INNOWALK


Experiences from two counties in Norway


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Experience so far has shown that Innowalk can improve or maintain endurance, stomach functioning and posture control. In addition, several users improved joint movement and for one user, Botox treatment was no longer indicated after the trial period ended.

Innowalk is a new aid for children with physical limitations who can benefit from inceased movement. On request by goverment department responsible for special aids for people with disabilities in Norway, the rehabilitation services in the two counties in Norwaytogether with EO Funktion, carried out a trial project with Innowalk.

The objective of the project was to defensibly show that it is possible to give assisted movement to children who have little or no ability to move on their own. At the same time, there was also a desire to record changes in the child related to increased movement and activity. The trial project is designed in collaboration with rehabilitation services in the two counties.

Method

The trial period was set at 4 weeks. The 5 children were chosen by rehabilitation services. During the trial, the children had to use Innowalk a minimum of 5 times per week, for a minimum of 30 minutes per day. The date, heart rate and length of time in movement was recorded. In addition, comments were written about each session.

It was desirable to record the heart rate, measured by a heart rate monitor, in order to evaluate the effect on endurance, seen in realation to Innowalk`s speed and the child`s own level of activity.

Stomach functioning, sleep pattern and presence of pain were systematically recorded before and during the trial period with a view to assess possible changes related to an increase in activity level. Specific functions, in accordance with individual goals, were videoed before and after the trial period in order to document possible changes.

The thigh and calf circumferences were measured before and after the trial peroid, along with recording of the joint movement and spasticity.

Both carer and theapist gave an overall evaluation of the child after the trial period. This overall evaluation included a description of how movement in Innowalk, in combination with the treatments already in place for the child, effected the child´s functioning and participation in relation to what was desirable to achieve with Innowalk during the trial period.

All measurements, tests and analyses were undertaken by a rehabilitation physiotherapist (local hospital) and physiotherapist from the local government agency.


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Facsimilie: Barnestafetten nr. 56 – 2009

Innowalk trial project

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INNOWALK AS AN AID FOR STIMULATION AND ACTIVATION


A summary of project experiences


NAV´s specialist unit for disability aids and facilities and the Norwegian Labour and Welfare Service, in collaboration with the disability aid centres (HMS) in Østfold, Vestfold and Telemark, the rehabilitation services (HABU) in Telemark and Vestfold, and the supplier EO Funktion, have summarised experiences recorded in the project period 2009 and 2010.


Objective

Innowalk is a motorised, multi-functional product offering sitting and standing functionality. It allows children with severe multiple disabilities to experience walking movements.

As Innowalk was a new aid, and the child was being moved without having any independent control over the device, the aim of the project was to:

  • Register the effect on the child (www.nav.no/Hjelpemidler search: survey form for Innowalk)
  • Assess the need to monitor the child and the aid

The specialist unit received feedback from 12 disability aid centres. EO Funktion conducted a user survey at the end of 2009 (Quest Back), achieving an 86% response rate. A total of 145 Innowalks were loaned out on trial, of which eight were returned. Every county was involved. A total of 83 children have NF-Walker too, while 62 only have Innowalk.

For information purposes the rehabilitation service in Vestfold, in collaboration with the dis ability aid centre in Vestfold and EO Funktion, is carrying out a project focusing on long-term effects (comletion date June 2012).


The summary has focused on:

  1. Requirements of and for the child when using Innowalk
  2. Guidelines
  3. Recorded effect

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Facsimilie: Letter from NAV disability aid centres [Hjelpemiddelsentraler, HMS]
The rehabilitation service in Østfold,
Vestfold and Telemark.

CASE 1

3 year old Girl, Rett Syndrome

Goals

Prevent joint contractures, Maintain upperbody stability, Maintain standing ability, Improve circulation, Improve Gastrointestinal function, Improve sleep pattern, Improve muscle strength

Status before trial

Motor function loss (no longer crawling), Moved from 4 point position to sitting position, Sat alone on small bench (under observation), Stand in an NF-Walker, Stood against a pillow with support on the knees, Used Sensory Dynamic Orthosis – full suit, Used Dynamic Ankle Foot Orthosis

Results

Improved Gastrointestinal function, Improved circulation, No improvements on sleep pattern, Walks with support of a person (Walking was not a goal), Uses supported walking for transfer, Sits alone on a small bench, Moves from sitting – standing – sitting position from a small bench with light support, Range of movement in joint – status quo, Redused stereotyped movements with her hands in Innowalk


CASE 2

13 year old Girl, CP, Spastic bilateral, GMFCS IV

Goals

Increase range of motion in knees and hips, Reduce spasticity, Improve digestion and prevent obstipation

Status before trial

Typical asymmetry, with windswept (turning) towards the right side, Corresponding curvature in the spine, Left hip was operated in 2007 because of hip dislocation, High risk for dislocation of the right hip (Reimers index 48% June 2010), Contracture in both knees, respectively 15 and 19 degrees, Highly distressed with obstipation, Problems with consuming enough fluid, After operation in 2007, lost her walking ability in the NF-Walker

Results

Innowalk corrects asymmetri in hips and upper body, Full stretch in knees is not possible because of pain, Reimer’s index  April 2011: Right hip:  39% (48% June 2010), Improved Gastrointential function, Walks in NF-Walker just after using the Innowalk (This was not a goal), Improvement of bone density was registrated on ordinary x-ray (This was not a goal)

CASE 3

4,5 year old Boy
CP, spastic bilateral, GMFCS V

Goals

Improve Gastrointentional function, Improve range of motion in legs, Maintain or improve position of the hips

Status before trial

No head control, No voluntary movements, Very spastic, Problems with digestion, Percutaneous Endoscopic Gastrostomy (PEG) from aug. 2008, Uses Continues Positive Airway Pressure (Slime mobilization), Subluxation of the hips respectively 50% and 45%

Results

Improved digestion, Bilateral hip surgery carried out after one year, Improved head control (Was not a goal), Relaxed after training in the Innowalk, Good slime mobilizing effect (Was not a goal), Pleased and satisfied in the Innowalk


CASE 4

9,5 year old Boy
Acquired Brain injury

Goals

Improve head and upper body control, Improve Gastrointentional function, Prevent development of misalignments, Improve leg muscle strength

Status before trial

Severe brain injury after trauma, 100% need of nursing, Little independent movement/mobility, Spastic, No head control

Results

After 4 months neck collar can be removed in the Innowalk, Control of head for shorter periods of time, After 12 months, head support changed to i2i without chin support (Stealth product), Control of head for several minutes, Improved Gastrointentional function, Range of motion Status Quo, Muscle strength is not possible to measure, Improved arousal (This was not a goal)


CASE 5

Physiotherapeutic justification of the Innowalk treatment of

XXXX , DOB 23/03/1997

Dear Colleagues,
We report on the abovementioned patient, who received inpatient treatment at our facility from 21/09 to 18/11/2011.

Diagnoses:
ICP of spastic tetraparesic type

Hip dysplasia with decentration of the right hip joint with increasing pain and adduction contracture.

Orthopaedic therapies:
Angulation osteotomy with head-neck resection of the right hip joint with angular stability plate
implantation and post-operative application of a hip-leg cast on 24/08/2011.

1. Reason for the rehabilitation measure
2. The above mentioned operation of the right hip joint had become necessary because XX suffered significant adduction
contracture pain and loss of function. The goal of a procedure of this kind is to preserve the patient’s sitting ability and therefore
participation in the social environment. The intention of the rehabilitation was to bring XX back to changing positions without
pain and a build-up of tension – he was supposed to achieve sitting ability for a day-to-day relevant period of time and become able
actively to assist, to a minor extent, in transitional movements.

Download PDF to read the whole letter


CASE 6

Physiotherapeutic evaluation

XXXX , DOB 04/01/2003

Diagnosis according to the prescription: Central muscular hypotonia

Combined development disorder / complex malformation syndrome

Therapy according to the prescription: Physiotherapy-CNS-children

(according to Bobath Vojta)

Physiotherapeutic evaluation for the prescription of the Innowalk therapeutic device

XX is an eight year old boy who has been coming to my surgery for therapy since June of 2003. He is being treated with the
Bobath and Vojta methods, with input from SI therapy. XX is also regularly treated with manual therapy, as he presents with
recurring blockages over the entire spine.Because of hemiparesis on the right hand side, XX presents a distinct tone asymmetry,
which constitutes an impairment especially in connection with changes in position. XX is dominated by hypotonia in his torso,
and he finds it very difficult to overcome gravity. His head/neck area is also hypotonic, which also becomes evident in a strongly
diminished eye-hand coordination and the dominance of early childhood reactions.

Download PDF to read the whole letter


CASE 7

INNOWALK-PRO in XXXXXXX, 29/05/2012 – 08/06/2012

XXXX , DOB 21/04/2004

29/05/2012 + 04/06/2012:
XX came to the Innowalk-Pro trial accompanied by his mother. Ms XX reports that XX had already tested the device
twice some time ago. At present, on the Posterior Walker XX demonstrates an alternating, small step, outward rotated gait
with increased knee flexion and a forward inclination of the torso. XX appears very interested and motivated to try out the
Innowalk Pro. As compared to the Posterior Walker, in the Innowalk Pro XX is increasingly able actively to straighten his torso,
and knee extension is also easier in this device. The leg axis positions during the motion processes are highly satisfactory.
However, a greater range of movement would be desirable in the knee flexion area, which is however currently not yet supported
by the device. XX is well able to coordinate the additional use of his arms. His stamina and endurance are good, so that he is
easily able to perform two 15 minute sessions.

Download PDF to read the whole letter 

Infographics

infographics

Testimonials

 

«My client uses the Innowalk at school. With the Innowalk, my client can train and stretch his legs,
and at the same study and learn at school.»

- Physical Therapist

 

«I have a disease called Proteus Syndrome, and it is quite progressed. After I turned 12 I began to move less and less,
and I completely stopped walking and moving by the time I turned 15/16 years old. I noticed I became more and more stiff.
In May of 2008, I had to amputate my left leg just over my knee. I was able to move to the bed and sofa with a wheelchair,
but it was difficult and I pulled my muscles a lot. Before I was amputated, I saw the Innowalk on TV and I thought to myself right
away that I wanted to have one of those! I asked my therapist if we could apply for one. At first she said no, but luckily she agreed in the end.
Now I use the Innowalk anywhere from 20 to 80 minutes almost every day. I’ve noticed that I have become stronger and it’s much easier
for me to move around. I almost never pull my muscles anymore! I am very satisfied with the Innowalk!»

- User

 

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«
Our 4 year old girl has enjoyed using both the Innowalk and the NF-Walker. After she received the Innowalk,
she has actually started to move her legs by herself in the NF-Walker. Now she is more physically active.»

- Physical Therapist


«
We chose the Innowalk because it gives the closest “normal walking” training as possible, and it’s so easy!
The movement is the closest to being anatomically correct, which is invaluable for children who are trying to build themselves
back up after an injury. It is an especially fantastic tool for us therapists who use the Normal Movement principals. Training to stand
is often passive for children in this group. Innowalk is active, and that’s what I as a therapist want to see more of. Also, it’s fun to use,
and that means an increased motivation to train with it. There is only ONE thing that I would change about it: That it would come in
larger sizes for taller children! Some children are already 170cm tall by the time they are 13 years old….and the last time I was testing
the Innowalk, I asked about this. I’m not sure if you have looked further into this matter, but I hope you do! Remember that
training and activity aids are granted (by the state) until the age of 26!»

- Occupational Therapist

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