Supported standing and stepping device use in young children with cerebral palsy, gross motor function classification system III, IV and V: A descriptive study

ABSTRACT

This study described and compared use of supported-standing and stepping devices by young children with cerebral palsy, Gross-Motor Function Classification System (GMFCS) levels III-V following power mobility introduction. Data was collected at two time-points, 5–6 months apart, for 42 participants, aged 18–80 months, using the Home Use of Technology for CHildren (HUTCH). Supported-standing and stepping device choice and time in each device remained stable over 6 months. Associations between device use and three functional classifications were examined. Children with more impaired motor, postural and manual abilities were more likely to use a supine stander rather than a prone/upright stander or no stander. Children at GMFCS V tended to use hands-free stepping devices, while support-arms stepping devices were more common for children at GMFCS IV. Only children at GMFCS III used convertible stepping devices. Using power mobility, standers and supported-stepping devices was feasible and 19/34 classified at GMFCS IV/V used all three devices over 6 months. A key finding was that introduction of power mobility did not reduce use of supported-stepping devices at any GMFCS level. Use of multiple upright positioning and mobility devices may assist children with limited mobility to be actively engaged and participate in daily life.

KEYWORDS:

• Assistive technology
• gait trainer
• powered mobility
• stander
• walker

Disclosure statement

RWL and DAF declare no conflict of interest. GSP has worked as an educational consultant for Prime Engineering, a manufacturer of supported-standing and stepping devices. This relationship had no influence on this unfunded study.

Authors contributions

RWL and GSP designed the study with consultation from DAF. RWL completed the statistical analysis with consultation from DAF. RWL wrote the first draft of the manuscript and refined it with GSP and DAF. All authors reviewed and refined tables, figures, Appendices and manuscript for publication and are in agreement with the final version.

Supplementary data

Supplemental data for this article can be accessed online at https://doi.org/10.1080/10400435.2023.2283461.

R packages used in the statistical analysis

Kassambara, A. (2021). _rstatix: Pipe-friendly framework for basic statistical tests_. R packageversion 0.7.0, <https://CRAN.R-project.org/package=rstatix>.

Mangiafico, S. (2022). _rcompanion: Functions to support extension             education program evaluation_. R package version 2.4.18, <https://CRAN.R-project.org/package=rcompanion>.

Bonett, D. (2022)._statpsych: Statistical methods for psychologists_.R package version 1.2.0, <https://CRAN.R-project.org/package=statpsych>.

Patil, I. (2021). Visualizations with statistical details: The “ggstatsplot” approach. Journal of Open Source Software, 6(61), 3167, doi:10.21105/joss.03167.

Additional information

Funding

HUTCH data collection was completed by RWL and DAF as part of the larger pre-post power mobility study supported by Sunny Hill Health Centre for Children. Time to complete this portion of the analysis and write the manuscript was unfunded.