Load Experienced While Using a Stander in Children With Cerebral Palsy

Non-ambulatory children with a neuromuscular disability are at significant risk for poor
bone health as reflected by low bone mineral density (BMD) and increased propensity to
fracture. In large part, this is due to abnormally low levels of load experienced by the
skeleton. A common approach for increasing BMD is to stimulate the musculoskeletal system by
increasing the amount and duration of weight-bearing in the lower extremities. For
non-ambulatory individuals, this typically takes the form of using an assisted standing
device to enable the child to spend time in a standing position so that their lower limbs
can experience some degree of body weight. Some of these physical interventions result in
varying degrees of improvement in BMD, and some do not. This lack of clarity in outcomes may
result from a failure to objectively measure the magnitude and duration of the load
experienced by the lower extremities. A lack of change in BMD may be due to the extremities
experiencing only a fraction of the body weight due to load-sharing with the assistive
device, or to an inadequate duration of standing time. The goal of this project will be to
design and validate a force-measuring platform that will measure the magnitude and duration
of the load experienced by the lower extremities of individuals with a neuromuscular
disability who use a stationary assisted standing device to increase their BMD.

Inclusion Criteria:

1. < 18 years old

2. Diagnosed with Cerebral Palsy (CP)

3. Treated at Gillette Children's Specialty Healthcare

4. Gross Motor Function Classification System level of IV or V (non-ambulatory without
assistance)

5. Participating in a standing program using a stationary assisted standing device

6. Parent/Guardian willing and able to give consent

Exclusion Criteria: