Technology Can Be a Powerful Tool in Assessing Children with Mobility Issues
Children who experience challenges with mobility require a comprehensive physical therapy evaluation and a thorough treatment plan to ensure their needs are adequately met. Technology is critical in making sure that these children get the right treatment at the right time.
Often, children who have been diagnosed with cerebral palsy, spina bifida, seizure disorders, developmental delays or brain tumors, can experience mobility issues that make it difficult for them to get around. This can seriously impact the quality of their lives including participation in school and community activities.
Thankfully, physical therapy and rehabilitation can help these children to manage their conditions and improve their mobility. The first step in developing a treatment plan is to assess a child and to pinpoint his or her particular mobility needs. That means assessing for functional limitations and working with the family to develop a plan of care to allow the child to better access the environment and ultimately, achieve independence.
The assessment process is vital, but with many children, especially those with developmental challenges, the assessment process can be difficult due to limited attention, decreased understanding, or patients who are very young and unable to follow certain directions. Often, physical therapists must use unique methods, including games and play, to ensure that we get the information we need to provide the right treatment.
Technology can help.
Video can be a powerful tool in assessing children with mobility issues. Having a video record of a child’s gait, or walking pattern, when they enter therapy is extremely useful later on because it provides a means of comparison. For example, comparing gait before and after braces are prescribed can show us if there is improvement and the degree of improvement. Video is helpful in looking at a young patient’s progress over time and is something that most clinics can afford to add to their practices. We encourage families to record areas the child is having difficulty with during their day to day life in order to adequately problem solve solutions. For example, “Coach’s Eye App” is a video analysis app that records the movement and then allows the therapist to play back and evaluate the movement. You can slow down the movements and annotate. Other programs on smart phones include applications with goniometers to assess range of motion or posture from a photo.
Computerized assessment devices for gait and balance can also provide a wealth of information when evaluating children with mobility issues. Electronic walkway systems, for example, measure spatial and temporal gait parameters. As the patient walks across the walkway, the system captures the geometry and the relative arrangement of each step. This gives concrete information regarding step and stride lengths, pressure mapping of each footprint, foot progression angles and speed parameters. In addition to sensored walkways, electrodes can be placed on the muscles to track timing the muscle is working for better understanding of the needs within each step of the pattern.
Technology advances daily and now the incorporation of robotics or “dynamic” response can track shifts in weight or movements. One physical therapy intervention studied in adults, and now children, is the use of body-weight support (BWS) technologies to assist in improvements in body structure, function, activity and participation.
Good Shepherd uses technology to assess children with mobility issues.