Recommendations for Mobility in Children with Spinal Cord Injury

Top Spinal Cord Inj Rehabil, 2013 · DOI: 10.1310/sci1902-142 · Published: January 1, 2013

Spinal Cord Injury Assistive Technology Pediatrics

Simple Explanation

Mobility is a crucial aspect of rehabilitation for children with spinal cord injuries, impacting their development and overall quality of life. It goes beyond just walking, encompassing movement in various settings like home, school, and the community. The type of mobility needed varies based on the child's age and the severity of their neurological impairment. Options range from bed mobility and transfers to using wheelchairs or other devices for movement at home and in the community. As children grow, their mobility needs change, requiring periodic re-evaluations and adjustments to their assistive devices. Anticipatory guidance should be provided to children and their parents regarding potential needs and alternatives.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Level 5: Expert Opinion, Literature Review

Key Findings

1
Power wheelchairs offer various drive wheel configurations (front, mid, rear) to suit different terrains and maneuverability needs.
2
Manual wheelchairs come in rigid or folding frames, each with its own advantages and disadvantages regarding weight, durability, and adjustability.
3
Upright mobility can be facilitated through various orthotics (AFOs, KAFOs, HKAFOs, RGOs) and functional electrical stimulation (FES) systems, depending on the child's strength and functional abilities.

Research Summary

This article provides recommendations for selecting appropriate mobility options for children with spinal cord injury (SCI), considering medical necessity, neurological level, ASIA Impairment Scale score, and developmental factors. Mobility is crucial for the proper development of children, influencing cognitive, social, and communication skills, as well as participation in various activities. Clinicians caring for children with SCI should address mobility comprehensively and longitudinally across all environments, regularly re-evaluating and adjusting assistive devices as the child grows and develops.

Practical Implications

Customized Wheelchair Configuration

Healthcare providers should focus on customizing wheelchairs to meet the unique needs of each child with SCI, optimizing factors like seat support and axle positioning.

Early Power Mobility Training

Early introduction of power mobility training, even in infants and toddlers, can promote psychosocial development and independence.

Comprehensive Mobility Planning

Mobility plans must consider not only medical necessity but also the child's developmental stage, community involvement, and access to therapy.

Study Limitations

1
Lack of specific age-related guidelines for initiating power mobility training.
2
Limited discussion on the psychosocial impact of different mobility options.
3
Scarcity of research comparing the effectiveness of various orthotic devices in pediatric SCI patients.

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