Cerebral palsy (CP) equipment and orthotics (orthoses) refer to products offering positioning, mobility and/or alignment support. When looking at equipment and supportive devices it is important that the family and medical team understand the goals for the child and the needs of the caregiver.
Common Cerebral Palsy Equipment and Orthotics (orthoses)
Durable medical equipment (DME) is a term commonly used to describe the equipment ordered by a healthcare provider for every day or extended use. It includes devices such as wheelchairs, walkers, standers, bathing chairs and orthotics. Orthotics or orthoses are devices that are used to help prevent foot and ankle deformities, improve stability during walking and sometimes to relieve pain. They may also help prevent or delay surgery. Some examples of orthoses include shoe inserts, ankle braces, ankle-foot orthotics (AFOs) and even trunk orthoses.
- Assistive Technology Devices- Anything that helps the person with cerebral palsy achieve daily tasks and/or goals, such as speech boards, hearing aides, adaptive eating utensils, and even electronics, such as iPads, or other tablets, to help with communication or educational purposes.
- Crutches/Canes- Forearm crutches, walking sticks, hand canes and other types of crutches/canes can assist persons with cerebral palsy with mobility, walking around their home, or out in their community, when a wheelchair or walker is not needed but extra stability is still necessary.
- Splints- Hand splints may be used to help people with cerebral palsy improve their hand function, especially with grasping things.
- Standers- Standers are used to provide support for standing and offer individuals the experience and freedom of using their hands while in an upright position. Standing is important for bone and muscle development and peer interaction.
- Walkers- Children and adults with cerebral palsy who can walk but need something more than forearm crutches or a cane, may use a walker to give them the added support that makes independence possible. They may use a walker for short distances and use a wheelchair for longer distances.
- Wheelchairs- Power and manual wheelchairs can give people with cerebral palsy a mobility option for navigating the world when walking isn’t possible or becomes too painful.
- Ankle Foot Orthoses (AFOs)- Different types of braces worn on the foot, coming up to just below the knee, that are built from different materials, helping support the foot, ankle, help with arch support, aide walking and more.
- Supra-Malleolar Orthoses (SMOs): Typically an insert placed inside the shoe that braces the foot and heel bone and comes up just over the ankle.
What to Consider When Looking at Equipment for Cerebral Palsy
Look at each equipment option as part of your child or adult loved one, helping them to access their environment, be with their peers, and support their independence. Equipment will give them a chance to experience life and explore on their own. For example, children of walking age should be up at the same level as their peers which opens up a sense of equality and opportunities for exploration.
Mobility equipment like walkers, wheelchairs and standers are offered in different sizes. A ‘fitting session’ may be needed to ensure comfort, alignment and proper positioning. There are many types of equipment and manufactures on the market and your therapy team and equipment vendors can help in deciding the best ones for your child.
There are also options to help with personal care such as bathing. The goal is to give as much independence and comfort as possible. Hand rails or grab bars for the bathroom may be found at home improvement stores or also ordered through your DME. Attachments for the toilet, bathing chairs and lifts to fit most bathrooms, are also available.
Adaptive bicycles, jogging strollers and beach wheelchairs are recreational equipment options that are available but insurance may not provide coverage for these options. There are organizations and nonprofits that may help with these purchases.
Transportation options are available and can help the transfer process of getting in and out of your vehicle. Transporting a person with cerebral palsy as they grow can become hard, maybe at times painful for them and the person lifting and carrying them. Car seats that swivel, portable ramps and transport vans are things to consider as solutions. Electronic lifts may also be added to a vehicle (either inside or on the exterior) for wheelchair transport.
There are many types of orthoses including ankle, foot and hip which are used to encourage proper alignment. Ankle/Foot Orthoses (AFO’s) help with stability, ankle placement, walking, gait pattern, and bone development. They are regularly used among people with cerebral palsy. A prescription is necessary along with a referral to a podiatrist or orthotist who will create a cast of the foot/leg . The cast will either be sent away for development, or the AFO will be made in office.
Assistive Technology (AT)
Assistive technology services can open up many possibilities for people with CP. It can allow the person to engage in life by supporting communication, education, and better physical access to the world.
Some examples of assistive technology include:
- Environmental Control Switches (to control the doors, lights, tv or toys)
- Adapted Keyboards and Mice
- Visual Aids
- Books in Audio
Assistive technology provides the support that allows an individual to complete their intended action that their body may not be able to achieve or achieve easily. AT services can be provided by a variety of service professionals including speech therapists, vision professionals, physical therapists, occupational therapists, and teachers.
If you’re unsure of which equipment to purchase you can request to ‘test out’ equipment. Many facilities, such as physical therapy offices, have lending closets for you to test different types of equipment over several days and in different settings. You, or your therapist, may also have your equipment vendor bring in demonstration models to test. Take your time choosing equipment. Many items are expensive investments that will be used for a long period of time. It is important to test equipment to make sure that it has all the benefits you are looking for, that your child is ready for it, and comfortable using it to get the full benefit.
Agencies Providing Support/Emergency Funds to Families
- Jack’s Helping Hand-California
- Helping From Heaven-Illinois
- Children With Special Needs Fund-Michigan
- The Cerebral Palsy Outreach Network-Michigan
- Share A Smile-Michigan
- Catastrophic Illness in Children Relief Fund Commission-New Jersey *medical expenses only
- Ten Doves-Texas
- Mumsnet: London, England
The information on cerebral palsy equipment and orthotics (orthoses) appears in our free and downloadable cerebral palsy tool kit.