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Contribution of stepping while standing to function and secondary conditions among children with cerebral palsy
Sharon Eisenberg1, Luba Zuk, Eli Carmeli
1Physical Therapy Department, The Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
Insights
Using a Hart Walker (HW) device improved bowel function in children with severe cerebral palsy. While it enabled independent stepping, it did not lead to functional walking or enhanced bone density compared to passive standing.
Area of Science:
- Pediatric rehabilitation
- Assistive technology for mobility
- Cerebral palsy research
Background:
- Severe cerebral palsy often limits mobility and increases the risk of secondary conditions.
- Assistive devices aim to improve function and participation in daily activities for children with disabilities.
Purpose of the Study:
- To assess the feasibility and efficacy of using a Hart Walker (HW) for stepping in children with severe cerebral palsy.
- To evaluate the impact of the HW on functional abilities and the prevalence of secondary conditions.
- To compare the HW intervention with a passive standing program.
Main Methods:
- A comparative study involving 22 children with severe cerebral palsy.
- Intervention group: 11 children used a Hart Walker (HW) device.
- Control group: 11 children participated in a passive standing program.
- Outcomes measured included bowel function, bone density (tibia quantitative ultrasound), activities of daily living (Pediatric Evaluation of Disability Inventory), and adverse events.
Main Results:
- Children using the HW showed improvements in bowel function.
- No significant difference in bone quantitative ultrasound measurements was found between the HW group and the passive standing group.
- Children in the HW group could take independent steps within the device but did not achieve functional walking.
- No significant adverse events were reported.
Conclusions:
- The Hart Walker (HW) shows potential for improving bowel function and enabling stepping in nonambulatory children with severe cerebral palsy.
- While HW offers opportunities for movement, it does not currently lead to functional walking or enhanced bone density compared to passive standing.
- Facilitating opportunities for ambulation, even with assistive devices, may be crucial for enhancing participation and preventing secondary health issues in children with severe cerebral palsy.
Purpose:
To explore the feasibility and efficacy of stepping while standing and its effect on function and prevalence of secondary conditions among children with severe cerebral palsy.
Methods:
Of 22 children with severe cerebral palsy, 11 underwent treatment using a Hart Walker (HW) device, and the other 11 underwent a passive standing program. Constipation prevalence and adverse events were recorded. Bone quantitative ultrasound was performed for the tibia. The Pediatric Evaluation of Disability Inventory was used to assess activities of daily life.
Results:
Children exposed to the HW improved bowel function, but no added quantitative benefit to bone was observed when compared with passive standing. Children using the HW were able to take steps independently in the device, but did not reach a functional walking level.
Conclusions:
Providing a child who is nonambulatory the opportunity to walk may be important both for participation in activities of daily living and social roles and for preventing secondary conditions.
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