Cerebral Palsy & Mobility

ORTHOTIC DEVICES

Orthotic devices are external braces that offer stability and support for children diagnosed with cerebral palsy. A child may use a temporary orthotic device to support a specific developmental period, or the child may use a permanent orthotic device for help with standing, walking, or range of motion. Your physician may also recommend orthotic devices to help supplement larger mobility devices.

Orthotic devices may help with any of the following conditions:

• Hip or knee dislocation
• Spasticity
• Fallen arch
• Abnormally high arch
• Inward (inversion) angled foot
• Outward (eversion) angled foot

Orthotic devices are customized for your child. These devices can consist of a combination of rigid and soft materials, including plastic, rubber, carbon fiber, or leather. Orthopedic specialists, physical therapists (PT), and occupational therapists (OT) can also provide guidance to help your child get the most out of the device. These specialists and therapists might recommend any of the following common orthotics:

• Foot Orthotics – Custom shoes or inserts that help provide support, alignment, and balance
• Ankle-Foot Orthotics (AFOs) – L-shaped semi-rigid braces that provide support and stabilization for the foot, ankle, and lower leg
• Knee Orthotics – Provide support, stabilization, and alignment for the knees
• Hip-Knee-Ankle-Foot Orthotics – Provide support, alignment, and balance for the lower body
• Spinal Orthotics – Braces that assist with sitting or standing in children with limited trunk stability
• Knee-Ankle Orthotics – Long-leg orthosis that spans the knee and ankle to stabilize the joints and support muscles in the leg

WALKERS, STICKS, CANES & CRUTCHES

Walkers

Walkers provide firm support and stability to help children with cerebral palsy move more independently. These mobility devices can come with or without wheels. The most common types of walkers include the following:

• Two-Wheeled Posture Rest Walker – This mobility device features four posts that provide stability. Two of the posts have wheels, and the other two posts have rubber tips. This device assists with ambulatory pace and control. Some varieties come with a seat or resting bench for walking breaks at any time.
• Four-Wheeled Posture Control Walker – Often designed for toddlers and young children, this device provides stability and speed for various activities.
• Chest-support walker – This walker provides chest-level support for balance and bearing while standing or walking.
• Gait trainers – These walkers provide greater clearance for walking and remain adjustable to accommodate the child’s height.
• Suspension walker – This device helps children improve coordination and hold themselves upright with greater agility. Suspension walkers are often beginner devices before the child moves on to gait trainers
• Knee walker – This device provides stability or support for children with knee, hip, ankle, or foot problems.

Walking Sticks or Canes

Some children diagnosed with CP use walking sticks or canes to provide stability or help bear down on their weight. Walking sticks or canes are among the most versatile mobility devices due to their portability and accessibility for indoor and outdoor use. There are three common types of canes for developing children:

• Folding cane – These adjustable canes fold into two or three components, making them perfect for portability or part-time use.
• Offset cane – These canes feature an additional bend in the shaft, thereby providing more stability and natural motion.
• Quad cane – These canes feature a long shaft with four points of contact at the base, thereby providing sturdy support for standing or walking.

Crutches

Children who can walk but need extra support may benefit from crutches. There are two common types of mobility crutches:

• Underarm Crutches – These mobility aids closely resemble the familiar crutches that patients receive after a leg injury. The crutch fits neatly beneath the armpit and can be used singularly or in pairs.
• Forearm crutches – A forearm crutch features a strap or collar that wraps around the child’s forearm. Great for assistive walking or steering, this short crutch remains attached to the arm even if the child needs to let go of the handle for any reason.

STANDERS & LIFTS

Standers

Your child’s physical therapist or CP specialist may also recommend a stander to increase strength, stability, and personal independence. Standers allow children to maintain an upright position and encourage use of limbs and lower extremities (particularly the hips and hamstrings). These mobility aids can also help children engage with their surroundings and environment. Using a stander can help the child practice motor control and recognize more of their capabilities. Some of the most common standers include the following:

• Prone Stander – This front stander allows the child to lean forward for increased stability.
• Supine Stander – This stander provides support from the back. It holds the child upright or angled slightly toward the rear, and it is often customized with trays or accessories for functionality. This is one of the most recommended standers for people with limited head control.
• Sit-to-Stand Stander – This mobility device helps children with muscle weakness move from sitting to standing positions with greater ease.
• Mobile Stander – This mobility device uses large wells to help push or propel the child in any direction. Mobile standers work best for children with good head control and upper-body strength.

Lifts

Lifts either help children with CP support their own weight or help therapists and caregivers make transfers between devices or locations. There are four primary types of lifts:

• Stair Lift – Typically installed on home or therapy staircases to help the child move without needing to climb stairs
• Transfer Lift – Known colloquially as the Hoyer lift, it provides hydraulic assistance to move the child into various settings
• Ceiling Lift – Permanently installed ceiling tracks that help the child move about without assistance
• Sit-to-Stand Lifts – Helps children move from seated to standing position with ease

WHEELCHAIRS & SCOOTERS

Wheelchairs and Scooters

This category includes manual wheelchairs, electric wheelchairs, and power scooters. These mobility aids are often highly customizable to accommodate leg requirements, height and width proportions, seat cushioning, battery options, and drive capabilities. Most manufacturers can consistently modify the wheelchair and accessories based on the child’s abilities.