TRAM

1. Move or remove the wheelchair footplates, armrests and trunk laterals if possible. Use the TRAM’s expansion handle to widen the base frame before approaching the client.

2. Evaluate the client’s body type and size. Adjust the straps and height of the body support accordingly.

3. Fully shorten one end of each thigh strap and attach that end to the yellow clips at the front of the body support, gray side facing the client. The other ends of the thigh straps should be fully lengthened.

TIP: If needed to prevent outward movement of thighs, the straps can be crossed in front and attached to the yellow clips on opposite sides.

4. Have the client raise their arms slightly. Position the TRAM so that the body support pads are around the client’s rib cage a few inches below the armpits and just above the hips.

5. Secure both back buckles and tighten the two adjustment straps snugly by pressing on one side of the body support while tightening the belts.

6. Lock the caster brakes.

7. Make sure both thigh pads are positioned well under the client’s thighs, gray side up. Attach the other end of each thigh strap to one of the colored clips along the sides of the body support system. For clients with lower tone, choose a clip further back for greater support.

TIP: To ensure the straps are as far back as possible, help your client to raise one leg and place it on the curved tube in front or on your knee. This will make it easier.

TIP: In some cases, placement of the straps under the thighs may be performed first, before bringing the TRAM up to the client.

8. Pull the T-handles on the back end of the straps snug. If you can stand behind the client, pull them both evenly at the same time. Straps should be adjusted so that thighs form a 90° angle to the client’s trunk during transfer.

9. Unlock the caster brakes and raise the client.

Incorrect positioning pictured here.

Watch closely to make sure the body support system does not ride up under the client’s armpits, and the client remains balanced and comfortable and does not sag.

Correct positioning with the seat strap pictured here.

If the client sags or feels insecure, you can add the seat strap (which is simply a third thigh strap), hooked onto the clips on both side. Tighten both ends while standing behind the client.

10. Move the client to the transfer destination.

11. Gently lower the client onto the seat. Avoid lowering too far, so the body support system doesn’t push down on the client’s hips. (The TRAM will automatically stop and beep if it meets resistance.) Lock the caster brakes. Unclip the back rings on the thigh straps and gently pull the straps out from under the client.

TIP: If you used a seat strap, pause just above the seat surface and remove it.

12. Release the back buckles and caster brakes and pull the TRAM away from the client.

1. Adjust all 4 straps of the pelvic support to full length.

2. Position the pelvic support under the client, either by lifting the client using steps 1 through 9 of the seated transfer procedure or by folding the saddle, shifting the client to one side, and positioning the saddle under the client one half at a time. Make sure the pelvic support is gray side up.

3. Lower the client onto the pelvic support. Unclip and remove the thigh straps.

4. Attach the pelvic support rings to the colored clips on the body support using these general guidelines: (A) For slim clients, cross the straps on both sides as shown. Attach back strap rings to the red or yellow clips and front straps to the blue or black clips. (B) For larger clients, you may want to attach the back strap rings on the blue or black clips and front straps on the red or white clips.

TIP: The attachment points of the pelvic support can be used to control the position of the pelvis and affect posture. See the Product Manual for more information.

5. While the client is still seated, tighten all straps.

TIP: The pelvic support straps should be snug so that the body support does not ride up on the torso when lifting the client.

6. As you raise the client, pull the TRAM gently toward you to mimic the natural sit-to-stand arc. Watch closely to make sure the client is comfortable and well supported throughout the lift.

7. Adjust the body support height and other supports so the client can walk comfortably.

TIP: The body support pads should not be positioned too high under the armpits.

TIP: Arm prompts can be adjusted to accommodate a wide range of positioning needs.

8. Using the T-handles, adjust the pelvic support straps to optimally position the pelvis for good walking posture.

Positioning the arm prompt

Height adjustment: Press button A and slide the post to desired position
Pad adjustment: Loosen knob B to:
• Slide the arm pad toward or away from the user
• Angle up or down
• Rotate in or out
• Move the arm pad backward or forward
Handhold adjustment: Loosen knob C to:
• Slide the handhold forward or back for different forearm lengths
• Rotate the handhold from side to side
• Remove the handhold

For clients with shorter trunks, the arm support mounting bracket can be removed and reattached upside down to prevent the bracket from interfering with the client’s leg position during seated transfers.

Shown here is the arm support holder in the four positions possible. The arm support holder can be placed on either side of the body support, with the post forward and up, forward and down, rearward and up, or rearward and down, giving a wide range of adjustment.

The arm and wrist straps may be used to coach a client’s arm to stay in the arm support.

POSITIONING TIP: Arm supports generally give the most lifting support when adjusted to the rearmost position, with the client’s elbow directly below the shoulder. Using the arm supports like this is particularly helpful when you’re having difficulty lifting a client.

The scale can be used to measure a client’s weight, and to measure the weight a client is bearing during ambulation.

1. Turn on the display and use the lb/kg button to display either pounds or kilograms.

2. Attach all the components needed for the client (arm prompts, thigh straps, etc.) and then press the ZERO button to zero the scale.

3. Lift the client. Once a client is completely supported by the TRAM, the client’s weight will be displayed.

Watch this video to see how the TRAM’s scale can connect with the Gait Tracker app on your phone.

TIP: When gait training, lift the client completely and zero the scale. Lower the client to begin walking. The weight that the client is bearing will display as a negative number.

The Gait Tracker app allows data from the TRAM scale to be displayed on mobile phones and tablets via a Bluetooth connection. The app is available for Android and iOS devices.

The app has two primary functions:

1. It displays the weight measured by the scale, averaged over a 10 second interval for smoothness.

2. It calculates the average weight on the TRAM over the course of a gait training session. This value can be used to record and track a client’s weight bearing capability over time.

The smartphone can be attached to the TRAM’s handhold using a smartphone bike handlebar mount, allowing the client to see their progress while the caregiver views the scale monitor.

Caster swivel locks allow the caregiver to control the TRAM’s movement in several ways by preventing one or more of the TRAM’s casters from swiveling.

One lock on front caster:

Allows both rear casters to swivel and steer fully in all directions while the front casters follow.

This can make control easier when repositioning an empty TRAM between sites, and in some cases during seated transfers.

One lock on rear caster:

Allows both front casters to swivel and steer fully in all directions while the rear casters follow.

This helps with stability and directional control during gait training.

One lock on front caster and one lock on rear caster:

TRAM will track in a straight line during gait training.

This allows the client to focus on forward movement without steering.

See our online resources for several different methods for toileting with the TRAM:

TRAM FAQs

Step by step toileting with the TRAM

Toileting in schools with the TRAM

Four Field-Tested Approaches For Toileting with the TRAM