Provision of Aids
- Standing frames
- Prone stander
- Aki seat
- Corner seats
- Wheelchair adaptations
We use standing frames for children who need help to stand firmly on two feet. Research shows that it is an advantage for children to stand for several reasons:
- Psychologically it is good for the children. It gives them a sense of being like other children, tall and more grown up. It also frees the hands for play or activities.
- A prolonged stretch of the calf muscles in standing helps to maintain the muscle length. This means at least 30 to 40mins a day, twice a day.
- Taking full weight through the heel and not the toes helps to promote better standing and hip development, as long the alignment between hips and feet is good.
- Physiologically standing is good for kidney and lung function.
- Our standing frames are simple and cheap to custom make. They are safe and easy for parents to use. They are designed to copy the effects of a commercial standing frame but at a fraction of the cost. We can therefore afford to give them to children for home use free of charge.
- We give just enough support to the child to allow for safe standing but with the opportunity to develop upper body postural abilities and strength.
- Some children cannot immediately maintain a fully upright position so we can incline the stander and so give them more support. This is called a prone stander.
- The perspective the child views the world from is entirely different when they sit than when they are reclined or lying. Imagine spending most of your life lying down, how hard it is to see what everyone is doing.
- It is harder to eat and swallow and to learn to communicate when lying down.
- The lungs do not expand as much, deep breathes are more difficult, coughing is more difficult. Many children with CP get repeated chest infections, sitting up helps to improve respiratory function.
- Sitting makes it easier for the child to bring their hands forward in front of them. It helps them see them more easily and therefore try to reach for things.
- A child who is sitting with everyone else is more likely to be included in activities than one who is lying down.
- • Trollies allow for safe, independent development of mobility for the very young child.
- • Preparing them for later use of crutches or a wheelchair by active strengthening of upper limbs.
- • The trollies are a fun piece of equipment envied by their peers and so increasing self esteem. (Rules given to parents are to make sure this is for the exclusive use of the child we have given it to and not their brothers and sisters! So the special child feels very special.)
At AKi we don’t use tilt tables.
At AKi we have a variety of Seating Solutions that allow children to sit comfortably. We give special chairs if children have poor balance in sitting, if they are weak or if they have a tendency to have tight legs and hips that prevent them from maintaining sitting on their own.
Our chairs are designed to promote a good position that reduces the tightness in the legs and allows for some active practise for the muscles that are used in sitting. Some chairs give more support to the child who is too weak to hold their head up or who has floppiness in their trunk muscles.
The advantages of sitting instead of lying on a bed, floor or charpoy, or being held in mother’s lap, are:
At AKi we have a variety of mobility aids that we make ourselves. Again we use commercially available designs but modify them and manufacture them in-house for a fraction of the cost. We can afford then to offer them for home use for all children who will benefit from them.
Our Trollies, usually prescribed for our Spina Bifida children, have been a great success. These allow children as young as one year old to benefit from independently and actively exploring their environment without damaging their legs. Spina Bifida children have the ability to pull themselves around using their hands but because they cannot feel their skin or legs then they often injury themselves severely with no pain. Our trollies have the following advantages:
Many children with CP will learn to walk, sometimes with some help of walking frames or sticks. There are some children though who can only walk short distances indoors or who cannot walk at all. For these children we make adaptations wheelchairs. Pakistan does not manufacture its own wheelchairs for children. We buy small imported Chinese wheelchairs for our children. These wheelchairs are not ready to give the children the correct position or posture to help them be active in their chair. Often they have to have support systems designed by our staff to fit the chair to the child. We are also given 100 special chairs and wheelchairs each year from a charity Motivation UK, we dispense xxxxxxxxxxxxxxxxx last year. Again we supply these free of charge.
Two of our staff have travelled to Nepal to attend a World Health Organisation training course for wheelchair provision for children with postural deficits.
There are numerous small aids that we use with a variety of purposes to help with our aims for each child. We are constantly updating our equipment designs as children show us what works the best. New designs come from close cooperation between the clinicians and the appliance officers. These two men started with us as carpenters but now are very much more. They offer practical solutions and help design efficient and functional aids. They work closely beside the clinicians when we are deciding what will help the child the best.