Dynamic Standing Exercise Using the Innowalk Device in Patients with Genetic and Acquired Motor Impairments

For individuals with motor impairments, dynamic standing has been proposed as an opportunity for regular daily physical activity. Records of 46 patients (50% cerebral palsy; 50% diverse syndromes) were evaluated. Improvements were found for: passive assisted motion (79%), stimulation of intestinal functions (71%), body stability (64%), joint mobility (56%), secure means of allowing supine position (52%), and revision of abnormal motion patterns (48%).

Product: Innowalk
Ana Pekanovic, Walter Strobl, Ulrich Hafkemeyer, Jens Kleine, Peter Bernius, Rolf Burghardt, Caroline Schmidt-Lucke


Dynamic Standing Exercise in a Novel Assistive Device Compared with Standard Care for Children with Cerebral Palsy Who Are Non-Ambulant, with Regard to Quality of Life and Cost-Effectiveness

Dynamic standing using the Innowalk was the preferred alternative from the family perspective, as it had lower costs and greater benefits than the standard care of static standing. Additional factors that may affect family preferences towards DyS or StS need to be investigated. From both a healthcare and a societal perspective, DyS was better but more costly than StS. If the value of a one-unit change in quality of life as measured in the CPCHILD score is considered to be above €100, DyS can be considered to be cost-effective. These findings may contribute to the development of individualized standing recommendations.

Product: Innowalk
Katarina Lauruschkus, Johan Jarl, Katharina Fasth Gillstedt and Åsa B. Tornberg.


Acute Response to One Bout of Dynamic Standing Exercise on Blood Glucose and Blood Lactate Among Children and Adolescents With Cerebral Palsy Who are Nonambulant

The main finding of this exercise study is that 42% (n = 10) had mild hyperlactatemia at rest, and one participant had blood lactate levels corresponding to metabolic acidosis (Figure 1). However, the most important finding was that the children and adolescents with the highest levels of lactate at rest had the most positive effect of exercise on lowering the lactate levels after only one bout of dynamic standing (Innowalk). Moreover, the higher GMFCS-E&R levels seem to elevate resting levels of blood lactate.

Product: Innowalk
Petra Lundstöm, Katarina Lauruschkus, Åsa Andersson, Åsa B. Tornberg


Electromechanical and Robotic Devices for Gait and Balance Rehabilitation of Children with Neurological Disability: A Systematic Review

In the last two decades, a growing interest has been focused on gait and balance robot assisted rehabilitation in children with neurological disabilities. Robotic devices allow the implementation of intensive, task-specific training fostering functional recovery and neuroplasticity phenomena. This systematic review aims to provide an overview of the existing literature on robotic systems for the rehabilitation of gait and balance in children with neurological disabilities and their rehabilitation applications.

Product: Innowalk Pro
Valè et al.


Early mobilization of a patient with acquired brain injury using a new standing aid, the Innowalk Pro. A single subject experimental design

Early mobilization is regarded as important in patients with severe acquired brain injury. The Innowalk Pro was in a singled-subject experimental study considered as a feasible and motivating intervention. Heart rate tended to decrease during Innowalk Pro training, while the blood pressure remained stable.

Product: Innowalk Pro
Alhed Piene Wesche, Liv Inger Strand, Vivien Jørgensen, Arve Opheim & Ellen Høyer


Non-ambulatory children with cerebral palsy: effects of four months of static and dynamic standing exercise on passive range of motion and spasticity in the hip

Aim of the study was to compare the effects of static standing (StS) versus dynamic standing (DyS) on passiv range of motion (PROM) and spasticity in the the hip. Twenty non-ambulatory children with CP participated in an exercise intervention study with a crossover design. Thirty minutes of DyS increased PROM and spasticity and four months of DyS increased PROM in the hip.

Product: Innowalk
Åsa B. Tornberg, Katarina Lauruschkus


Effect of assisted walking-movement in patients with genetic and acquired neuromuscular disorders with the motorised Innowalk device: an international case study meta-analysis

Raw data of nine studies were pooled including a total of 31 patients observed between 2009 and 2017. A total of 94% used the Innowalk in a home-based or day-care setting. For nearly all individuals (94%), improvements were recorded for: walking or weight-bearing transfer (n = 13), control/strength of the trunk or head (n = 6), joint mobility (n = 14), sleep (n = 4 out of 6/67%), or muscle strength (n = 17), vital functions (n = 16), bowel function (n = 10), attention/orientation (n = 2). PROM of the hip (flexion, abduction, and adduction) significantly (p < 0.001 for multiple comparisons) increased after 1 month (p < 0.05 flexion, adduction) and further after 5 months (p < 0.05 each) in contrast (p < 0.05 each) to a control group with state-of-the-art therapy.

Product: Innowalk
Caroline Schmidt-Lucke, Jana Käferle, Britt-Marie Rydh Berner, Lotta Ahlborg, Hege Marie Hansen, Ulrika Skjellvik Tollefsen, Tonje Thon, Rikke Damkjær Moen, Ana Pekanovic, Åsa B. Tornberg, Katarina Lauruschkus


Effects of robotic rehabilitation on walking and balance in pediatric patients with hemiparetic cerebral palsy

This prospective, controlled study included 24 children with hCP. All children attended to a standard physiotherapy rehabilitation (PTR) program (three days a week for 12 weeks); those in the study group (n=12) also attended to an Robotic Gait Training (RGT) program three times a week. The evaluations were similar for both groups before treatment. After treatment, walking speed, endurance and peripheral O2 saturation were increased and balance abilities and functional performances improved in the RGT group as compared with the pre-treatment evaluations; these improvements in balance and functional performance were generally preserved after 3 months of treatment. An increase in 6-min walking distance and a partial increase in gross motor functions and functional muscle strength were observed in the control group; however, these abilities were not preserved after the treatment.

Product: Innowalk
Yazıcı M, Livanelioğlu A, Gücüyener K, Tekin L, Sümer E, Yakut Y.


Factors Associated with Enhanced Gross Motor Progress in Children with Cerebral Palsy: A Register-Based Study

Intensive training was associatedd with enhanced gross motor progress over an average of 2.9 years in children with CP.

Gunfrid V. Størvold, Reidun B. Jahnsen, Kari Anne I. Evensen, Ulla K. Romild, Grete H. Bratberg


Electromechanical‐assisted training for walking after stroke

People who receive electromechanical-assisted gait training in combination with physiotherapy after stroke are more likely to achieve independent walking than people who receive gait training without these devices. Specifically, people in the first three months after stroke and those who are not able to walk seem to benefit most from this type of intervention.

Jan Mehrholz, Simone Thomas, Cordula Werner, Joachim Kugler, Marcus Pohl, Bernhard Elsner


Exercise interventions for cerebral palsy

For children with CP, there is evidence that aerobic exercise may result in a small improvement in gross motor function, though it does not improve gait speed.

Ryan JM., Cassidy EE., Noorduyn SG., O'Connell NE.


Parents’ experience of participation in physical activities for children with cerebral alsy – protecting and pushing towards independence

How do parents of children with cerebral palsy (CP) experience their child's participation in physical activities and to identify facilitators and barriers for being physically active and reducing sedentary behaviour?

Lauruschkus K., Nordmark E. & Hallström I.


Participation in physical activities for children with cerebral palsy: feasibility and effectiveness of physical activity on prescription

The aim of this study was to evaluate the feasibility of PAP for children with CP and its effectiveness on participation in physical activity and sedentary behaviour.

Katarina Lauruschkus, Inger Hallström, Lena Westbom, Åsa Tornberg and Eva Nordmark


Effect of weight bearing exercise to improve bone mineral density in children with cerebral palsy: a meta-analysis

Weight bearing exercise has a significant effect on improving BMD of the femur in children with CP.

Kim SJ., Kim SN, Yang YN., Lee IS, Koh SE.


Early mobilization by locomotion therapy following minimally invasive multi-level surgery for children and young adults with cerebral palsy

Product: Innowalk
Strobl, W.M., Senghaas, P., Schuseil, J. & Kollaschinski, M.


Exercise and physical activity recommendations for people with cerebral palsy

Verschuren, O., Peterson, M.D., Balemans, A.D.J. & Hurvitz, E.A.


Chronic Conditions in Adults with Cerebral palsy

We examined estimates of chronic conditions in a population-representative sample of adults with CP.

Mark D.Peterson, Jennifer M.Ruan, Edward A.Huvitx and Elham Mahmoudi


It’s fun, but …Children with cerebral palsy and their experiences of participation in physical activities.

Lauruschkus, K., Nordmark, E. & Hallström, I.


Health-related physical fitness for children with cerebral palsy

Maltais, D.B., Wiart, L., Fowler, E., Verschuren, O. & Damiano, D. L.


Muscle activation and energy-requirements for varying postures in children and adolescents with cerebral palsy

Verschuren, O., Peterson, M.D., Leferink, S. & Darrah, J.


A systematic review of interventions for children with Cerebral Palsy: state of the evidence

The aim of this study was to describe systematically the best available intervention evidence for children with cerebral palsy.

Novak I., McIntyre S., Morgan C., Campbell L., Dark L., Morton N., Stumbles E., Wilson SA., Goldsmith S.


Systematic review and evidence-based clinical recommendations for dosing of pediatric supported standing programs.

Standing programs 5 days per week positively affect bone mineral density (60 to 90 min/d); hip stability (60 min/d in 30° to 60° of total bilateral hip abduction); range of motion of hip, knee, and ankle (45 to 60 min/d); and spasticity (30 to 45 min/d).

Paleg, G.S., Smith, B.A. & Glickman, L.B.


Physical activity in a total population of children and adolescents with cerebral palsy

The aims of this study were to describe the participation in physical activity of children with cerebral palsy (CP) at school and during leisure time and to identify characteristics associated with physical activity.

Lauruschkus K., Westbom L., Hallström I., Wagner P., Nordmark E.


Effects of passive versus dynamic loading interventions on bone health in children who are nonambulatory.

Dynamic standing demonstrated the potential of moderate-magnitude, low-frequency loading to increase cortical BMD. Further investigations could provide insight into the mechanisms of bone health induced through loading interventions.

Damcott M., Blochlinger S., Foulds R.


Fractures in children with cerebral palsy: a total population study

Analyse factors associated with fractures in children with cerebral palsy (CP) in different levels of Gross Motor Function Classification System (GMFCS).

Ulrike Uddenfeldt Wort, Eva Nordmark, Philippe Wagner, Henrik Duppe and Lena Westbom.


Can a six-week exercise intervention improve gross motor function for non-ambulant children with cerebral palsy?

A pilot randomized controlled trial.

Bryant, E., Pountney, T., Williams, H. & Edelman, N.


Health-Enhancing Physical Activity in Children With Cerebral Palsy: More of the Same Is Not Enough

Verschuren, O., Darrah, J., Novak, I., Ketelaar, M. & Wiart,L.


Differences in habitual physical activity levels of young people with cerebral palsy and their typically developing peers: a systematic review.

Carlon, S.L., Taylor, N.F., Dodd, K.J. & Shields, N.


Physical activity in a total population of children and adolescents with cerebral palsy.

Lauruschkus, K., Westbom, L., Hallström, I., Wagner, P. & Nordmark, E.


A systematic review of supported standing programs

Glickman, L.B., Geigle, P.R. & Paleg, G.S.


Physical activity in young children with cerebral palsy

Zwier, J.N., Schie, P.E., Becher, J.G., Smits, D., Gorter, J.W. & Dallmeijer, A.J.


The Effects of the Norsk Funktion-Walking Orthosis on the Walking Ability of Children With Cerebral Palsy and Severe Gait Impairment

Product: NF-Walker
Kuenzle, C. & Brunner, R.


Contribution of stepping while standing to function and secondary conditions among children with cerebral palsy

Product: NF-Walker
Eisenberg, S., Zuk, L., Carmeli, E. & Katz-Leurer, M.


Quantifying weight bearing while in passive standers and a comparison of standers

Kecskemethy, H.H., Herman, D., May, R., Paul, K., Bachrach, S.J. & Henderson RC.


Exercise Programs for Children with Cerebral Palsy: A Systematic Review of the Literature

Verschuren, O., Ketelaar, M., Takken, T., Helders, P.J.M. & Gorter, J. W.


Quantifying weight bearing by children with cerebral palsy while in passive standers

Herman, D., May, R., Vogel, L., Johnson, J. & Henderson, RC.


Promotion of Physical Fitness and Prevention of Secondary Conditions for Children With Cerebral Palsy

Section on Pediatrics Research Summit Proceedings

Fowler, E.G., Kolobe, T.H.A., Damiano, D.L., Thorpe, D.E., Morgan, D.W., Brunstrom, J.E., Coster, W.J., Henderson, R.C., Pitetti, K.H., Rimmer, J.H., Rose, J. & Stevenson, R.D.


Evaluation of the longer-term use of the David Hart Walker Orthosisby children with cerebral palsy: a 3-year prospective evaluation.


Product: NF-Walker
Wright, F.V. & Jutai, J.W.


Heart rate and heart rate variability parameters at rest, during activity and passive standing among children with cerebral palsy GMFCS IV-V.

Israeli-Mendlovic, H., Mendlovic, J. & Katz-Leurer, M.


Effects of a Dynamic Versus a Static Prone Stander on Bone Mineral Density and Behavior in Four Children with Severe Cerebral Palsy

Gudjonsdottir, B. & Stemmons Mercer V.