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Supported Standing and Supported Stepping Devices for Children with Non-Ambulant Cerebral Palsy: An Interdependence and F-Words Focus

Author

Listed:
  • Ginny S. Paleg

    (Independent Researcher, Silver Spring, MD 20901, USA)

  • Sian A. Williams

    (School of Allied Health, Curtin University, Perth, WA 6009, Australia
    Liggins Institute, University of Auckland, Auckland 1023, New Zealand)

  • Roslyn W. Livingstone

    (Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 2B5, Canada)

Abstract

Children functioning at Gross Motor Function Classification System (GMFCS) levels IV–V cannot maintain an aligned standing position or take steps without support. Upright positioning and mobility devices have psycho-social significance for these children and their families, enhancing use of vision, communication, functioning and emotional well-being. Standers and supported stepping devices facilitate opportunities for biomechanical loading, potentially helping to build and maintain muscle and bone integrity, and they promote physical development. However, families are often required to choose between these two devices for their young child. This study aims to synthesize evidence for use and benefits of both supported standing and stepping devices through the lens of two contemporary theoretical frameworks to support clinical reasoning and implementation. The F-words for childhood development (functioning, family, fitness, fun, friends, future) and the interdependence-Human Activity Assistive Technology (iHAAT) models were combined to illustrate the complex interactions between the child, family, caregivers, peers and contextual factors when implementing standing and stepping devices with children at GMFCS levels IV and V. Supported standing and stepping devices provide complementary benefits, and both may be necessary starting at 9–15 months. We propose they both be included ON-Time, along with other age-appropriate positioning and mobility devices, to promote more equitable developmental opportunities for children with non-ambulant cerebral palsy.

Suggested Citation

  • Ginny S. Paleg & Sian A. Williams & Roslyn W. Livingstone, 2024. "Supported Standing and Supported Stepping Devices for Children with Non-Ambulant Cerebral Palsy: An Interdependence and F-Words Focus," IJERPH, MDPI, vol. 21(6), pages 1-19, May.
  • Handle: RePEc:gam:jijerp:v:21:y:2024:i:6:p:669-:d:1400310
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    References listed on IDEAS

    as
    1. Isabel Rodríguez-Costa & Irene De la Cruz-López & Ignacio Fernández-Zárate & Saturnino Maldonado-Bascón & Sergio Lafuente-Arroyo & Susana Nunez-Nagy, 2021. "Benefits of a Low-Cost Walking Device in Children with Cerebral Palsy: A Qualitative Study," IJERPH, MDPI, vol. 18(6), pages 1-9, March.
    2. Roslyn W. Livingstone & Ginny S. Paleg, 2023. "Use of Overground Supported-Stepping Devices for Non-Ambulant Children, Adolescents, and Adults with Cerebral Palsy: A Scoping Review," Disabilities, MDPI, vol. 3(2), pages 1-31, March.
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    1. Roslyn W. Livingstone & Ginny S. Paleg, 2023. "Use of Overground Supported-Stepping Devices for Non-Ambulant Children, Adolescents, and Adults with Cerebral Palsy: A Scoping Review," Disabilities, MDPI, vol. 3(2), pages 1-31, March.

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