Cruisin' into 2021
London Edmondson and Thor Sage, both age 1, aren’t yet walking on their own, but they’re already driving.
London and Thor are among Children's Mercy patients with mobility impairments who are benefiting from the “Explorer Mini,” a little power chair that facilitates self-initiated movement and early exploration.
The chair is being used in therapy sessions with older babies in the Neonatal Intensive Care Unit (NICU) and other hospital units to provide kiddos their first experience of moving themselves.
“The babies we have tried it with so far absolutely love it,” said Abby Blair, PT, DPT, Physical Therapist. “They quickly put together how to drive it forward to see their favorite nurse, reach for a familiar toy, be nosy with a neighbor or make Mom and Dad smile.”
Abby added, “Those babies are being passively moved a lot; they get out of their bed or to the floor by a nurse; they’re held by volunteers or put in different positions by therapists. But they’re never in a spot where they can move themselves whether it’s because they’re developmentally delayed or they don’t have the motivation. When they’re in this device, they’re safe, secure and learn to move.”
The Explorer Mini has a joystick with a bright yellow ball handle 18 inches from the patient’s face; it allows for grasp and release, creating cause and effect so the child can quickly learn forward, backward and turning in circles. An adjustable saddle seat secures the child without a seatbelt; they are standing in the device, which allows weight-bearing positions for proper hip development and opportunities to improve strength, endurance and postural control. It has five speed options, maxing out at 1.5 mph.
London, born at 25 weeks gestation, has Bronchopulmonary dysplasia (BPD), a breathing disorder that develops as a result of a newborn’s lungs not developing fully due to prematurity. She has been at Children's Mercy nearly a year and is on a ventilator via a tracheostomy, but that doesn’t prevent her from enjoying her therapy sessions in the Explorer Mini. Staff members are able to adapt her connections so that she has a space of 6-7 feet in which to maneuver.
“London was 9 months old when she first used the Explorer Mini,” said her mother, Charlette. “When her therapist prompted her to place her hands on the joystick there was some uncertainty. But London began to explore her environment with one movement of the joystick. Her eyes brightened with interest at discovering the device can help her control and move in her environment. London was clearly having mobility issues, but now she’s engaging more since using the Explorer Mini device. I enjoyed watching London be a kid for once, and that’s a moment I’ll always cherish. Her experience with the Explorer Mini has been astounding to observe and made a difference in her life.”
Thor's parents say he loves driving the Explorer Mini and they believe the equipment is helping him make great progress.
Thor’s parents, Ashley and Kevin Sage, said, “Thor was born at 26 weeks and has been through so much, including ECMO (a treatment used to circulate blood through an artificial lung back into the bloodstream) before getting a trach. He loves driving the Explorer Mini and has so much fun with it! We appreciate his therapy team using this equipment and feel he is making great progress.”
Laura Brite, OTR.L, CNT, Occupational Therapist, notes that therapy sessions with the Explorer Mini attract a crowd of staff members to watch the fun and discovery as patients develop their first sensations of independent movement.
Abby led the effort to obtain an Explorer Mini for the hospital after attending a symposium where the device was demonstrated.
“It’s marketed for 1- to 3-year-olds, but in a therapy setting we can use it for younger kids,” she said. “My thought was that this could provide more variety in their therapy sessions. NICU babies are essentially growing up within the walls of our hospital. It’s not uncommon for them to be there from birth to 18 months old, which is a really long time to be stuck in the same bed space. And with prematurity being the leading cause of their admission to the NICU, they are already at risk for delayed gross motor, fine motor and language skills. Then you add the lack of environmental exploration due to always being passively moved in their designated bed space. So, in reality, these kids are missing out on learning how to move by themselves and they need new experiences to bring excitement, challenge and exploration.”
Abby made a pitch for the Explorer Mini, and Dr. Ann Modrcin, Director-Division of Rehabilitation, agreed that the equipment would be beneficial, so Rehabilitation Medicine purchased the unit for use throughout the hospital.
Abby and Speech Pathologist Jessica Weight are conducting research designed to evaluate and document the benefits of the Explorer Mini.
“We’re doing developmental tests on these kids, looking at their gross motor, fine motor and language skills,” Abby said. “We’re comparing their scores with data collected before we had this piece of equipment to see what differences there are in their overall development. We hope to wrap up our testing in June so that by this fall we can release the results.”