PAEDIATRICS/MOBILITY
Equipment
Equipment
CLIENT:
8-year-old Male
Motoring With My Classmates
CONDITION:
Cerebral Palsy,
Spastic Diplegia
Debra Kennedy, BScOT(c)
CASE HISTORY: Mark is an eight-year-old boy with cerebral palsy. He lives with both of his parents and teenage brother. Mark
likes to be physically active. He uses forearm crutches or a rollator and a manual wheelchair for mobility. He wears ankle-foot
orthoses (AFO’s) bilaterally. His favourite activities involve using his home computer, listening to audiotaped stories and being outdoors.
Mark attends his community school and is in a special education program. Mark’s classmates have varying degrees of mobility. When Mark entered school in September 1995 he was ambulatory using the rollator walker and, with physiotherapy gait training, he progressed to using forearm crutches in December 1996.
CLINICAL CONSIDERATIONS: In April 1997, Mark’s gait began to deteriorate. Mark was growing at a tremendous rate and
muscle shortening appeared to be inhibiting his gait. Mark has been followed closely by his orthopedic surgeon and conservative
interventions have been planned until Mark’s growth spurt finished.
Mark has become frustrated by his difficulties with mobility. He is becoming reluctant to assist with transfers or pursue walking. His class has gym time daily and the time is used to expand everyone’s gross motor abilities. With Mark’s reduced abilities in
walking and standing, his choices for activities were becoming severely limited.
TREATMENT/APPROACH: Mark’s school had ongoing consultation available from an occupational therapist in the employ of
the school board. As a result of ongoing contact, it was apparent that Mark needed an alternative form of mobility to maintain an
optimum level of gross motor functioning and to maintain his motivation to be mobile. The York Region District School Board
Regional Special Education Support Services maintained a limited equipment pool for loan to community schools. An adapted tricycle, the TMX cycle, was loaned to Mark’s school. Mark was thrilled at the sight of the tricycle. Minor adjustments were needed
to accommodate Mark’s size. He took to riding immediately. With practice he has become skilled with steering and maneuvering
the tricycle through doorways in the school. He has been motivated to assist with transfers to get on and off the tricycle. Further,
Mark’s sitting posture is excellent while on the tricycle. He sits with good trunk extension and his pelvis in neutral while on the
TMX cycle.
OUTCOME: Mark’s interest in gross motor skills and his muscle strength is being maintained during this time when it is difficult
for him to be walking. He is happy about his abilities on the TMX Cycle. Mark’s family recognizes the benefits of this device beyond
its therapeutic applications and are investigating purchasing an adapted tricycle for use at home.
EQUIPMENT: TMX cycle.
ACKNOWLEDGEMENTS:
Mark Sloan and his
family, Motion
Specialties, Barrie;
York Region District
School Board
Publication supported by a grant from Motion Specialties Inc.
COTF CASE STUDY REVIEW
ABOUT THE AUTHOR:
Debra Kennedy,
BScOT(c), is with the
York Region District
School Board and
holds a Status
Appointment with the
University of Toronto.