This year's EACD (European Academy of Childhood Disability) conference was held in beautiful Paris, and 1300 participants from all over the world attended. It was a very engaging theme: Innovation for participation, and the scientific program featured both well known speakers and new and upcoming researchers.
Made for Movement has developed new and innovative assistive devices since 1995 and we have always believed in engagement from the field of therapists and doctors, as well as users, to be able to develop devices that cover their needs. In Parallel with developing innovative devices we also support scientific research, to assure the devices cover the needs of the patients and are safe to use.
European Universities are engaged in clinical research involving Made for Movement’s robotic mobility device, Innowalk and at this year’s EACD three posters were presented.
Poster 1:
EFFECTS ON THE PASSIVE RANGE OF MOTION AND SPASTICITY AFTER DYNAMIC STANDING AMONG NON-AMBULATORY CHILDREN WITH CEREBRAL PALSY IN THE LOWER EXTREMITIES.
Presented by Lauruschkus, K. RPT, PhD., Lund University.
- 20 children with CP
- GMFCS IV and V
- 5-17 years of age (mean 11.6 +/- 3.6 years; 9 female)
- 4 months static standing
- 4 months dynamic standing
- PROM and spasticity measured before and after each exercise period
Conclusion
30 min of dynamic standing increases passive PROM and lower spasticity in the muscles around the joint in the lower extremities.
30 min. of static standing does not alter passive PROM or spasticity.
Poster 2:
Presented by Tornberg, Å. Associate Professor, RPT, Lund University.
- 18 non-ambulatory children with CP
- Crossover design
- 4 months of static standing
- 4 months of dynamic standing
- Measuring breath-by-breath oxygen consumption, carbon dioxide production, and ventilation as well as heart rate.
Conclusion
A highly statistically significant difference was found in the metabolic adaptation, described as oxygen consumption, carbon dioxide production, and ventilation to static standing versus dynamic standing.
Static standing and dynamic standing represent different exercise modalities.
Dynamic standing through robotic walking offers new possibilities to design different exercise regimes to non-ambulatory children with CP.
Poster 3:
POSITIVE EFFECTS OF ASSISTED WALKING-MOVEMENT WITH THE MOTORISED DEVICE INNOWALK IN PATIENTS WITH NEUROMUSCULAR DISORDERS
Presented by Lauruschkus K, RPT, PhD.
In this meta-analysis raw data were pooled, including all studies identified in three European countries. A total of 31 patients from 9 case studies were analysed. 94% of patients (age 10 [2 - 58] years; 58% male; 67% non-ambulatory, 86% CP) used the Innowalk in a home-based or day-care setting.
Conclusion
Improvements were recorded for: walking or weight-bearing transfer (n=13), control/strength of the trunk or head (n=6), joint mobility (n=14), sleep (n=4 out of 6), muscle strength (n=17), vital function (n=10), attention/orientation (n=2). PROM.
This is the first report of this novel device showing benefits for patients with severe physical disabilities. Small sample sizes and varying study designs of the included studies claim a prospective randomised-controlled trial to prove the concept and mechanism of action of this device.
In addition to the posters presented, an oral presentation was also performed by Ria Cuppers from the University of Antwerp, who is a clinical physiotherapist and the inventor of a new and innovative walking device (Hibbot) for children with walking limitations.
Oral presentation
Presented by Cuppers, R.
A multidisciplinary team developed a new walking device based on the clinical need for better alignment, proper muscle activity, weight bearing (i.e. no saddle) and walking handsfree.
Patients and methods
Next to developing a new walking device, a literature review at the University of Antwerp was conducted, resulting in 1815 articles of which 27 were selected based on inclusion criteria and the Oxford levels of evidence.
Conclusion
Walking devices can be classified into handheld-walkers, gait trainers, and robotic devices. These differ regarding the degree of support provided to body segments, the quantity of weight-bearing, and self-initiated or actuated movements. No clear evidence-based recommendations regarding the use of walking devices in CP are currently available. Based on clinical experience, the innovative walking device might provide better alignment by having an individually adjustable amount of support and the possibility to walk hands-free. Selecting an appropriate walking aid for the individual child may not only affect the child’s activity and participation but also the body structure and function.
The developed device might strike a better balance to address this issue.
A pilot study is ongoing, aiming to analyse kinematics, gait pattern and ground reaction.
Publications
The three posters represent research under publication. Poster nr. 3 has been approved for publication and will be found online soon. The two others are under review.
We will keep you updated on publications.
