Restoring the ability to walk is a key step toward independence
Restoring the ability to walk is a key step toward independence

User Experience from Maureen Donohoe PT, DPT, PCS

I am a pediatric physical therapist involved in a arthrogryposis clinic since 1988. I see children who have joint contractures and associated muscle weakness. Due to the arthrogryposis, many of these children have limited use of their upper extremities. When learning to walk, the assistive device options are significantly limited due to the upper body limitations. Although many of the children lean to walk independently without an assistive device, there is often a moment of time where they need external support and protection of an assistive device.

I have been using the Up and Go walking device for several years as a treatment adjunct in the gait training process. Rather than the child leaning on the assistive device, the child has the opportunity to learn how to stand, balance, and weight shift, without upper extremity support, which translates to independent gait in the future. Here are 2 stories that stand out:

A young lady named Kylie was getting ready to go to kindergarten. She had another gait trainer that she had used marginally for several years and had recently outgrown it. Kylie had a clubfoot and a knee extension contracture on one side and a boyd’s amputation and an instable knee on the other side. She had extended elbows, flexed, wrists, and limited grip strength. She was able to stand independently with a locked KAFO and a prosthesis, but was absolutely terrified of shifting her weight and stepping, with or without her gait trainer. We tried the Up and Go and she was happy and successful on the first attempt. She quickly learned how to shift her weight and take steps without loss of balance. Three weeks after getting the Up and Go, she was walking independently without an assistive device household and classroom distances. A year later, she still uses the Up and Go on the playground and during gym class, for safety but for the most part, she is an independent ambulator with her braces due to the skills she developed through the use of the Up and Go.

N. T. is 3 years old and has amyoplasia. He has flexed elbows, weak shoulders, and virtually no grip strength. He has bilateral KAFO’s to help control his clubfeet and to support the fact that he lacks antigravity quadriceps strength. N.T. has been working on standing balance and stepping for over a year and could not take a step without someone assisting with the weight shift. Given his limited strength, he was not successful in managing a wide range of walkers. One day we tried the Up and Go. Over the course of a 20 minute period, he walked 50 feet, regaining his balance with each step. After practicing in the Up and Go for 4 sessions, N.T. was able to talk ten independent steps without an assistive device in his braces, with close supervision. A month later he is able to take 40 steps at a time without assistance. In this case, it was his opportunity to experience what independent weight shift feels like, that allowed him to gain success outside the device. Once he goes to school, we are considering the device for the educational environment so N.T. will be able to move throughout the classroom and the playground safely, on his feet with his peers.

Maureen Donohoe PT, DPT, PCS
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