Ormesa Birillo Manual

SITTINGWALKING FRAME
USE AND MAINTENANCE HANDBOOK
USA - Cod. 22833 - 30/07/12
SITTINGWALKING FRAME

1/21
ORMESA thanks you for choosing the BIRILLO walker.
BIRILLO is a walker that combines attention to functionality with respect for the principles of
ergonomics and safety.
ORMESA s.r.l. recommends that you read this manual very careful to fully understand its
contents.. In addition to helping you become familiar with BIRILLO quickly, it also contains practical
tips for making the best use of it safely and keeping it in good working order.
Following the recommendations of this manual will help you achieve the rehabilitative goal for which
this aid was developed.
If, after reading it, you still have questions, contact your retailer, who will be happy to help you, or
call INNOVATION IN MOTION directly at 1.260.665.2769, send a fax to 1.260.665.3047 or
send an e-mail to [email protected]
Luigi Menichini
Managing Director
TABLE OF CONTENTS
WARNINGS ....................................................................................................................................2
WARRANTY....................................................................................................................................4
HOW TO STORE AND TRANSPORT THE MEDICAL DEVICE.....................................................4
SOME EXAMPLES OF WHAT NOT TO DO WITH BIRILLO .........................................................5
LABELS AND PLATES...................................................................................................................5
INITIAL PREPARATION.................................................................................................................6
TECHNICAL FEATURES................................................................................................................7
WHAT DOES BIRILLO DO?...........................................................................................................8
HOW BIRILLO WORKS AND HOW TO USE IT.............................................................................9
ADJUSTING THE HEIGHT OF THE BODY....................................................................................11
ADJUSTING THE SPREADER WEDGE........................................................................................11
ADJUSTING THE HEIGHT OF THE HANDLE...............................................................................12
ADJUSTING THE DEPTH OF THE HANDLE.................................................................................12
SOME TREATMENT SUGGESTIONS...........................................................................................13
MOUNTING AND ADJUSTMENT OF ACCESSORIES..................................................................17
INSERTING AND ADJUSTING THE TRAY....................................................................................17
INSERTING AND ADJUSTING THE HEADREST..........................................................................18
MAINTENANCE, CLEANING AND DISINFECTION.......................................................................19
CUSTOMER SERVICE AND SPARE PARTS................................................................................20
CONDITIONS FOR DURABILITY, REUSE AND
REASSIGNMENT TO A NEW USER..............................................................................................21

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WARNINGS
-CAREFULLY READ AND UNDERSTAND THE INSTRUCTIONS IN THIS MANUAL
BEFORE USING THE DEVICE BECAUSE THEY HAVE BEEN WRITTEN WITH THE
USER'S SAFETY IN MIND and they will help the carer use the product safely and keep
it in good working order. The Use and Maintenance Manual is an integral part of the
product and must be carefully preserved for future reference.
-THE MANUAL IS INTENDED FOR TECHNICALLY QUALIFIED RETAILERS, HEALTH
CARE WORKERS, AND FOR USERS AND THEIR ASSISTANTS; it provides
instructions for using the product correctly and must be supplemented by adequate
knowledge of the rehabilitation program for which it has been prescribed.
-The manual reflects the technical state of the product at the time it was sold.
ORMESA RESERVES THE RIGHT TO MAKE ANY CHANGES TO THE PRODUCT OR
MANUAL suggested by experience, technical considerations or regulatory
developments without any obligation to update its previous production and relevant
manual.
-BIRILLO AND ITS ACCESSORIES MUST BE PRESCRIBED BY A MEDICAL
SPECIALIST WHO WILL ALSO SUPERVISE ITS USE in conformity with current law,
regulations and standards. In particular, the medical specialist must check for, and
evaluate, any lesions on the lower limbs, their extent, the subject's weight and the
capacity of the child that will be using the device to follow instructions and make use
of its potential.
-BIRILLO WAS EXCLUSIVELY DESIGNED FOR INTERIOR USE. In particular, the
device is intended for use at home, in specialized rehabilitation centres, hospital
gymnasiums and schools.
-The walker must only be used by persons whose bodily measurements and weight
conform to the specifications in the paragraph “Technical Characteristics” on page 7
and it has been exclusively designed for children.
-The device is available in 4 SIZES: change to a larger product as the child grows.
-THE CHILD MUST BE TRAINED TO USE BIRILLO, AND ITS EFFECTIVENESS
EVALUATED, BY THE THERAPISTS AND MEDICAL SPECIALISTS OF A
REHABILITATION DEPARTMENT.
-Make sure that all adjustable parts HAVE BEEN LOCKED BEFORE EACH USE.
-Always make sure that THERE ARE NO OBSTACLES in Birillo's range of motion that
could cause it to tip-over, such as rugs, steps and objects on the floor.
-TAKE CARE TO REMOVE KNICK-KNACKS AND OTHER OBJECTS that could
accidentally be knocked over and fall when using Birillo.
-BE AWARE OF DANGEROUS AREAS BECAUSE CHILDREN USUALLY MOVE
QUICKLY.
- THE DEVICE IS INFLAMMABLE. KEEP IT AWAY FROM SOURCES OF IGNITION SUCH
AS MATCHES, CIGARETTES OR FIREPLACES.

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BIRILLO IS A MECHANICAL MEDICAL DEVICE:
Perform REGULAR MAINTENANCE and
CLEANING following the instructions shown in the
"Maintenance" chapter on page 19-20 and HAVE THE
DEVICE INSPECTED AT THE INTERVALS
INDICATED to VERIFY that it is WORKING
PROPERLY and in GOOD CONDITION, otherwise
warranty will fail and marking will lapse
PRODUCT REPAIRS other than the regular
maintenance shown on page 19-20 of the manual
must be ONLY MADE by a SPECIALIZED
SERVICE CENTER in the maintenance of
mechanical aids for disables, otherwise warranty and
marking will be voided
Any CHANGES in the product and the
REPLACEMENT WITHOUT ORIGINAL PARTS
OR COMPONENTS ARE NOT AUTHORIZED.
REFER ONLY TO ORMESA, otherwise warranty and
marking will be voided
In case of DOUBT about the SAFETY of the product
or DAMAGE to parts or components, you are urged
to IMMEDIATELY DISCONTINUE USE and
CONTACT a SPECIALIZED SERVICE CENTER in
the maintenance of mechanical aids for disables, or
directly ORMESA.

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WARRANTY
ORMESA and INNOVATION IN MOTION warrant the product for 2 years; in case of
problems, contact the retailer where you purchased it. Always ask for original spare
parts, otherwise the guarantee will decline
ORMESA will not be liable for damage in the following cases:
-use by an unsuitable person;
-incorrect assembly of parts or accessories;
-unauthorized modifications or service;
-use of other than original replacement parts and parts subject to wear (upholstery,
wheels, etc);
-improper use (such as, transporting objects or loads larger or heavier than those
shown in the instruction manual);
-damage caused by incorrect use and lack of regular maintenance, as shown in the
instruction manual;
-exceptional events;
-failure to follow the instructions in this manual.
THE GUARANTEE DOES NOT COVER WEAR PARTS, which are subject to wear
and tear, such as the upholsteries and the wheels.
HOW TO STORE AND TRANSPORT THE MEDICAL DEVICE
TO AND TRANSPORT THE MEDICAL DEVICE
THE DEVICE MUST BE STORED AND PACKED using the Ormesa original
packaging materials, unless the guarantee will be voided
-Once unpacked, THE TRANSPORT OF THE DEVICE must be done by
ANCHORING ADEQUATELY it to the vehicle
-When travelling by plane, or in the car, DO NOT SUBJECT THE FOLDED FRAME
TO LOADS THAT, especially with road bumps, COULD DAMAGE ITS
STRUCTURE
THE DEVICE MUST BE PARKED / STORED IN CLOSED AND DRY PLACES
-THE OPERATING ENVIRONMENT HAS NO PARTICULAR INFLUENCE ON THE
DEVICE UNLESS IT IS USED INCORRECTLY, such as by leaving it parked for a
long time in direct sunlight or exposed to bad weather such as rain, or in
MARINE ENVIRONMENTS, where the salt air could corrode the paint and sliding
parts. IN THIS CASE, WE RECOMMEND CAREFULLY CLEANING AND DRYING
THE FRAME FOLLOWING THE INSTRUCTIONS SHOWN IN THE
“MAINTENANCE, CLEANING AND DISINFECTION” CHAPTER ON PAGES 19-20
AND THE WARNINGS ON PAGE 20

5/21
-
SOME EXAMPLES OF WHAT NOT TO DO WITH BIRILLO
-BIRILLO must not be used without the constant PRESENCE OF A QUALIFIED PERSON
OR FAMILY MEMBER.
-The device must not be used if THE WEDGE OR OTHER ADJUSTABLE ELEMENTS HAVE
NOT BEEN ADEQUATELY LOCKED.
- DO NOT REST EXCESSIVELY HOT CONTAINERS OR OBJECTS ON THE TRAY SURFACE
because they could tip over and because the tray could be seriously damaged.
- NEVER LEAVE THE CHILD IN THE WALKER UNATTENDED.
- NEVER STOP BIRILLO ON SLOPING GROUND.
-NEVER USE BIRILLO ON ROUGH OR STEEP SURFACES OR STAIRS.
- DO NOT LET ANYONE ELSE USE THE WALKER, not even to play with it.
-ALWAYS USE ORIGINAL REPLACEMENT PARTS OR CONSUMABLE MATERIALS or the
warranty and the mark will be voided.
LABELS AND PLATES
THE MAR
K
CERTIFIES THAT BIRILLO CONFORMS TO THE SAFETY REQUIREMENTS OF THE
EUROPEAN UNION AND, IN PARTICULAR, DIRECTIVE 93/42/EEC REGARDING “MEDICAL DEVICES”
AND SUBSEQUENT MODIFICATIONS AND SUPPLEMENTS
Series number Article number
Max load
Date of
production
Warning! Read the
useand maintenance
handbook before use
Conformity with the
European safety
standards
LOT code
®
s.r.l.
Via A. Da Sangallo, 1 06034 Foligno (PG) ITALY Tel. [phone] Fax [phone]
MOD E L . PA RT N°
S N
LOT MAX. KG
!
Name of the model
SORGFÄLTIG!BITTE LESEN SIE DIE GEBRAUCHSANWEISUNG
SORGFÄLTIG DURCH UND BEACHTEN SIE DIE ENTSPRECHENDEN HINWEISE
FR
DE
ATTENTION! LIRE ET COMPRENDRE LES INSTRUCTIONS POUR
L’UTILISATION ET L’ENTRETIEN
WARNING!READ AND UNDERST AND THE USE AND
MAINTENANCE INSTRUCTIONS
EN
ATENCIóN
ES
IT
!LEER Y COMPRENDER LAS INSTRUCCIONES DE USO
Y MANTENIMIENTO

/21
INITIAL PREPARATION
PACKAGING INFORMATION
WALKER A
cm B cm C cm VOLUME m³ WEIGHT kg
BIRILLO 1 67 57 40 0.152 11
BIRILLO 2 67 57 40 0.152 12
BIRILLO 3 78 65 50 0.253 14
BIRILLO 4 78 65 50 0.253 16
HOW TO REMOVE BIRILLO FROM THE BOX
ATTENTION!
CUT WITHOUT PRESSING TOO HARD
WITH THE BLADE SO AS NOT TO
DAMAGE THE CONTENTS OF THE BOX
REMOVE IT FROM THE BOX

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TECHNICAL FEATURES
BIRILLO is an aid that allows children from age 2 to 8 to move autonomously in a seated position.
IT CONSISTS OF:
-Frame: height-adjustable, made of steel painted with non-toxic epoxy paint
-Seat: triangular to hold the pelvis (seat/back at a 90° angle). It is padded and wrap-around,
upholstered with strong, washable plastic
-Bumpers: elastic bumpers to protect the wall and protective balls on the upper ends of the rods
-Wheels: fully-swivelling, rolling on ball-bearings, posterior with brakes
-Handle bar: adjustable in both height and depth
-Spreader wedge: adjustable to contain the pelvis Dimensions in inches
BIRILLO 1 AID WEIGHT Lbs. 18.7 MAX. CAPACITY Lbs. 66 TURNING WIDTH 26.3”
BIRILLO 2 AID WEIGHT Lbs. 22 MAX. CAPACITY Lbs. 88 TURNING WIDTH 28.7”
BIRILLO 3 AID WEIGHT Lbs. 24.2 MAX. CAPACITY Lbs. 110 TURNING WIDTH 31.8”
BIRILLO 4 AID WEIGHT Lbs. 28.2 MAX. CAPACITY Lbs. 132 TURNING WIDTH 35”

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WHAT DOES BIRILLO DO?
BIRILLO WAS DESIGNED AND BUILT TO ALLOW:
- Even small children to move in a seated position by extending their legs
- Active control of the seated position facilitated by the angle and shape of the back, which prevent
the excessive extension of the hips and trunk and align the head and chest (fig. 4)
ALL VOLUNTARY MOTOR ACTIVITY IS BASED ON THE ASSOCIATION OF POSTURE AND MOVEMENT. THE
CORRECT POSTURE PREVENTS DEFORMITIES AND PROMOTES THE DEVELOPMENT OF MOVEMENTS
THAT ARE INDISPENSABLE FOR A RICH AND MEANINGFUL INTERACTION WITH THE PHYSICAL AND
SOCIAL ENVIRONMENT.
DUE TO ITS SHAPE AND COLOUR, BIRILLO IS ACCEPTED AS A “TOY” THAT IS USED CALMLY AND
WITHOUT FEAR. IT IS RECOMMENDED FOR STIMULATING THE CHILD'S CURIOSITY TO EXPLORE THE
SURROUNDING ENVIRONMENT WHEN OTHER MEANS OF LOCOMOTION ARE NOT POSSIBLE DUE TO
REASONS OF AGE OR PATHOLOGY (A TEMPORARY OR LONG-TERM INABILITY TO STAND ERECT).
SPECIFICALLY, BIRILLO'S CORRECT USE FAVOURS:
- Experiencing an alternative posture to that “required” or “semi-required” by the pathology
(fig. 1)
- Training for alternating flexion-extension movements with forward and backward propulsion, useful
for developing footstep patterns and preventing deformities
- The dissociation of the shoulder girdle, which is free to rotate in all directions, from the pelvic girdle
that, instead, is contained in a symmetric and correct position (fig. 2)
- Breaking the “scissors” adductor pattern of the lower limbs, obtainable with the use of the spreader
- Training for vital cardio-circulatory and respiratory functions
- In addition, Birillo plays and extremely important role in the development of the perceptual
and visual-motor functions that are indispensable for the awareness and representation of space
Fig. 2Fig. 1

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HOW BIRILLO WORKS AND HOW TO USE IT
BIRILLO IS SIMPLE AND SAFE. NEVERTHELESS, WE RECOMMEND
THAT A REHABILITATION DEPARTMENT PROVIDE TRAINING IN ITS
USE AND MONITOR ITS RESULTS, UNDER THE SUPERVISION OF THE
CHILD'S DOCTOR AND PHYSIOTHERAPIST.
The instructions for its correct use are few and simple:
1. Position the child in the triangular seat
We recommend that an adult (parent or therapist) stand in front of
the child and help him enter Birillo by holding him firmly by the
sides until he is seated (fig. 3)
2. Identify the most functional postural system by taking the following criteria into account:
- first of all, seek the maximum stability of the proximal segments of the body so as to facilitate the
functionality of the distal segments;
- it is a good idea to, first, stabilize the pelvis in the triangular seat before moving on to the rest of the
trunk and body.
-
FOR THIS REASON, IT WILL BE NECESSARY TO POSITION THE PELVIS AND TRUNK SYMMETRICALLY SO
AS TO, FIRST, DISTRIBUTE THE WEIGHT UNIFORMLY AND, SECOND, ALIGN THE SUPPORT POINTS OF
THE FOLDING BACK.
3. Adjust the frame, taking care to provide an adequate angle between thighs and pelvis.
There is no standard angle that is valid for everyone; this is related to the needs of the child and the
treatment plan. As a guide, a flexion angle of the hip of 85-95° is usually adequate to control spasms
in extending the trunk and to facilitate the subsequent voluntary flexion-extension.
For adjustments, see pages 9 and 10.
4. At this point, there is an operation that is indispensable for
movement
a) set a flexion of the knees of about 80° to allow a pushing
movement of the legs (fig. 4);
b) position the handle to achieve a graduated, modulated and
controlled extension of the upper limbs (the more the frame is
extended forwards, the greater the elbow extension obtained)
REMEMBER THAT A CORRECTLY SUPPORTED SEATED POSTURE,
WITH A SOLID GRIP OF THE PELVIS, FREES THE HANDS FOR
EXPLORING AND HANDLING OBJECTS.
(fig. 4)
(fig. 3)

1/21
5. Follow this movement plan:
a) Allow a phase of getting comfortable with the aid. Most children, even very small ones, are not
afraid to use it and, in fact, tend to “try it out,” immediately learning to move in all directions. Our
experience is that children usually start by moving backwards. This is obviously the most natural
way and should not be opposed (fig. 5).
In this case, which is very common, it will be necessary to make sure
that there are no hazards (stairs, fireplaces, burners, etc.).
If you find that the child is “timid” (probably due to perceptual
problems that are influencing his awareness of space, depth and
distance), it is a good idea to proceed cautiously without forcing.
In any case, it is a good idea to allow the child to experiment with
the aid as freely as possible; later you can transition to a more
specific and targeted use.
During this phase, the child must never be left alone; an adult
SHOULD KEEP HIS HANDS IN CONTACT WITH THE AID AND PROGRESSIVELY REMOVE
THEM.
a) Some activities are performed stopped: grasping objects, turning the head to locate sounds and
simultaneously turning the head and trunk.
b) At this point, the adult will slowly and gently move the aid in all directions to give the child a
sense of the movement.
c) Having achieved a certain sense of security and ability to maintain the equilibrium of the trunk,
it's time to take the first steps, first with the aid of the adult and then without.
It is a good idea to delimit the spaces with visual indicators that facilitate orientation and spatial
and temporal organization.
(fig. 5)

1/21
ADJUSTING THE HEIGHT OF THE BODY
1. LOOSEN THE FOUR SCREWS OF THE FRAME
2. POSITION THE BODY AT THE DESIRED HEIGHT
3. TIGHTEN THE SCREWS
ADJUSTING THE SPREADER WEDGE
LOOSEN THE HANDWHEEL
ADJUST THE WEDGE IN THE DESIRED POSITION
TIGHTEN THE HANDWHEEL
indicator of the
adjustment in height
1.
2.
3.

1/21
ADJUSTING THE HEIGHT OF THE HANDLE
LOOSEN THE TWO SCREWS OF THE FRAME
POSITION THE HANDLE AT THE DESIRED HEIGHT
TIGHTEN THE TWO SCREWS
ADJUSTING THE DEPTH OF THE HANDLE
1. LOOSEN THE TWO HANDWHEELS
2. ADJUST THE DEPTH OF THE HANDLE
3.
1.
2.
3.
TIGHTEN THE TWO HANDWHEELS

1/21
SOME TREATMENT SUGGESTIONS
ATTENTION!
- THESE ACTIVITIES MUST BE PERFORMED UNDER THE SUPERVISION OF A
PARENT AND OTHER SPECIALIZED AND AUTHORIZED PERSONNEL
- REMOVE ALL OBSTACLES
- BEFORE STARTING ANY EXERCISE, MAKE SURE THAT THERE ARE NO
DANGEROUS OBJECTS OR SHARP CORNERS IN BIRILLO'S RANGE OF
MOTION
As described above, Birillo can be a valid tool for exercising several functions; in this section, we will
illustrate several activities that can be performed in the gym or at home.
GRASPING AN OBJECT PLACED
IN FRONT
This exercise involves control of the
flexion-extension of the trunk
The child must grasp a fixed or moving
object placed in the centre of his visual field
GRASPING A FIXED OR MOVING OBJECT
LOCATED TO THE SIDE
This exercise, which involves rotating the trunk
and head, benefits the dissociation between the
shoulder and pelvic girdles and the bilateral
coordination of the upper limbs.
The child must visually locate an object
located on the right or left periphery of his
visual field and grasp the object with his
parallel hands
-
-

1/21
MOVEMENT OF BIRILLO INDUCED BY THE
THERAPIST IN ALL DIRECTIONS AT
VARIABLE SPEED
This exercise induces the postural
compensations of the head-trunk-pelvis that are
necessary for maintaining equilibrium during
movements.
The child must maintain or restore head-
trunk-pelvis alignment after slow or abrupt
movements in all directions
PATH WITH PERCEPTUAL MARKERS
ON THE GROUND
This exercise involves following a path marked
by strongly contrasting shapes located along
the ground at regular distances that involves
alternating the direction of the feet on the
ground to move forwards and backwards.
The child must alternate resting his feet on
the shapes and push forwards, backwards or
to the side
PATH WITH PEGS, HORIZONTAL STRIPES
AND A FIXED OBJECT TO REACH
This exercise involves planning and executing
movements to achieve an objective by
integrating visual and motor functions
The child must move to reach an object
located at the end of the path
-
-
-

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PATH WITH PEGS AND HORIZONTAL
STRIPES
This path serves to integrate visual information
with movements
The child must organize movements, first
forward and then back, visually controlling
the direction
PATH WITH PEGS, HORIZONTAL STRIPES
AND A MOVING OBJECT TO REACH
This activity requires coordinating ones own
movement with those of the object and, thus,
awareness of space
The child must reach a moving object
PATH WITH PEGS, HORIZONTAL STRIPES
AND A MOVING OBJECT THAT
APPROACHES AND MOVES AWAY
This exercise improves perception of distances
in a variable context
The child must reach an object that first
approaches and then moves away and vice
versa
SLALOM WITH PEGS AND BELLS
This path integrates visual and sound
information with forward and front-side
movements
The child must reach a moving object by
passing through pegs
_
_
_
_

1/21
MOVING WITH SUDDEN STOP
This activity helps the development of a
stepping motion, i.e., stopping when you wish to
The child must stop at a precise point on the
path. The stopping point must continually
change and can be indicated by the adult or
the child
FOLLOWING WITH SLOW OR FAST
CHANGE OF DIRECTION
This activity serves to organize the fields of
directions during movement, also integrating
movement and vision
The child must follow the adult while
maintaining a constant distance
AVOIDING A BALL
This game organizes the positions of the
different parts of the body in relation to the
movements of an object
The child must avoid being touched by the
ball that is thrown from all directions at
varying speeds
THE CHILD MOVES TOGETHER WITH A
MOVING OBJECT
This is another game that combines movement
of the body with a moving object
The child must follow the movement of a ball
at the same speed and in the same direction
-
-
-
-

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MOUNTING AND ADJUSTMENT OF ACCESSORIES
INSERTING AND ADJUSTING THE TRAY
1. LOOSEN THE TWO HANDWHEELS
2. ADJUST THE DEPTH OF THE TRAY
3.TIGHTEN THE TWO HANDWHEELS
1. LOOSEN THE TWO SCREWS
OF THE FRAME
2. POSITION THE TRAY
AT THE DESIRED HEIGHT
3.TIGHTEN THE TWO SCREWS
824

1/21
INSERTING AND ADJUSTING THE HEADREST
1. LOOSEN THE SCREW
2. POSITION THE ROD AND HEADREST
3. TIGHTEN THE SCREW
1. LOOSEN THE SCREW
2. POSITION THE HEADREST
3. TIGHTEN THE SCREW
860