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Supported standing and stepping device use in young children with cerebral palsy, gross motor function classification
Roslyn W Livingstone1,2,3, Ginny S Paleg4, Debra A Field1,2
1Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada.
Insights
Supported-standing and stepping devices are feasible for young children with cerebral palsy (CP). Power mobility introduction did not decrease their use, promoting participation for children with limited mobility.
Area of Science:
- Pediatric Rehabilitation
- Assistive Technology
- Cerebral Palsy Research
Background:
- Cerebral palsy (CP) significantly impacts motor function in young children.
- Supported-standing and stepping devices are crucial for mobility and engagement.
- The impact of power mobility introduction on other assistive device use in CP is not well understood.
Purpose of the Study:
- To compare the use of supported-standing and stepping devices in young children with CP (GMFCS levels III-V) after power mobility introduction.
- To examine associations between device use and functional classifications.
- To assess the feasibility and impact of using multiple assistive devices.
Main Methods:
- Longitudinal study of 42 children (18-80 months) with CP (GMFCS III-V) using the Home Use of Technology for CHildren (HUTCH) database.
- Data collected at two time points, 5-6 months apart.
- Analysis of device choice, time in device, and correlations with motor, postural, and manual abilities.
Main Results:
- Device choice and usage time remained stable over 6 months.
- Children with greater impairments used supine standers more often.
- GMFCS V children favored hands-free stepping devices; GMFCS IV children used support-arms devices; GMFCS III children used convertible devices.
- Power mobility introduction did not reduce the use of supported-stepping devices.
- 19/34 children at GMFCS IV/V used all three device types (power mobility, standers, supported-stepping).
Conclusions:
- Supported-standing and stepping devices are feasible for young children with CP across GMFCS levels.
- Introduction of power mobility does not preclude the use of other essential assistive devices.
- Utilizing multiple upright positioning and mobility devices can enhance active engagement and participation for children with limited mobility.
Abstract:
This study described and compared use of supported-standing and stepping devices by young children with cerebral palsy, Gross-Motor Function Classification System (GMFCS) levels III-V following power mobility introduction. Data was collected at two time-points, 5-6 months apart, for 42 participants, aged 18-80 months, using the Home Use of Technology for CHildren (HUTCH). Supported-standing and stepping device choice and time in each device remained stable over 6 months. Associations between device use and three functional classifications were examined. Children with more impaired motor, postural and manual abilities were more likely to use a supine stander rather than a prone/upright stander or no stander. Children at GMFCS V tended to use hands-free stepping devices, while support-arms stepping devices were more common for children at GMFCS IV. Only children at GMFCS III used convertible stepping devices. Using power mobility, standers and supported-stepping devices was feasible and 19/34 classified at GMFCS IV/V used all three devices over 6 months. A key finding was that introduction of power mobility did not reduce use of supported-stepping devices at any GMFCS level. Use of multiple upright positioning and mobility devices may assist children with limited mobility to be actively engaged and participate in daily life.
