Operation section 4
The Leander 900 series multi-purpose adjusting table has many standard and optional features. Each of these will be described in this section along with instructions for their use.
I. Motorized Flexion Distraction
The primary feature of the Leander 900 series is motorized flexion distraction. This is the original function for which this table’s predecessors were designed and built. Motorized flexion distraction accommodates Motion Assisted Adjusting TM. It frees the doctor’s hands for palpating and adjusting, reduces injury to doctor’s hands, back and upper extremeties , creates predictable repetitive motion, increases circulation and range-of-motion, “pumps” nutrients to the discs, and allows the doctor to bill for Joint Mobilization (CPT Code 97265).
The caudal section of the 900 model table is moved by the Isolated Flexion Drive System through a range of motion beginning at horizontal and ending at a position 16 degrees below horizontal. The standard table moves from horizontal to horizontal in 2 seconds, completing 30 cycles each minute. A table equipped with an EVS may have the cycling frequency adjusted.
Isolated Flexion Drive System
Electrical Variable Speed (EVS)
2. Isolated Flexion Drive System
The Isolated Flexion Drive System smoothes out the transfer of power from the gearbox to the caudal section and reduces noise and vibration normally associated with flexion distraction tables. It includes vibration isolators, pushrod brackets, top and bottom pushrod bushings, pushrod (sliding pushrod if the table is Uplift equipped), driveplate, state-of-the-art gearbox, motor, and EVS control board if the table is EVS equipped.
3. Patient Flexion-off Switch
An easily utilized flexion-off switch is provided for patients. A squeeze-bulb connects to left side of the 6 cover via a flexible hose. The patient can stop the flexion motor by imply squeezing the bulb. For increased safety, once flexion distraction has been stopped, it may only’:be re-started by depressing the “On” side of the On/Off pedal. Some patients will feel more relaxed knowing that, should it be necessary, this switch allows them to stop the flexion motor at the FIRST sign of discomfort.
The switch may be removed from the table by pulling the hose out of the base (it is tightly secured, pull hard), replace the switch by wetting the hose slightly and re-inserting it into the base.
“T-bar and Release Mechanism”
Figure2 Lateral flexion handle.
4. Lateral Flexion
The entire front section of the table, including the head and abdominal sections, may be flexed laterally 22 degrees to each side for a total range of 44 degrees. This motion is refered to as “lateral flexion”. Lateral flexion allows unilateral traction, derotation of the lumbar and thoracic spine in conjunction with long (Y) axis traction, and passive motion stretching of paravertebral hypertonous muscles. Lateral flexion also accommodates Gonstead side posture technique.
The entire front section may be un-locked, moved, placed in position, and re-locked very easily. Squeeze the handle located on either side of the table (see figure 2, ensure that you grasp the chrome lever located under the handle at the same time), use it to position the front section, and release it. The positioning is infinite to allow the user to place the patient anywhere within the available range.
5. Adjustable T-bar
At the head of the table is a “T-bar” that may be extended up to 10 inches to accommodate different patient heights and to increase distraction. This T-bar is both wider and lower than previous versions. A wider grip provides more room for hands and lower positioning allows more freedom of movement in the thoracic spine and easier adjusting by lowering the patients scapulae.
Patients are able to vary the amount of distraction force applied to the spine by pulling against the T-bar with lighter or heavier force.
Under the front edge of the T-bar is a chrome lever which controls the T-bar locking mechanism. To extend the T-bar, squeeze: the lever and pull outward. With the lever depressed, the T-bar may be placed anywhere in the available range by moving it to that position and releasing the chrome lever.
6. Hinged Head Section
The head section hinges at the joint between the head section and the abdominal section. It travels from 15 degrees below horizontal to 45 degrees above. When the head section is released from the locked position, it is supported by a gas strut which counterbalances the weight of the table and the patient’s head.
Raise the head section during side posture movements to help support the patient and reduce stress throughout the cervical and thoracic vertebrae.
Above the front edge of the T-bar is a chrome lever which controls the locking mechanism for the head section. Raise or lower the head section by squeezing the chrome lever. The head section is now free to “float” with the gas strut supporting it and may be positioned anywhere in the available range by moving it to that position and releasing the lever.
7. Adjustable Face Cushions
The two face cushions may be adjusted away from or toward the center of the table. Adjusting the cushions improves support for a variety of patients.
Directly below the side of the left face cushion is a lever similar to the lateral handle. Squeeze this lever to move the face cushions closer together or further apart.
“Adjustable Face Cushion and Control Lever”
Fig. abdominal release lever.
8. Abdominal Release
The table is equipped with an individual section for supporting the patient’s lumbar and lower thoracic spine. This section is referred to as the abdominal section. It has two operating positions: locked (up), and lowered (floating). It may be lowered to allow normal lordosis and also provides a more comfortable treatment for larger and pregnant patients.
When the table is used for CPM flexion distraction, in most cases the abdominal section should be in the lowered position. To lower the abdominal section, support the abdominal cushion with one hand and lift the abdominal release lever (see figure 3). Gently lower the cushion. Important: without properly supporting the cushion (patient), patient discomfort could result.
“Adjustable Ankle Slider”
9. Adjustable Ankle Support
At the foot of the table is an adjustable ankle cushion that may be extended up to 10 inches to accommodate different patient heights. Straps are provided for securing the patient’s legs and increasing distraction force if so desired. Patients may increase the amount of distraction force applied to their spine by pulling against this cushion with their toes.
Under the rear edge of the ankle cushion is around, foam covered bar. Behind it is a chrome lever. While standing at the foot of the table, squeeze the lever to disengage the lock. Then, place the cushion anywhere in the available range and release the lever to re-engage the lock.
IO. Vinyl Covered Cushions
Standard upholstery on the 900 series includes Boltaflex Grand Sierra vinyl covering and various types and densities of foam padding. The head cushions are padded with a foam slightly softer than the other sections and the abdominal cushion has a reinforcing layer of special ”bottomless” foam to provide increased support and comfort for patients during “Motion Assisted Adjusting™.” See page 29, Upholstery. Also, see the new “ThoraciSupport Cushion” system for sensitive, large or augmented breasted women.
11. Arm Rests
Arm rest cushions are located at either side of the head section. These cushions are provided for patient comfort and allow for reduced tension in the thoracic spine during treatment. They are not meant to support the weight of the practitioner.
Figure 4 Head-roll paper system components.
12. Head-roll paper system
Rather than leave the practitioner to place and retrieve face paper sheets, a head-roll paper system has been built into the table (see figure 4). A hanger (A) is provided for a 12-1 /2 inch paper roll on the right side of the head section. A flexible but unbreakable guide rod (B) keeps the paper down and in place between the head cushions. An improved paper cutter (C) is provided on the left side of the head section.
13. Foot Switches
The motorized CPM flexion distraction and uplift features of the table are both operated by foot switches that leave the practitioner’s hands free to work.
The flexion motor is started or stopped by simply pressing the On/Off pedal. A second On/Off switch is now located on a control panel under the rear of the pelvic ( caudal) cushion.
The uplift adjusts to any preferred height by pressing and holding the uplift pedal until the table reaches the desired level. These controls are located on the base of the table: at the front and on both sides of the base cover. Also, controls for variable height are now located at the rear of the table under the pelvic cushion. Controls are located on both sides of this cushion.
14. Leveling Feet
Under each corner of the table are leveling feet. These are smooth faced, adjustable height levelers provided to accommodate irregularities in floors.
To adjust the feet use a thin 7/8 inch wrench while the table rests on the floor or simply lift the table and tum them by hand. The feet are threaded into the legs and will change height when twisted.