Prosthetic Gait Training for a Three-Year-Old Quadrimembral Traumatic Amputee
ROBERTA O'SHEA, PT AND MARCIA SCHWARZ, OTR/L*
Joseph is a 3-year-old quadrimembral amputee who lost his limbs as a result of vasculitis from bacterial meningitis. He has bilateral short above-knee, right long below-elbow, and left short below-elbow amputations. We saw him after he had progressed from stubbies to height-appropriate lower-limb prostheses. He was non-weight-bearing on them. First, a Kaye posture walker was modified so he could grasp it; we turned the walker backwards, enabling him to ambulate independently. After 3 weeks, bilateral forearm crutches were introduced. On the first training session, Joseph needed hands-on guiding for crutch placement and sequencing. After two therapy sessions, he could ambulate with the crutches and transfer from sitting to standing independently. We are now encouraging ambulation with one crutch and will then attempt to progress to unassisted gait. He is competent in upper-limb function, and can assist with dressing himself.
*LaRabida Children's Hospital and Research Center, East 65th Street at Lake Michigan, Chicago, IL 60649