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When Upsee isn’t right

Katie is a seven year old girl with an undiagnosed orthopedic disorder and unidentified seizure disorder. She is dependent for all areas of ADLs, mobility, and classroom transitions. She utilizes a wheelchair for her primary mobility, but can ambulate with total support. She also uses a prone stander, in class, during the day. She has prescribed AFOs.

Clinical Background

Katie has a very vague medical history. She has an unidentified seizure disorder and has had a lot of medical and genetic tests that have only ruled out diagnoses, not ruling in anything. Her previous Individualized Education Plan (IEP) listed developmental delay as her primary exceptionality. However, in the more recent years, this has changed to “Orthopedically Impaired.” Her current goal is: “Given moderate support, and her weight shifted for her from side-to- side, Katie will walk forward 18 feet, 3 times a week for 5 weeks.” Katie receives no outside Physical Therapy services at this time.

Our Approach

Upsee first came to the attention of Katie’s school-based physical therapist through social media. The school district purchased one to offer a way of gait training and upright standing for Katie, to help her meet her educationally relevant goals. Therapy sessions consisted of; simple standing at a table, upper extremity activities/exercises and gait training within her classroom setting.

The Result

Despite Katie enjoying being out of her wheelchair and being upright, she does not like ambulating or having someone “move” her body for her, therefore the Upsee was not appropriate for her. Katie experiences significant involuntary and non-purposeful voluntary movement of her lower extremities which makes it difficult for her to tolerate keeping her feet in the sandals. However, keeping her feet out of the sandals would provide no ability for the adult to give any tactile cuing to take steps.

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