stroller for EI (Full Version)

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Lilli Egan -> stroller for EI (April 7, 2005 10:56:00 PM)

I am ordering a stroller for a 24 month old who has CP. It looks like he's going to have spastic quadruplegic or possibly athetoid CP. His tone is high, mainly extensor tone. He has not been officially diagnosed yet, and his family have not yet accepted that he has a disability. I am looking for a wheelchair that looks as much like a stroller as possible, but reduces his trunk to hip angle to break up that tone and provides him with lateral trunk support. Right now I've narrowed it down to two choices - the Special Tomato MPS push chair or the Columbia tilting stroller. Does any one have any experience with either of these strollers? Does anybody have any other suggestions?



gerry -> Re: stroller for EI (April 8, 2005 3:53:00 AM)

Hi Lilli,

You could also investigate the Kid Kart from Sunrise Medical. I don't have any direct experience with the 2 you mentioned, although I'm familiar with them.

I know there are a lot of considerations involved. I would urge you to remember growth possibilities. Depending on the payment source you will be using, it may be difficult/impossible to obtain funding for another chair for years. We have had problems with children outgrowing the growth available in the Kid Kart very quickly. I know this is difficult to discuss with the family, particularly if they do not think their child will need a chair for very long.

Did the family initiate the request for a chair? Good Luck!



Lilli Egan -> Re: stroller for EI (April 10, 2005 12:38:00 AM)

The funding source wants 4 - 5 years of growth so they're pushing for the Convaid Rodeo or Safari both of those chairs are huge and look like wheelchairs. I started the chair request. The family thinks it's fine to put him in a regular stroller, belt him in, and throw his legs over the snack tray so that he slides down sideways. This position does prevent him from extending his hips and arching his back but it's terrible for his back and legs and all he sees is the stroller canopy. I've tried using blanket rolls and swimmming pool noodles to position him in the stroller but those things keep getting "lost".



Andrew M. Ball PT PhD -> Re: stroller for EI (April 10, 2005 12:40:00 PM)

For a kid who appears to have athetoid CP, whose family is in denial, I'd definately go with a KidKart. It looks like a stroller, offers (in my opinion) better (or at least as good) seating support than either the Convaid or Safari. As you imply, however, that's beside the point.

A perfect chair that's never used because it's either too "medical looking" or too cumbersome is always the wrong choice versus a nearly perfect seating system that is actually used. In my experience, I have to be hard talked out of a Kid Kart because I like the seating system, it looks like a regular stroller, and it's easy to collapse.

A regular stoller is not "fine" and the family must be educated as to how the position you describe will contribue to further de-conditioning of core musculature and actually further delay neurodevelopment of sitting, standing, and walking, as a result.

Make sure that you have a good DME who is more than a little familiar with the Kid Kart, however. I've seen some great systems rendered significantly sub-optimal because a DME didn't fasten the butterfly harness correctly (for example, it should be anchored OVER THE SHOULDER and NOT OVER THE SEAT BACK because the latter disallows for normal scapulohumeral movement and limits the very functioning that the PT is trying to encourage by providing better core support).

Drew



gerry -> Re: stroller for EI (April 8, 2005 3:53:00 AM)

Hi Lilli,

You could also investigate the Kid Kart from Sunrise Medical. I don't have any direct experience with the 2 you mentioned, although I'm familiar with them.

I know there are a lot of considerations involved. I would urge you to remember growth possibilities. Depending on the payment source you will be using, it may be difficult/impossible to obtain funding for another chair for years. We have had problems with children outgrowing the growth available in the Kid Kart very quickly. I know this is difficult to discuss with the family, particularly if they do not think their child will need a chair for very long.

Did the family initiate the request for a chair? Good Luck!



Lilli Egan -> Re: stroller for EI (April 10, 2005 12:38:00 AM)

The funding source wants 4 - 5 years of growth so they're pushing for the Convaid Rodeo or Safari both of those chairs are huge and look like wheelchairs. I started the chair request. The family thinks it's fine to put him in a regular stroller, belt him in, and throw his legs over the snack tray so that he slides down sideways. This position does prevent him from extending his hips and arching his back but it's terrible for his back and legs and all he sees is the stroller canopy. I've tried using blanket rolls and swimmming pool noodles to position him in the stroller but those things keep getting "lost".



Andrew M. Ball PT PhD -> Re: stroller for EI (April 10, 2005 12:40:00 PM)

For a kid who appears to have athetoid CP, whose family is in denial, I'd definately go with a KidKart. It looks like a stroller, offers (in my opinion) better (or at least as good) seating support than either the Convaid or Safari. As you imply, however, that's beside the point.

A perfect chair that's never used because it's either too "medical looking" or too cumbersome is always the wrong choice versus a nearly perfect seating system that is actually used. In my experience, I have to be hard talked out of a Kid Kart because I like the seating system, it looks like a regular stroller, and it's easy to collapse.

A regular stoller is not "fine" and the family must be educated as to how the position you describe will contribue to further de-conditioning of core musculature and actually further delay neurodevelopment of sitting, standing, and walking, as a result.

Make sure that you have a good DME who is more than a little familiar with the Kid Kart, however. I've seen some great systems rendered significantly sub-optimal because a DME didn't fasten the butterfly harness correctly (for example, it should be anchored OVER THE SHOULDER and NOT OVER THE SEAT BACK because the latter disallows for normal scapulohumeral movement and limits the very functioning that the PT is trying to encourage by providing better core support).

Drew



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