Stories The Magic of the Floating Frame March 19, 2018 by Amanda Blankley
A teenage boy using a gray Rifton Pacer gait trainer to walk.
Saad is a young man who just transitioned to our adult services from his school program in September 2017, and even though I try hard not to have favorites, Saad tests my resolve; he never fails to brighten my day. When Saad first arrived, he only had the wheelchair he came in. We put him in an old-style Rifton XL Pacer. Saad has cerebral palsy, involving a complex history with both his knees requiring...
PT/OT Intervening Early for Better Mobility in CP March 06, 2018 by Elena Noble, MPT
A young girl with cerebral palsy receives early intervention gait training services while walking in a pink Pacer.
I recently attended the annual American Physical Therapy Association Combined Sections Meeting (APTA CSM) in New Orleans. Among the wealth of great programming, I chose a course looking at early intervention for children with cerebral palsy (CP), and I’d like to share a few points I took away. For therapy purposes, early intervention means providing services to a child before two years of age...
Evidence Based Practice Don’t Be Afraid of Early Mobilization in Acute Brain Injury February 20, 2018 by Mary Beth Osborne, PT, DPT, NCS
A therapist helps a patient with brain injury in an early mobilization exercise in the ICU.
This article was originally written for Medbridge and is shared here with permission. People who suffer brain injuries require extensive medical care to preserve vital organ functions and prevent secondary injury. Physical therapists are in a unique position to positively influence the ultimate outcome for these individuals by simply providing early mobilization. Two studies provide support for early...
PT/OT Child-focused vs Context-focused Intervention February 13, 2018 by Carlo Vialu, PT, MBA
A young girl smiles as she sits in her activity chair in the cafeteria during her child-focused intervention curriculum.
In a fascinating research project, Law and colleagues set out to test the efficacy of context-focused intervention.¹ What is the context-focused approach? In this approach, the primary therapist (either an occupational or a physical therapist), works with the parents to identify tasks the child is interested in learning. The therapists assists to identify task and environmental modifications and...
Evidence Based Practice Evidence Update: Adding Resistance to BWSTT November 27, 2017 by Elena Noble, MPT
A close up of the legs of a young girl with cerebral palsy as she practices bwstt in the dynamic Pacer gait trainer.
Although integrated into pediatric clinical practice for the last decade, body weight supported treadmill training (BWSTT) continues to be an area of research interest and an evolving intervention. We can see this reflected in a recent study examining effective motor learning strategies for treadmill training. For children with disabilities, the treadmill is a safe place where they can organize their...
Evidence Based Practice Evidence Update: Dynamic Gait Training for Child with SCI October 17, 2017 by Elena Noble, MPT
A child with sci in a blue dynamic gait trainer smiles at his caregiver as he walks through the school hallway.
Because good clinical evidence on the benefits of gait training is so scarce, we celebrate every contribution we find. Here’s one that specifically explores the effect of dynamic gait training on a child with a spinal cord injury. After sustaining a complete T10 spinal cord injury (SCI) at 23 months old, this child began a walking program six months later. She initially started with a posterior...
Stories In Praise of the Athlete August 25, 2017 by Elena Noble, MPT
Johnny Agar cheers as he is pushed in an all-terrain stroller by his dad while training for the Kona Ironman.
Johnny Agar never considered himself an athlete. Born with cerebral palsy, he used a wheelchair, depended on others to care for him and took his first steps—23 total—at 11 years old. But sports was always part of his life—after all his dad had been a pitcher for the Detroit Tigers. But father and son did not bond on the baseball diamond. Inspired by My Team Triumph, a program where able...
Evidence Based Practice Improving Gait in Chronic TBI with Motor Learning Strategies July 25, 2017 by Elena Noble, MPT
tbi gait rehab
Long-term disability is a frequent sequel of traumatic brain injury (TBI) and takes the form of persisting motor impairments that impact walking and autonomous movement. So to improve environmental negotiation and basic care skills, independent gait is an essential therapy goal for TBI patients.    Literature shows that the best time for independent gait recovery occurs within the first few...
PT/OT Busting that Persistent Myth about Adaptive Bikes and Recreation July 18, 2017 by Codi Andersen, DPT
A young boy in a blue shirt and shorts rides on a green adaptive bike as his therapist helps to push him for functional mobility exercise.
I love the adaptive tricycle and the opportunities it affords many of my students. But how often have insurance companies denied requests for adaptive tricycles because they only see the recreational purpose? For my students with the most severe disabilities, the tricycle is a life-saver, and often the only piece of adaptive equipment that will help them achieve functional gains and participation. I&rsquo...
Evidence Based Practice Evidence Update: Dynamic Seating for Children with Autism May 30, 2017 by Elena Noble, MPT
dynamic seating children autism
Teachers and therapists working in inclusive classrooms continue to work to improve academic outcomes for students with autism spectrum disorder (ASD).  One fascinating area of inquiry is seating modification to improve in-seat performance, as students may need to sit for five hours during a normal school day. In one recent article on the topic, researchers examined how dynamic seating options...
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