Integration of Armeo Spring Pediatrics in inpatient Rehabilitation of children and adolescents with Hemiparesis
Aims: Examination of practicability and training effect of Armeo® Spring Pediatric (ASP) as a part of the rehabilitation of hand and arm function of children with hemiparesis (HP). Evaluation of possibilties to integrate ASP in the therapeutic setting.
Methods: 22 patients (age: 5–23 years) with congenital or acquired HP (n=20) or unilateral accentuated tetraparesis (n=2). Besides occupational therapy and physiotherapy every child practiced computer games of different difficulty levels on the ASP with an average frequency of 12 sessions (average duration 16min of practice) for a training periode of 5 to 114 days. A weight alleviation of the arm allows recruitment of residual available motoric activity. An Augmented Feedback motivates patients to train different muscles. At the beginning and in the end of the training period the hand- and arm function was tested (e.g. AHA, Jebson-Taylor) and 21 of 22 children passed standardised assessments to document the progress of the therapy.
Results: Mechanical adjustment of the device proved to be somewhat problematic concerning adaptation to the infant anatomy. The difficulty level of the training could be adjusted individually to the child's abilities. Complications or abruption of therapy did not occur. Children and parents showed high motivation concerning the training with ASP. After 4 weeks motivation decreased. The execution time of the same assessment improved in average by 13s at the the end of the training period compared to the results in the beginning.
Conclusion: Further child-friendly adjustment of the device would make sense. The use of ASP demands thorough instruction of the therapists. Motivation of patients concerning ASP is high. Therapy sequences of approx. 12 sessions seem to be promising concerning outcome and motivation. Device internal evaluation instruments indicate the outcome of the therapy. To transfer functional improvements to daily routine the embedding of ASP into an integrative therapy seems to be precondition.