The Use of Dynamic Weight Support with Principles of Infant Learning in a Child with Cerebral Palsy: A Case Report

Abstract

Aims

Typical infant movement is characterized by a high degree of motor exploration, error, and variability. However, children with cerebral palsy (CP) often cannot create these experiences due to their neuromotor impairments. The purpose of this case study is to describe a 6-month course of physical therapy (PT) incorporating principles of infant motor learning using dynamic weight support (DWS) in a child with CP.

Methods

The child was a 27-month-old girl with diplegic CP who functioned at Gross Motor Function Classification System Level IV. The child received 68 PT sessions over a six-month period. DWS was used during therapy to encourage motor practice. The therapy area was arranged to encourage active exploration, motor variability, and error experience. Gross motor function, postural control, parent perception of performance, and parent satisfaction were measured before, during, and after the course of therapy.

Results

Gross motor function increased during the treatment beyond the level predicted from natural progression. Postural control fluctuated and demonstrated no appreciable improvement. Parent-perceived performance and satisfaction improved on three of four goals.

Conclusions

Using DWS to incorporate principles of infant learning may have facilitated the development of gross motor skills in a child with diplegic CP.

Keywords:

• Cerebral palsy
• dynamic weight support
• motor learning
• physical therapy
• toddler

Acknowledgments

We offer special thanks to the child and his family who participated in this study.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This research was supported by the National Institute on Disability, Independent Living, and Rehabilitation (H133G140166).

Notes on contributors

Samuel R. Pierce

Samuel R. Pierce, PT, PhD, NCS, is a physical therapist at The Children's Hospital of Philadelphia and a Board Certified Clinical Specialist in Neurologic Physical Therapy. He works in multidisciplinary clinic settings with a special focus on children with neurogenetic disorders. His research interests include the assessment of development in children with neurological disorders.

Julie Skorup

Julie Skorup, PT, DPT, PCS, is a physical therapist at The Children's Hospital of Philadelphia and a Board Certified Clinical Specialist in Pediatric Physical Therapy. She works in outpatient and multidisciplinary clinic settings with a special focus on children with cerebral palsy.

Morgan Alcott

Morgan Alcott, PT, DPT, PCS, is a physical therapist at The Children's Hospital of Philadelphia and a Board Certified Clinical Specialist in Pediatric Physical Therapy. She works in outpatient and multidisciplinary clinic settings with a special focus on children with cerebral palsy.

Meghan Bochnak

Meghan Bochnak, PT, DPT, PCS, is a physical therapist at Rady Children's Hospital in San Diego, CA and a Board Certified Clinical Specialist in Pediatric Physical Therapy.

Athylia C. Paremski

Athylia C. Paremski, BA, is a clinical research assistant in the Division of Rehabilitation Medicine at The Children's Hospital of Philadelphia.

Laura A. Prosser

Laura A. Prosser, PT, PhD, is a pediatric physical therapist in the Division of Rehabilitation Medicine at The Children's Hospital of Philadelphia and an Assistant Professor in the Department of Pediatrics at the University of Pennsylvania.