The significance of uprightness: parents’ reflections on children’s responses to a hands-free walker for children

Abstract

The benefits and drawbacks of facilitating independent walking in children with physical mobility impairments, such as cerebral palsy, remain to be determined. This knowledge gap creates decision dilemmas about which mobility practices parents and children should adopt and rehabilitation professionals should foster. These dilemmas are reflected in continuing debates about allocation of time, effort and resources to optimize walking versus encouraging use of manual or powered wheelchairs. Recent studies have reported only modest measurable walking progress for severely disabled children using hands-free walkers. Despite these seemingly disappointing results, parents remained highly motivated to encourage their children to use these walking devices and appraised them very positively. In the present paper, we suggest that parents’ symbolic value of their children assuming upright comportment may explain why they perceive hands-free walkers positively and why they are so motivated to devote much time and effort to improving independent, walking-based mobility of their children.

Keywords:

• children
• mobility
• walker
• rehabilitation

Acknowledgements

We thank KidsAction Research (formerly The Easter Seal Research Institute) (Grant #9732), Ontario, Canada for funding various components of this research, and the Windsor Rotary Foundation which provided funding for the David Hart Walker Orthosis in the first year of the study. We greatly appreciate the funding support of both the Bloorview Research Institute for the analytic work specific to the qualitative data and the Bloorview Kids Foundation Chair in Childhood Disability Studies for manuscript preparation. Sincere thanks to the parents who agreed to be interviewed. Thanks are extended to Dr Denise Guerriere who assisted in designing the interview guide and conducted the interviews; to Greta Theobalds for transcribing the interviews; and to Judy Gargaro and Carol Blackwell who assisted with data entry and qualitative analysis of the interviews. Finally, we want to thank Jane-Anne Bradbury whose master’s thesis inspired this manuscript.

Notes

1. For the NF-Walker^™ see http://madeformovement.com/ (accessed September 16, 2011), and for the Canadian SMART Walker™ Orthosis see www.aodmobility.com/smart-walker (accessed September 16, 2011).

2. Manufactured by Walker UK Ltd, Keighley, West Yorkshire, UK. See http://davidhartclinic.co.uk/contact.html.