................................................................3
2. When to use DALMATIAN.................................................3
3. Technical specification.........................................................4
4. Standard equipment of DALMATIAN.................................5
5. Additional equipment available............................................7
6. Safety rules...........................................................................8
7. Placing patient in upright position.......................................10
Preparation of the patient.............................................10
Preparation of the device.............................................11
Adjustment of the device to the patient.......................11
8. Maintenance and cleaning...................................................20
Akces-Med Sp. z o.o. Company introduced quality management
system ISO 9001 and ISO 13485 regarding production, sales and
service. The system is certified by Det Norske Veritas.

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1. Upright standing as relevant element of the process of
rehabilitation
Clinical tests show how important is for the patient to stand in
upright position every day. Systematic placing of the patient in
upright position is a significant part of the process of
rehabilitation and has positive influence on correct functioning
of following organs and systems:
-the most important advantage when using the standing frame
is stimulation of psychomotor development of the child
-improvement of patient’s psychological well-being
-prevents contractures and improves functioning of joints
-prevents muscle decline
-enables exercise of upper limbs in upright position
-improves functioning of cardio-vascular system
-improves air exchange in lungs – pneumonia prevention
-prevents osteoporosis and is used in osteoporosis treatment
-improves peristalsis of intestines
-prevents and helps in treatment of urinary system stasis,
helps in restoring the functions of neurogenic bladder
-static upright standing is usually one of the stages of
rehabilitation before the patient starts learning to walk,
patient’s independence is gradually increased.
Decision to use the standing frame DALMATIAN is
always made by the doctor in charge.
2.When to use Standing Frame DALMATIAN
a)as a standing frame for individual use in long term therapy-
permanent supply
-infant cerebral palsy with tetraplegia, paresis of lower limbs,
flaccid and spastic children
-meningomyelocele
-brain and spinal cord damage with atony of limbs

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C
A
D
FE
B
J
H
I
K
N
M
size 1
15-23
15-23
47-56
25 kg
12-31
20-34
86-105
17
15-24
19-26
19-26
48-62
45 kg
15-31
20-34
92-122
21
22-34
21-33
21-33
64-77
60 kg
15-45
25-50
115-150
26
24-40
2 3
a) as rehabilitation device to be used in the period of intensive therapy
-after brain and spinal cord injury, with atony and paresis, especially
tetraplegia, in case of plegia of lower limbs (as a stage of the
rehabilitation process)
-upright standing of patients after long term immobilizing in
various health conditions
2. Technical specification of DALMATIAN
Standing frame DALMATIAN is a device designed for individual use
and only us such can perform according to its function. It must be
properly adjusted to the height and weight of the patient, the supporting
pelottes and clamping rings must be adjusted on proper level.
Adjustment is always done by an authorized dealer or therapist in order
to assure maximum comfort and safety to the patient.
A. pelvis width in cm.
C. chest width in cm.
J. trunk height (from trochanter to the top of the head) in cm.
G. weight of the user (max)
I. length of shin (as standing frame) in cm.
I. length of shin (as chair) in cm.
N. height of the child in cm.
M. length of foot in cm.
L. distance from back to calf in cm.

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lenghtwidth weightsize
46
52
64
75
80
102
105
110
120
32
37
51
1
2
3
55
56
65
107
116
134
74
91
106
33
38
42
1000 N (DT3 2000N)
~2A
2 Ah
24V
230V
dimensions of the device dimensions of the packaging
Force of the drive
Use od electricity
Battery capacity
Operating voltage
Input voltage or the converter
The drive can work uninterrupted for maximum 2 min.
The proportion of work and break is 10%. (after 2 min.
of constant work it requires 18 min. break). Full
charging of the battery takes minimum 2 hours.
4.Standard equipment of DALMATIAN
1. frame with street wheels and brakes
2. head rest
3. back rest pillow
4. chest supporting pelottes
5. pelvis belt
6. vest
7. sit
8. knee stabilization with upholstery
9. elbow rest
10. foot rest with 3D regulation
11. table
12. head stabilizing belt
13. neck rest pillow
14. electrical drive
height width lenght height weight

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6
1
2
3
4
5
6
7
8
9
10
12
12
FRONT VIEW OF THE STANDING FRAME

1
4
11
1
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VIEW FROM THE BACK OF THE STANDING FRAME REMOTE CONTROL
5.Dalmatian- additional equipment
1. Table for manual therapy

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6.Safetyrules
1. Standing frame DALMATIAN must be used acording to this
instruction.
2.Beforeeachuseofthedevice:
- make sure that all parts are in working condition, properly assembled
andthedeviceisnotdamagedordeformed
-checkifallscrews,nutsandallpartswhicharegluedorstitchedtogether
etc.aretight
-checkifclipsareworkingproperly
-checkfunctioningofwheelsandbreaks
-makesureallmovingpartsarestableandblocked
3.The device mustn’t be pulled, dropped, etc. especially if the patient is
inside.
4. Standing frame shouldn’t be used without presence of trained member
ofthefamilyofanotherqualifiedperson.
5.Thedevicemustn’tbeusedorleftonunevensurface,stairsorslopes.
6.The device shouldn’t be used if it is damaged or if any part of it is
missing.
7.The device should be kept away from fire and sources of high
temperature.
ATTENTION!! Do not leave the remote
control with the key inside
ATTENTION!!
The product contains little parts which can be dangerous if swallowed
by a child.
In case of any questions, please contact directly the company office
(tph. 0048 17 8640470).
AKCES-MED Sp. z o.o. sells the product technically in proper
working condition, free of design, manufacture and material etc
defects. There is a 24 month guarantee on the stnading frame
Dalmatian starting on the day of purchasing.

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The producer takes no responsibility for damages in following cases:
-damages happened when the chair was handled by untrained
staff or family
-usage of standing frame without assistance of trained staff or
family
-incorrect assembly of parts and accessories
-self modification of parts
-usage of non-original parts and accessories
-repair by unauthorised service
-natural wear off of parts (upholstery and wheels etc.)
-damages resulting form incorrect usage (wrong weight, size of
chair for the patient)
-damage caused by weather conditions
-damage caused by usage of wrong chemicals for maintenance
-not following the maintenance instruction
-not following the rules included in this instruction.
WARNINGS:
-be careful when opening (cutting) the package not to damage
thechairupholstery
-assembly of the standing frame must be done by a qualified
person (dealer, sales consultant) or specially trained medical
staff
-thestandingframeisdesignedforindividualuse.
-the standing frame should be handled only by qualified staff:
therapists,doctors,qualifiedstaffafterspecialtraining
-standing frame DALMATIAN can be used at rehabilitation
wardsandathomeonlyinpresenceofspeciallytrainedpeople
-thedevicehaselectricaldrive
Additional information:
-maintenance and cleaninng should be done according to
instruction “Maintenance and Cleaninng” (page 20).
-In case of any accident or damage, please contact the dealer
where you purchased the product.

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7.Upright standing of the patient
First upright standing of the patient usually takes place at hospital
wards: rehabilitation, neurology, neurosurgery or orthopaedics.
Usually the doctor and physotherapoit are present during the
first trial as some medical problems may accur: loss of
consciouosness, drop of blood pressure, dizziness etc.
Uprigt standing is continued at home by:
specially trained medical personel (rehabilitation specialist,
nurse, trained members of the family)
Standing frame DALMATIAN should be used according
to this instruction. It is neccessary to prepare the patient
and the device prior to every use.
Preparation of the patient
a)Clothes should be light and comfortable, preferably sport-type.
Shoes should be comfortable and well stabilizing the ancle joint (due
to higienic reasons and in order to prevent sores patient body should
be always covered in the places of contact with the upholstery)
b)In case other orthopaedic devices are used (collar, corset, soft
orthopaedics, orthopaedic shoes) it is necessary to put them on prior to
uprightstanding.
Decision about use of any orthopeadic devices is
always made by the leading doctor.
a)All drains, catheters itc. Must be secured and protected from damage.
Theyshouldn’tinteruptuprigtstandingeither.
d) All exercisse must be done in presence of qualified people.

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Preparation of the device.
First adjustment of the device to the patient is done only by
specially qualified personel.
1. Place the device on even surface, without slopes. The device must
be well accessible by the patient and in safe distance from the sources
of fire of high temperature.
2. Make sure that all parts are working, properly assembled and stable.
3. Check the condition of wheels and brakes
4. Block the brakes
Adjust the device to the patient
Standing frame DALMATIAN has 3 main functions: chair, standing
frame, lying
Chair fuction Standing frame function

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Lying function
DALMATIAN standing frame must be well adjusted to the height and
weight of the patient in order to perform its function well. Therefore it
is necessary to pay attention to the parameters (SIZE 1,2,3) given on
page 4. Provide the patient with maximum feeling of safety - is the
main rule to follow when adjusting the device to the patient. Position
of the child in the device shouldn’t be forced as it may cause
discomfort and lead to incorrect posture.
Adjustment of the device
A- adjustment of the footer angle
B- adjustment of the footer position
C- adjustment of the height of the footer
D- adjustment of the height of the thigh pillow
E- adjustment of the height of the arm support
F- adjustment of the angle of the arm support (table)
G- adjustment of the pillows of the knee pelottes
H- fixing screw of the knee stabilization in sitting position
I- adjustment of the position of the wedge (knee pelotte)
J- screws adjusting the sit position
K- adjustment of the angle of the back rest
L- adjustment of the position of the chest pelottes
M- adjustment of the position of the pelvis pelottes
N- adjustment of the height of the head rest
O- adjustment of the height of the head rest pillow

G
G
H
F
E
E
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R- adjustment of the position of the head rest
S- fixing screw of the knee stabilization in standing position
T- adjustment of the angle of the foot rest
Adjustments of knee pelottes
Adjustments on the side of the device

S
A
A
R
P
P
O
NLL
N
MM
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Adjustments of knee stabilization
Front view of the device
in upright position
Adjustment of tooters
Rear view of the device- upper part (back rest)

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JJ
JJ
TT
DD
B
B
C
C
Rear view of the device- lower part (sit)
View of footers- underneath

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ADJUSTMENT OF HEAD REST (concerns standing frame and chair)
To adjust the height of the head rest use the screw N. Set the required
height and tighten the screw.
Use screw R to move the head rest forward, backward or to the side.
Width of the head rest is adjusted with screws located inside the cover.
Loosen up the screws, set the required width and tighten the screws.
ASSEMBLY OF THE HEAD REST (ONLY FOR DALMATIAN SIZE 3)
1. Unscrew the nut, remove the washer and fixing cube
2. Assemble the head rest and insert in following order: fixing cube, metal
washer and nut.
Metal washer Fixing cube
Nut

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3. Head rest after assembly
CHEST PELOTTE (concerns standing frame and chair)
In order to adjust the chest pelotte loosen up the screws L located at
the back of the standing frame, place the support in required position
and tighten the screws.
PELVIS PELOTTE (concerns standing frame and chair)
In order to adjust the pelvis pelotte loosen up the screws M located at
the back of the standing frame, place the support in required position
and tighten the screws.
CHEST VESTAND PELVIS BELT (concerns standing frame and
chair)
The length of the belts is adjusted with clips. Pay attention to place the
chest vest exactly in the middle of the chest and the pelvis belt on the
trochanter level. Make sure the neckline of the vest is up
ANGLE OF BACK REST (concerns standing frame and chair)
In order to adjust the angle of the back rest loosen up the screw L, set
the required position and fasten the screws.

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ATTENTION
Before the child is placed in the device make sure the
fixing screws of the back rest are tight.
SIT DEPTH (concerns chair)
In order to change the depth of the sit loosen up the screws J (located
under the sit), place the sit in required position (pull it forward or push
backward)andtightenall4screws.
Very small children can sit in the chair with straight legs.
In that case adjust the sit in the deepest position.
FOOT REST (concerns chair and standing frame)
In order to adjust the height of the foot rest loosen up the screws C.
The angle of the foot rest is adjusted with screws D1. The foot rest
can be adjusted individually for each foot. Screws D are used to
adjust the height of the pillows of thigh support.
FOOTERS (concerns standing frame and chair)
Position of footers is adjusted with screws B. Footers can be moved
forwards,backwardsandtheiranglecanbealsoadjustedwithscrewsA
KNEESTABILIZATION(concernschair)
In case of the chair, the knee stabilization is adjusted with thumb screw
H. Next, using the screw I adjust the position of the stabilization and its
tightness. With screws G adjust the knee support from outside or (after
thesupportisturned)frominside.
KNEE STABILIZATION (concerns standing frame)
In case of the standing frame, the knee stabilization is adjusted with
screw S. Using the screw I adjust the position of the stabilization and
with screw H adjust the tightness.