Monday, May 19, 2008
Speaking of Joseph and his mobility
I've been meaning for awhile to post about Joseph's new long leg braces. They aren't all that new anymore, actually. I think this set arrived shortly after Christmas. You might remember that his old set of braces were very non-mechanical. The hope was that he could use the trace muscle control in his hips to move his legs forward without any mechanical assistance. Joseph made off-and-on forward progress with that set of braces. Last September when I posted a video of Joseph in those braces was pretty much the peak of his ability with those. He was also outgrowing that set so we met with his doctor and therapist to think about other options. We decided to go with a Reciprocating Gait Orthotic (RGO). (If you follow that link, note that Joseph has the isocentric design). The RGO is mainly different in that there is a joint on the back, pictured here:
The joint automatically swings the left leg back when the right leg moves forwards and vice versa. This means that Joseph can more or less just lean to one side and the mechanical motion gives him a lot of help advancing. This brace also lacks the "moon boot" design of the old set. These have a molded plastic piece that fits inside his shoes and attaches to metal pieces on the side of his leg. Joseph has lightweight ankle braces he wears all day long when he's not in his RGO so this is just the same thing all in one piece.
There is still a steep learning curve. We are very far from taking this brace out to use in public but Joseph can get across the room fairly easily using his walker. It's very wide and has a large, slow turning radius so it isn't all that much fun for him but he's usually willing to try it out for a few minutes.
Shannon, his therapist, also has Joseph working on walking with crutches. The crutches were actually Joseph's idea several months ago. He saw a kid at the hospital using crutches and wanted to try it himself. Typically, kids don't start with crutches until at least age five but Shannon wanted to go with Joseph's interests and she brought him some. Joseph was doing such a fantastic job with them this morning that I was able to snap these pictures. All he is actually doing here is standing unsupported but that is a huge milestone for him. Obviously the crutches are much less stable than a walker with four wheels and a wide base. Every little movement throws off his balance. But he did it. He stood for several minutes on his own this morning. He can walk around using the crutches if he gets a lot of assistance.
Progress is slow, but mostly steady. It is unlikely that Joseph will ever use braces and crutches for everyday mobility but they are very valuable as a therapeutic tool and he may find that he likes them better for around the house or around a workplace in the future. And they provide a lot of entertainment for Margaret who wants to be just like her big brother.