Purpose: The purpose of this case study and evidence based literature analysis is to determine the gross motor benefits to and feasibility of early independent power mobility on children with mobility impairments. Background: For children 3 years old and under, with mobility limitations, power mobility devices are not currently available. Having independent mobility has been linked to improvements in cognition, socialization, language and motor development. Supplying children with mobility impairments with early adaptive power mobility could improve overall functioning in later life. Case Description: Subject is a wonderful, loving 3 year old boy with spastic cerebral palsy. He started physical and occupational therapy 2 years ago after a referral from his pediatrician. Developmentally, the subject has the gross motor skills comparable to a 4 month old child, demonstrating emerging ability to roll to and from supine to prone, and does not have access to his environment. The subject is receiving a battery powered car modified for accessibility to provide independent mobility, which he has never experienced before. He will continue with physical therapy POC focusing on postural control, core stabilization, contracture prevention, management of tone, muscular strength and endurance training, and motor control training with an new dimension of independent mobility. The car will be modified by pediatric physical therapists who are experts on the musculoskeletal system and inspected by an electrical engineer. Outcomes: A review of current literature highlighted the lack of research that has been done in this area. The current level of evidence is not sufficient in answering the PICO question of "Are functional and developmental gross motor improvements made when the intervention of early independent power mobility is implemented into a plan of care of a child with functional mobility impairments?" The evidence does not show statistically significant data for improvements in gross motor skills; however, generalizable improvements in overall development are seen. Discussion: The results of this review, are inconclusive as to what gross motor skills are improved or affected when independent power mobility is implemented into a plan of care, however, they support the thought that this intervention has a positive effect on overall development. Of the 8 studies there was limited and variable evidence for the benefits of power mobility interventions in children with mobility impairments. The majority of the studies found that functional mobility was improved and general development progressed, however, the effects of early independent power mobility on gross motor development have not been determined. More research needs to be done in this field of physical therapy as implementing the use of independent mobility experiences into a plan of care has the potential to benefit the overall development of the child.
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Cerebral Palsy; Muscle Strength; Occupational Therapy
Winnegar, Shawna. "Functional and Developmental Gross Motor Benefits of Independent Adaptive Power Mobility Training for Children with Mobility Impairments." (2016). http://digitalrepository.unm.edu/dpt/22