August 2016

Click on image to Download the complete supplement in its original form PDF

Click on image to Download the complete supplement in its original form PDF

Editor Message

emily-delzell-196x198A new normal

When parent magazine LER first covered the idea that pushing kids with mobility impairments toward a “normal” gait—both in therapy and in their lives—could have both positive and negative consequences, I instinctively got it. (See, “The value of walking in children with CP: A matter of perception,” LER, January 2013, page 14.)

That’s because my closest friend’s 8-year-old daughter, who was adopted from China and has several physical and emotional issues, had just announced she was done with therapy and doctors forever. She said, “I know I’m broken, but I’m tired of being fixed.” She was refusing therapy for convergence insufficiency, in which the eyes don’t work together well during near vision and which can seriously impede one’s ability to read and learn.

Since first bringing her home, my friend had taken her to more than a dozen doctors and therapists, most of whom had helped her child make great strides. But the child had also absorbed a message: The things that are wrong with me are bad, and so am I.

This dynamic can leave both parents and practitioners unsure of the best way to deliver needed care, including gait therapy. Our story in this issue, “Improving gait without making kids feel ‘broken,’” page 11, provides some lower-extremity specific context and advice. One of the experts interviewed, Paul Jordan, DPM, emphasizes that he cares much less about normal gait than about kids being able to do the things they want to do.

He encourages them to try whatever activity inspires them. He notes, “They don’t care if they do an activity differently, they just want to do it.”

Last night I read about Matt Stutzman, who will soon compete in the Paralympics in Rio. Stutzman, born without arms and known as the “armless archer,” won a silver medal in the 2012 Paralympics. He aims and releases the bow in a complex series of moves involving his jaw and feet—and with incredible accuracy.

His mom noted on his web page, “Our family strategy was to allow Matt the freedom to try almost anything if he could accomplish it under his own steam.”

These are attitudes that could change the future of kids with gait impairments.

By Emily Delzell, Senior Editor

News


Bilateral long-jump practice ups takeoff leg performance

Benefits persist 3 weeks after training – Bilateral practice should be established early in youth long-jump training programs to improve the jumping performance of their dominant (takeoff) leg, according to research from Karlsruhe, Germany, that may have implications for other track and field events.

By Katie Bell

Surgery beats conservative care for first-time kneecap dislocations

Less recurrence, better sports outcomes – Adolescent patients with first-time acute patellar dislocations treated surgically have a lower risk for recurrent dislocation and higher knee-related quality of life and sports-related outcomes compared with those managed…

By Greg Gargiulo

Whole body vibration boosts speed, stride length in toe-walkers

Most improvements are transient – The findings of a recent Australian study add to early evidence in support of whole body vibration (WBV) as a potentially simple, noninvasive treatment for children with idiopathic toe walking (ITW), with mechanisms still to be worked out.

By Larry Hand

Features


Improving gait without making kids feel ‘broken’

A normal gait is often the goal for children with neuromuscular disorders and mobility impairments, but research suggests this may come at the price of children’s positive self-identity. These issues are leading some practitioners toward more holistic, family-centered approaches to walking.

By Brigid Galloway

Patellofemoral pain in children and teens

Pediatric patellofemoral pain hasn’t historically received much research attention. Recently some experts have said it can have a long-term negative impact. New research suggests some basic solutions to the common yet often overlooked problem that can cause kids to drop out of sports.

By Lori Roniger