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Developmental Equipment for Motor Skills: Stands, Walkers, and Gadgets

Explore essential developmental equipment for motor skill development in children, from stands to walking aids. Discover tips on selecting the right tools and techniques for enhancing mobility and communication abilities.

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Developmental Equipment for Motor Skills: Stands, Walkers, and Gadgets

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  1. Equipment Part II: Developmental Motor, ADL, and Communication Spring Break, March 28, 2006 (GRAT and Cases NEXT week!)

  2. Crawl, Sit, Stand, Make Your Parents Childproof Your House • Head up in prone – 3 months • Wedge • Sitting and postural reflexes – 6 months • Bolster • Corner Chair • Crawl, creep • Scooter board • Crawlabout

  3. Early mobility • Spatial Perception • Normal limit setting • Seated mobility not “normal” but so what? • Caster cart and variants

  4. Standers • Upright • Prone • Supine • Adjustable • Mobile • Dynamic vs Static Weightbearing • Need trays or use at tables

  5. Prone standers • Facilitate trunk extension • Require good head control

  6. Upright standers • “Normal” position • Commonly used for people with spina bifida • Simpler design, lighter, less space needed

  7. Supine standers • Maximum support, variable angle

  8. Tilt table

  9. Adjustable designs

  10. Easy Stand Magician • Options for independent or powered lift • Options for conversion to mobile • Pediatric to Adult sizes

  11. Standing wheelchairs • Power or manual • http://www.usatechguide.org/itemreview.php?itemid=131

  12. Walkers and Gait Trainers • Wider base of support • May have added supports and modifications for gripping ability • Gait trainer implies more supports • Weight, freedom of movement can vary • Face front or reverse • Should NOT be usable like baby walkers (slump and kick method) • TRY out in therapy first whenever possible

  13. Designs • Forward facing – visual support, folding • Reverse – better LE extension, avoid LOL mode • Add-on supports – abductor, pelvic stabilizer, arm troughs for poor grip or protecting joints

  14. !!!!

  15. Rifton style • Uses “prompts” • MOVE/conductive education philosophy

  16. Cricket/Pony style (prone support)

  17. Walking means… • Community* • Household* • Exercise only • Assisted only • Device vs helper * RLA “Functional” classification

  18. ARJO • Early rehab • With enough help, anyone can “walk” at least a little

  19. Bone and joint development • Limited evidence in PT literature for efficacy of static standing • “Ballistic” weightbearing believed necessary for normal stimulus to bone mineralization / ossification • Boys with Duchenne start losing bone before sitting down, documented in pre-steroid era • No real evidence for bowel, bladder, respiratory benefits • Prevent contracture, coxa valga, acetablular dysplasia (?)

  20. Bath equipment and lifts • Car and bath transfers most difficult • Weightbearing transfers ideal when feasible • Assisted standing and walking get easier as child gets taller, not harder (vs. total lift) • Lift equipment better strategy than chronic undernutrition • Decide how much support needed in bath, recline vs back support • Waiver may help with roll-in shower, use different equipment than regular tub/shower

  21. T.L.C. style

  22. Many options • Overhead track lifts desired but rarely funded (CMS, Waiver)

  23. Will it fit? • See also the Slider: http://www.adaptivemall.com/slidbatchair.html

  24. Going potty • Not necessary to wait for walking and talking • Support feet, trunk if needed, reduce size of hole to reduce fear of falling in

  25. ADLs - Eating • Ataxia – bigger, heavier utensils • Reduced dexterity – swivel and/or bent spoon

  26. Winsford feeders • Cheek switch to scoop and present food • Need some head control • Hands-free

  27. Food preparation

  28. Cultural relevance

  29. Dressing, doors, reaching

  30. Miscellaneous gadgets

  31. Writing and typing • Writing bird, typing stick (or use pencil eraser end down in cuff) • Don’t underestimate two or even single finger typing

  32. Computer access • Simple handwriting replacement – consider portable keyboard instead • AlphaSmart • QuickPad • Voice recognition still improving • Slower, hands free use possible • Adaptive keyboards • Smaller for weaker, less mobile hand use • Larger for less accurate hand use • Special ergonomic • One-handed (software vs hardware) • Alternative mouse access

  33. Motor, sensory, or cognitive issues • Trackball or Mouse Keys for mouse if can see it • Tactile mouse for blind person experimental • Need keystroke navigation • Screen reader – text to speech • Magnification software, large monitors • Voice rec. – speech to text • Different correction strategy • Scanning access – severe motor issues • Low efficiency • Compensate with word prediction

  34. AAC (Alternative – Augementative) • Prerequisites vs Participation • Interdisciplinary evaluation mandatory • May Rx “therapy units as needed” • Different choices for ambulatory vs not • Verbal communication may increase • Communicate more than basic needs to familiar caregivers • May interface with computer • Training and programming issues • Literate English vs special language vs pictures • Need for support

  35. The Strawberry Shake Story

  36. 10.OT- Function, Folks, and Fun 9. OT- You got the right one baby, uh-huh! 8. OT- When you care enough to have the very best 7. A.O.T.A.- Membership has its privileges. 6. Male OTs- You've come a long way, baby. 5. _T- "I'd like to buy a vowel, Pat." 4. OT- Built for the human race. 3. OT- Real Therapy for Real People 2. OT- it does a body good. 1. OT- JUST DO IT! THE TOP TEN ADAPTED SLOGANS

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