Harnessing Participation: Use of a Novel Body Weight Support System in an Early Childhood Education Classroom Megan Craft, SPT; Morgan Duren, SPT; Brennan Lashbrook, SPT; Anna Prickel, SPT; Maggie Thomason, SPT; Danielle Schulte, PT Faculty Mentor: Kendra Gagnon, PT, Ph.D.
Background & Purpose : Body-weight support systems (BWSS) have been part of PT practice for some time. However, they are often housed in medical facilities and limited to walking over a treadmill, which may affect dosing, freedom of exploratory movement, and natural social opportunities. The purpose of this case study was to investigate the effects of a “real world” BWSS used during daily routines in an early childhood education classroom for a child with visual and mobility impairments.
Case Description : The participant was a 4-year-old child diagnosed with Desmoplastic Infantile Ganglioglioma at six months old resulting in surgery with subsequent brain injury, seizures, and visual impairment. He presented with motor function equivalent to Gross Motor Function Classification System level 4. A 10-foot-by-10-foot BWSS with adjustable harness was placed in the child’s classroom for 12 weeks to assess the feasibility of a classroom-based BWSS and to determine its effect on motor performance and social interaction.
Outcomes : The education team was trained to use the BWSS with a recommended dosage of 60 minutes per day. The Gross Motor Function Measure (GMFM), daily documentation, caregiver/teacher surveys, and video analysis were used to measure daily use, motor performance, social interaction, and teacher/caregiver satisfaction with the BWSS during the 12-week trial. Daily documentation was collected for 29 of 46 total school days. Missing data were attributed to absence, child unable to use BWSS while waiting on new orthotics, or caregivers did not complete daily note. The child used the BWSS for a mean of 32 minutes per day. Video analysis revealed increased variability of movement in the BWSS over time. At week 1, the child stood 95% of coded intervals in the BWSS with an adult touching the child 100% of the time. At week 6, he stood 50% of coded intervals, but also demonstrated sitting (25%), kneeling (22%) and squatting (2%). An adult was touching the child for 16% of the coded intervals. At 12 weeks, walking movements emerged during 2% of coded intervals and there was no adult touching the child or the BWSS for 67% of coded intervals. In the BWSS, GMFM scores increased 6 points in dimension D (standing) and 16 points in dimension E (walking) during the trial period. No change in GMFM scores were noted out of the BWSS. Caregivers agreed or strongly agreed that they were satisfied with the BWSS, it was easy to use, and resulted in increased function and peer interaction.
Discussion : The outcomes of this case study suggest that the BWSS is feasible to use in an early childhood classroom with high teacher/caregiver satisfaction. A mean dosage of 32 minutes per school day resulted in increased variability of movement, improved motor performance, and decreased physical assistance from a caregiver. Future research is needed to determine whether improvements can be sustained or carried over to environments outside of the BWSS, and to discover strategies to support increased use of a BWSS in a classroom setting.
Acknowledgements: The research team would like to thank Variety Children’s Charity of Kansas City, The Children’s Center for the Visually Impaired, and Enliten LLC for their support of this work. We would also like to acknowledge Jacob Bothell for his work assisting with capturing and processing video footage.