Adaptation and Clinical Feasibility of Powered Mobile Stander Toys for Children with Motor Delays( I )

Background and Purpose: A lack of adapted powered mobile stander toys for children with movement disorders, including cerebral palsy (CP) in clinical settings, despite there is evidence-based recommendations for effective dosing of pediatric supported standing programs by using stander for preventing deterioration of musculoskeletal system for children with CP, as well as “early” power mobility experience for promoting independent mobility, social relationships and engagement in meaningful life experiences. Passive participation in standing for young children can be barriers for the optimal development of cognitive functions and visual perception. The “early” power mobility in sitting, such as powered wheelchair, was fun for young children, but cannot address their needs for promoting bony density in supported standing. Therefore, an innovative powered mobile stander toys will be implemented with the intention to promote active environmental exploration for young children. The purpose of this preliminary study will be to evaluate the safety, tolerability, and efficacy of adapted powered mobile stander toys in a sample of children with CP and explore the probable differences of the postural alignments between using the unilateral and the bimanual access devices to drive this powered stander. Methods: The study consisted of 3 phases. In the first phase, a powered toy car will be adapted with a supportive standing frame for young children. In the second phase, the first powered mobile stander toy will be remodified according to the pilot test for 10 young children with CP. The impact of unilateral or the bimanual access will be determined by the postural alignments assessment. In the third phase, clinical effectiveness will be examined by a randomized control trial (RCT) of 30 children aged 12-24 months with CP whom will practice either powered mobile stander or traditional stander at home for three months under supervision by parents. The primary outcome measurements for their physical condition will include Quality of Upper Extremity Skills Test (QUEST), Peabody Developmental Motor Scales- Second Edition (PDMS-2), Modified Sitting Forward Reach, and Gross Motor Function Measure (GMFM-88). The primary outcome measurements for their psychological condition will be Dimensions of Mastery Questionnaire (DMQ). In addition, the Goal Attainment Scale (GAS) will also be used for comparisons. Self-made parental satisfaction questionnaire will be used in this study to collect the caregivers’ opinion regarding to this training. Bone density measurements will be measured by dual X-ray absorptiometry (DXA) and a pediatric contact ultrasound bone analyzer. Analysis will follow standard principles for RCT, using two-group comparisons on all participants on an intention-to-treat basis. Discussion: This proposed study outlines the theoretical basis, study hypotheses and outcome measures for the 'child-friendly' powered mobile stander toys training to improve outcomes across the ICF.

Project ID:PC10703-0071
External Project ID:MOST106-2218-E182-002