Mobility Aids Overview
Mobility challenges are present in most cerebral palsy cases. The disorder can affect any muscle group, and often results in problems involving ligaments, tendons and joints. As part of a comprehensive therapy plan, assistive technology plays a vital role treating cerebral palsy.
Assistive technology encompasses an array of items and equipment used to improve and maintain functional capabilities of disabled individuals. Cerebral palsy patients benefit from many forms of assistive innovation – from power scooters and wheelchairs, to adaptive tools for writing and eating.
Technology for Limited Mobility
Assistive, adaptive and augmentative devices help cerebral palsy patients achieve greater independence and self-confidence. Help comes in many forms. Low-tech assistive devices, for example, may make it easier for patients to grasp and manipulate items, or provide bracing support for weak joints.
High-tech equipment, on the other hand, includes state of the art mobility aids and computerized communication devices. A custom cerebral palsy treatment plan may include the use of these aids and devices:
Orthotic devices are braces worn externally, providing support and stability for individuals facing mobility challenges. The devices may be used temporarily, to enhance a period of treatment and development, or utilized as lifelong aids for standing, walking and positioning.
According to the needs of each patient, orthotics can be used to correct and prevent:
- Hip and knee dislocation
- Spastic movements
- Fallen arches
- High arches
- Inward (inversion) and outward (eversion) angled feet
The devices are highly customizable, made from rigid and soft materials, such as plastic, carbon fiber, rubber, leather and various metals. Orthopedic specialists and physical and occupational therapists work with patients to determine the most beneficial orthotic alternatives. Their recommendations result in custom functional orthotics, prescribed and designed for each individual.
Orthotic solutions for CP patients include these types:
- Foot Orthotics – Inserts for shoes or custom-made shoes designed to enhance alignment and balance.
- Ankle-Foot Orthotics – L-shaped semi-rigid braces, referred to as AFOs, these orthotics stabilize the foot, ankle and lower leg.
- Knee Orthotics
- Hip-Knee-Ankle-Foot Orthotics
- Spinal Orthotics – When limited trunk stability is present, orthotics can be used to help a child sit or stand.
- Knee-Ankle Orthotics
- Various Braces – There are a number of different braces available that specialists can assist with depending on the needs of the CP patient.
According to the CDC, approximately 11% of 8 year-old cerebral palsy patients studied by the organization used a hand held device to assist mobility. A walker serves as a sturdy frame a patient holds as he or she walks.
The devices provide support and stability, giving CP patients greater independence and confidence. Various walkers meet the needs of cerebral palsy patients, including these distinct types:
- Two-wheeled posture rest walker – Four posts stabilize the user – two fitted with wheels and the others capped with rubber tips. This style of walker helps with pace and control while walking. It can also be equipped with a seat, giving users full-time access to a resting bench.
- Four-wheeled posture control walker – Four wheeled units help toddlers and young school children maintain their balance – without slowing them down.
- Chest-support walker – Chest-level support enhances balance and promotes standing and walking.
- Gait trainers – Designed with extra clearance for walking, gait trainers come in various sizes and can be modified and customized to accommodate evolving mobility needs of children finding their stride.
- Suspension walker – Extra support helps a child with CP stand and carry his or her body weight. Suspension walkers keep children upright as they build strength and coordination – before moving-on to gait trainers.
Walking Sticks and Canes
Special pediatric canes help young cerebral palsy patients find balance and stability. And various adjustable and adult-sized standing and walking aids assist CP patients across a range of developmental stages.
- Folding cane – Split to fold down in two or three pieces, folders are portable and versatile for those needing a cane part-time.
- Offset cane – Adding an extra bend to the shaft makes this cane more stable and adjustable. Ergonomic handles add comfort and better grip for safety.
- Quad cane – Using four points of contact for the base, instead of a single shaft, creates a sturdy, stable support structure. Quad cane bases are made in various sizes, accommodating children and adult CP patients.
More than 40% of CP patients exhibit limitations crawling, walking, running or playing. Crutches help patients able to walk, but need extra support. The versatile mobility aids come in two types:
- Underarm crutches – Like the crutches issued to patients with leg injuries, these familiar supports tuck-in below the shoulder, giving the user a cushioned underarm lift. Crutches can be used singly or in pairs.
- Forearm crutches – Shorter than underarm versions, these crutches incorporate a collar, which wraps around the users forearm, below the elbow. They are easier to manipulate than full-length underarm crutches, and the collar or strap keeps them attached to the arm – even when the user lets go of the handle.
Based upon the recommendation of pediatric physical therapists and other cerebral palsy specialists, standers can be beneficial for some CP patients. The mobility devices enable children with CP and other disorders to bear their own body weight, when physical limitations would otherwise prevent it.
Standing builds strength, balance and independence, so the therapeutic value of standers is widespread. Using a stander as part of a comprehensive therapy plan leads to these benefits:
- Reduces complications such as osteoporosis
- Increases range of motion
- Encourages use of lower extremities
- Facilitates hip and hamstring stretches
- Helps patients engage with their environments, placing them at the correct level to participate
- Enhances motor control
- Empowers patients to reach their potential
Several types of standers are used in cerebral palsy therapy, including:
- Prone stander – This type of stander supports the user from the front, enabling a child with CP to lean forward for stability. The angle of support can be adjusted, according to the patient’s level of strength and ability.
- Supine stander – Supine standers support patients from the back, holding the user upright or slightly angled to the rear. Trays and other accessories can be added to make the devices more functional. Supine positioning is particularly helpful for cerebral palsy patients with limited head strength.
- Sit-to-stand stander – Versatile mobility aids enabling users to move between sitting and standing positions.
- Mobile stander – These adaptive mobility aids incorporate large wheels, empowering children to pull themselves along or propel themselves. The units are most effective for patients with good head control and upper body strength.
Lifts help cerebral palsy patients support their own weight and make transfers between devices or locations. Lifts also assist caregivers with patient transfers and positioning. These lifts may be used to improve comfort, convenience and functionality:
- Stair lift – Installed on staircases to help patients move up and down, without the ability to walk.
- Transfer lift – Sometimes called Hoyer lifts, these multi-function units provide hydraulic assistance for moving patients in various settings.
- Ceiling lift – Permanently installed track systems enabling patients with physical limitations to move independently.
- Sit-to-stand lifts – Moving from seated to standing position is made easier with the help of this device, designed for cerebral palsy patients and others with muscle weakness in the lower extremities.
Wheelchairs are vital mobility aids for cerebral palsy patients with ambulatory issues. The essential devices are available as fully-manual versions or powered, electric alternatives, which can be equipped with advanced features.
Selecting the proper wheelchair accounts for several variables, including the following concerns:
- Leg requirements – Some chairs are equipped with stabilizing braces.
- Anticipated uses – Indoor, outdoor, and daily-use – each calls for a particular set-up.
- Cushioning preferences
- Patient’s abilities
- Height, width and seat proportions
- Portability – How will the wheelchair be transported?
- Price – Powered versions are more expensive than manual wheelchairs, but may yield better results for cerebral palsy patients.
- Accessories – Arm rests and other add-ons enhance comfort and performance.
Electric wheelchairs are highly customizable, offering various configurations, battery options and drive specifications. Manual wheelchairs typically fall into these classes:
- Rigid frame – These chairs do not collapse for transporting.
- Folding frame – Easier to transport than rigid models, folding wheelchairs can be broken-down and stowed in small spaces.
- Recliners – Reclining wheelchairs are equipped with adjustable back rests, typically extending higher than a standard chair.
- Pediatric – Specially sized wheelchairs for young patients.
This powered mobility solution comes in a three-wheeled or four-wheeled version. Mobility scooters furnish many of the advantages of powered wheelchairs, giving cerebral palsy patients another independent means of movement.
Although scooters are more affordable than cutting-edge electric wheelchairs, certain features, like head and neck support, may not be present. Upper body strength is not required to operate a mobility scooter, but users must possess coordination and control to navigate the devices.
Driving Assistance and Wheelchair Vans
There are numerous types of driving modifications available today, especially for people with cerebral palsy.
- Wheelchair Vans, Trucks and SUVs – If you would like to enter and exit your vehicle while sitting in a wheelchair, check out a wheelchair accessible converted vehicle. These vehicles are converted from the brands you already trust (such as Honda, Toyota and Dodge) so that a ramp or lift will allow you or a loved one to enter while staying seated. Some wheelchair vehicles allow for the drive to stay in the wheelchair while driving.
- Driving Aids, Hand & Foot Controls, Accessible Steering Options – Interior modifications, such as driving aids and other vehicle controls, offer a wide range of solutions for accessibility. These adaptive solutions, including pedal extensions, hand controls, and electronic controls, are seemingly limitless.
- Transfer Seats and Accessible Seating– Need some assistance while getting in and out of your vehicle? Try this option. Install something as simple as an extra handle to grab onto while entering and exiting your vehicle, or a seat that twists out of the vehicle, assisting your entry and exit.
- Wheelchair and Scooter Lifts – Install a lift that allows you store a wheelchair or scooter while on the road. Lifts can be stored in the interior or exterior of a vehicle.
To find the best option for your needs, locate your nearest Mobility Dealer, such as United Access, a wheelchair accessible vehicles & equipment company with locations nationwide.