Harnessing Mobility: A Medically Complex Child's Home Program Utilizing an In-Home Body Weight Support System.

PURPOSE: To describe a home program for a child with medical complexity using an over-ground body weight support (BWS) system. SUMMARY OF KEY POINTS: Children with medical complexity often use home programs due to challenges with regular therapy attendance. In this case, effective home program components including child centered design, family leadership, and best practice principles were prioritized around the PUMA (portable mobility aid for children). This BWS system was to be used for 1 hour per day to support mobility and active play. STATEMENT OF CONCLUSIONS: The CMC and family demonstrated high adherence, using over-ground BWS 87% of the 135 days it was accessible with an average daily usage of 59 min spread across 1-3 bouts per day. The average daily fun index during usage was 7/10. RECOMMENDATIONS FOR CLINICAL PRACTICE: This home program demonstrated over-ground BWS technology as a feasible, fun platform for functional mobility and socialization in a child with significant medical and physical limitations.

ON Time Mobility: Advocating for Mobility Equity.

Mobility is a human right. The traditional definition of mobility in physical therapy practice is centered on translocation and, while accurate, is not comprehensive. In this article, we propose the ON Time Mobility framework: that all children have the right to be mobile throughout their development to explore, engage in relationships, and develop agency to cocreate their lives. This perspective highlights interconnected principles of timing, urgency, multimodal, frequency, and sociability to begin discussions on supporting the right to hours of active mobility each day for all children. We propose critical evaluation and discussion of these principles followed by a call to action to shift our conceptualization and enactment of mobility. This mobility rights perspective challenges current medical systems, industry, and government to collaborate with children with disabilities, their families and communities to support mobility as a source of physical and social interactions that define and develop individuals (see Supplemental Digital Content 1, the Video Abstract, available at: http://links.lww.com/PPT/A398 ).

Standing Tall: Feasibility of a Modified Ride-On Car That Encourages Standing.

PURPOSE: The purpose of this study was to determine the feasibility of infants with Down syndrome to use a modified ride-on car with seated and standing modes. METHODS: Participants included 4 infants with Down syndrome. Families were asked to provide at least 8 minutes of modified ride-on car driving per day, at least 5 times per week throughout the 9-month intervention. RESULTS AND CONCLUSIONS: Families demonstrated a variety of adherence rates to the intervention. Infants demonstrated independent activation of the modified ride-on car in seated and standing modes and enjoyed driving. The modified ride-on car intervention was feasible and warrants further testing to address barriers that influence adherence to the intervention.

RESNA position on the application of power mobility devices for pediatric users.

This paper serves as an update to the previous RESNA Position on the Application of Power Wheelchairs for Pediatric Users with more current and additional scientific literature. This document contains typical clinical applications and best evidence from the literature supporting the application of power mobility (PM) for young children and to assist practitioners in decision-making and justification. It is RESNA' s position that age, limited vision or cognition, behavioral issues, and the ability to walk or propel a manual wheelchair short distances should not, in and of themselves, be used as discriminatory factors against providing PM for children. RESNA recommends early utilization of PM for children with mobility limitations as medically necessary, to promote integration and psycho-social development, reduce passive dependency, and to enhance participation, function, and independence.

Exploratory analysis of a developmentally progressive modified ride-on car intervention for young children with Down syndrome.

BACKGROUND: Children with Down syndrome (DS) may have limited opportunities to engage in self-directed mobility and play due to motor delays. A recent modified ride-on car innovation is the sit-to-stand (STS) model, which incorporates functional standing and walking training with the experience of powered mobility. AIMS: This study aimed to: (1) describe total dosage and daily usage of three modified ride-on car modes (seated, standing, and power-push) by young children with DS; (2) examine the ability of young children with DS to independently activate the modified ride-on car in seated and standing modes; (3) describe the age of onset of selected motor milestones of the sample in comparison to DS norms. MATERIALS AND METHODS: Eight young children with DS (8.6 ± 2.0 months) used three modes of the modified ride-on car over a 9-month intervention. RESULTS: All eight children independently activated the modified ride-on car in seated and standing modes. Most motor milestones were achieved earlier in this sample than expected for DS norms, including the onset of independent walking. CONCLUSIONS AND IMPLICATIONS: The developmentally progressive nature of the intervention and high dosage may have been instrumental in encouraging the onset of independent activation and earlier motor milestones.IMPLICATIONS FOR REHABILITATIONYoung children with Down syndrome were able to achieve independent activation in seated and standing modified ride-on cars.Developmentally progressive modified ride-on car interventions may facilitate motor skill development, but future work utilizing a randomized control group is needed to examine the potential motor developmental benefits of the STS model and power-push mode.The developmentally progressive nature of the intervention may have been instrumental in encouraging the onset of independent switch activation in both seated and standing modes, as well as the high dosage and adherence rates compared to previous studies.

RESNA position on the application of power wheelchairs for pediatric users.

This document, approved by the Rehabilitation Engineering & Assistive Technology Society of North America (RESNA) Board of Directors in March 2007, shares typical clinical applications and provides evidence from the literature supporting the use of power wheelchairs for children.