METHOD AND APPARATUS TO EXERCISE DEVELOPMENTALLY DELAYED OR
NEUROLOGICALLY IMPAIRED PERSONS FIELD OF THE INVENTION
The present invention relates to methods and devices to promote ambulation in developmentally disabled persons, especially children, or neurologically impaired persons. BACKGROUND OF THE INVENTION
The invention relates to a method and apparatus used to help developmentally delayed children exercise specific muscle groups, practice movement strategies and gain strength necessary to sit, to crawl, and to walk.
The prior art is replete with assistive devices . A sampling of the patents in this field is as follows. US Patent Nos. of 1,642,184 of Urso and 3,721,436 of Barthel, Jr. describe exercise and walker devices that support an individual in a harness and permits movements over a two- dimensional area and up and down adjustments. However in Urso and Barthel, Jr. '436, the harnesses only hold the person in an upright position, which does not assist the person in quadruped, crawling positions, which are necessary to strengthen arm development and to facilitate vestibular development for better balance, thus preventing the child to easily tip over and injure itself.
US Patent No. 3,582,069 of Flick and Burke discloses a crawling assistive device that is a sled type with movable hand and knee pads operated by linkages. It does not describe a body suit or body suit, which can assist a developmentally disabled child from learning to master the quadruped, crawling position as well as transition therefrom to a myriad of other positions while facilitating vestibular development through wide range movement opportunities such as bouncing, rocking and spinning.
US Patent No. 3,992,023 of Moorer describes a crawling assistive device that is a sled on wheels. It also does not describe a body suit or harness which can assist a developmentally disabled child from learning to master the quadruped, crawling position as well as transition therefrom
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thereby restricting transition into alternative postures. In addition, the child's body is in close proximity to a rigid, supportive frame.
In contrast to the prior art devices, the present invention uses a body suit to carefully distribute the stresses placed upon the body by the supporting straps. In addition, multiple attachment points permit the straps to adjustably counteract gravity in such a manner as to assist a child in attaining sitting, standing and crawling postures. Along with a supporting frame and track, as provided in several of the prior art devices, exercise and conditioning is tailored to the developmentally delayed child.
OBJECTS OF THE INVENTION
It is therefore an object of the present invention to help developmentally delayed children exercise specific muscle groups, practice movement strategies and gain strength necessary to sit, to crawl, and to walk.
It is also an object of the present invention to help the developmentally delayed child to master the sitting position.
It is also an object of the present invention to provide an exercise device, which promotes a "righting" response that will cause a developmentally disabled child to assume an upright position. It is also an object of the present invention to develop a protective arm response in a developmentally disabled child in order to prevent the child from falling, and to maintain upright balance.
It is also an object of the present invention to provides a device, which promotes dynamic, wide range neck and trunk control exercise opportunities, which are essential and foundational to all other physical development.
It is also an object of the present invention to assist the person in quadruped, crawling positions. It is also an object of the present invention to strengthen arm development and to facilitate vestibular development for better balance.
It is also an object of the present invention to assist a developmentally disabled child from learning to master the quadruped, crawling position while facilitating vestibular development . It is also an object of the present invention to provide a frame-supported or manually supported body suit, which can safely assist a developmentally disabled child from learning to master the quadruped, crawling position.
It is yet also an object of the present invention to provide a hand-held supported body suit, which can also safely assist a developmentally disabled child from learning to master the quadruped, crawling position.
It is also an object of the present invention to promote quadruped, weight bearing activities in a developmentally disabled child.
It is also an object of the present invention to lift gravity off of the developmentally delayed child, thereby making it possible for the child to assume weight bearing positions that they would otherwise probably not be able to assume.
It is another object of the present invention to promote an upright standing posture and weight bearing through the legs in preparation to walk.
It is yet another object of the present invention to allow a therapist to modulate their therapeutic handling of a child and change positions with simple adjustments.
It is yet another object of the present invention to provide a device, which permits the disabled child to make movement choices and to positively interact with the environment .
It is yet another object of the present invention to enable developmentally delayed children to learn where they are in space in relation to other objects, to help them learn depth perception. It is yet another object of the present invention to enable a developmentally disabled child to ambulate safely.
It is yet another object of the present invention to provide a device that allows a developmentally delayed child
to exercise and to facilitate transition into several postural and ambulatory positions.
It is yet another object of the present invention to improve over the disadvantages of the prior art. SUMMARY OF THE INVENTION
In keeping with the aforementioned objects and others which may become apparent, the present invention relates to an exercise assistive device to help a developmentally developed person, such as a child, or a neurologically impaired person develop vestibular balance and muscle control, so that the child can learn to perform mobility activities, such as crawling, sitting upright, standing or walking.
Structurally, in a preferred embodiment, the device includes a support such as a hand-held hanger, a wall mounted frame, a ceiling mounted frame or a frame having a upstanding base legs with a connecting frame extending therebetween. In the frame embodiments, a body suit glidable support dolly is mounted upon the frame, and travels preferably longitudinally, transversely and rotationally thereupon. In alternate embodiments, the body suit may travel longitudinally, without transverse movements or without rotation. Moreover, the rotation can be temporarily disabled with a locking pin. The body suit is suspended from the suit glidable support dolly, or from a hand-held hanger.
Flexible connector straps are provided between the body suit and body suit support, such as the glidable support dolly or hand-held hanger and are made of a material such as reinforced fabric, elastic or canvas. These connector straps are positioned in spaced-apart relation to one another about the body suit glidable support dolly.
The body suit is suspended from the frame or hanger by the connector straps that extend between the body suit and fasteners attached to the glidable support dolly. Each connecting strap is connected to a respective fastener upon the body suit support at one end and to a further fastener upon the body suit.
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These connector straps are connected to the body suit support, such as, for example, to a hand-held support hanger which may be a frame or disk, or to a glidable support dolly, which is slidably movable back and forth in axial directions along a pair of primary tracks of the support track system. In the frame supported embodiment, the support dolly preferably includes wheels or rollers engagable with the respective primary tracks.
In an alternate embodiment, the support dolly comprises a further set of secondary tracks placed perpendicular to the axis of the primary tracks. In this embodiment, the dolly therefore includes a further dolly support which is movable along the secondary tracks, in opposite directions which are transverse to the axial direction of the primary tracks . Such configuration is similar to a gantry, which moves in three axes, namely front, back and sideways.
Furthermore, the primary dolly support tracks are supported by upright stanchions, or by arches. However, the dolly support tracks may be also supported by horizontally oriented wall-mounted brackets, or by vertically descending ceiling-mounted brackets.
In yet a further embodiment, an optional lockable rotating wheel attached to the glidable support dolly allows for rotational directional change while the dolly moves along the tracks .
Therefore, the present invention is a method and apparatus used to help developmentally delayed children exercise muscle groups necessary to sit, crawl (creep) and walk. This multi-functional therapeutic device comprises a body suit with an overhead suspension system. The body suit is custom fit to each child. It includes fasteners on suit, which allow for position change. The overhead system includes either hand-held supports or a dolly that runs along a primary track.
When the child begins to move, the overhead system responds allowing the child to "feel" a slight falling sensation which will create an opportunity for a postural
response to stay upright that will cause the child to come upright. The child is safe from hitting the ground because of straps, which suspend the child from the suit to an overhead assembly. This overhead assembly may optionally include a rotational member, such as a hanger or disk, which allows for rotational directional change along the track. The system may also include a buoyancy feature provided by an optional compression spring within the overhead system, or by the use of elastic connector straps. This means that the child will experience a bouncing sensation, which helps to elicit further attempts to move and exercise.
In developmentally advanced children, weight bearing is essential in typical development. Such a child first learns to hold his or her head upright while developing a "protective arm response" in order to prevent a fall and maintain balance.
After this crucial milestone is achieved, a typical developmentally advanced child then learns to come up on its forearms and eventually on extended arms . This weight bearing through the arms prepares them for creeping.
Eventually, a typical developmentally advanced child likewise bears weight through the legs in preparation for walking. In contrast, the developmentally delayed child, however, due to an underlying neuro- uscular impairment is often too weak to begin this process, or might achieve some of it yet at a much slower pace.
The severely disabled child may never achieve these milestones at all.
Therefore, the present invention is designed to lift gravity off of the developmentally delayed child, making it possible for them to assume weight bearing positions that they would otherwise probably not be able to assume.
With respect to upright sitting positions, most children learn to sit up by six to eight months old. Prior to achieving this milestone, they have had hundreds and thousands of opportunities to practice this basic skill, including slight rocking front to back and side to side while
in their mother's arms or up against a crib side, for example.
Unlike typical developmentally advanced children, the developmentally delayed child is too weak to attempt this basic rocking practice. The first place to start treating a developmentally delayed child is then in the sitting position. The child is placed in the body suit and fasteners on the body suit at about the front and back shoulder area are attached to the connector straps that suspend the weight of the child to an overhead rail .
As the child moves, the dolly responds accordingly, allowing the child to experience a "falling sensation". In order to come upright, the child must use muscles in the neck and trunk area, as well as the abdominal. These attempts to right themselves provides these children with the much-needed opportunity for exercise. To date, there is no other prior art which provides such dynamic, wide range exploration to the postural system. Yet, neck and trunk control exercise opportunities are essential and foundational to all other physical development.
To begin treating a developmentally disabled child in the present invention, one would first need to evaluate the child's physical condition. If the child has not yet achieved head and trunk control , this would probably be the best place to start. The child is placed in sitting and the therapist or attendant determines the tension on the glider, which rolls above in response to the child's attempt to sit. The therapist also determines the length of travel along the rail . For example, a severe child only needs a short distance, of perhaps six inches in all directions to begin learning to sit upright.
If after some degree of head and trunk control is achieved, or if therapists determine it to be beneficial, the child is then placed on all fours in a quadruped position in preparation to creep. The fasteners are placed on the upper and lower back portions of the suit. Again, the therapist or
attendant determines the level of difficulty in tension and length of travel .
Likewise, standing is then attempted by placing the child in front and back upper fasteners and by height adjustment on the rotational overhead assembly, so that the child's feet touch the floor in order to weight bear.
Optionally, visual stimuli can be added to the present invention to encourage the child to move forward. For example, if the upstanding frame embodiment is used, a kit can be provided with a safety mirror with soft edges can be placed beyond one set of legs, to attract the child to advance forward. On the other hand, at the other end of the frame, the kit can also include a net which can be strung between two legs to hold toys which might attract the child's attention.
This system of the present invention allows a therapist to modulate their therapeutic handling of a child and to change positions with simple adjustments. Unlike other equipment used to exercise developmentally delayed children, the present invention does not limit a child to a single postural or ambulatory position. It allows the child to practice movement strategies, make movement choices and interact with the environment.
Many developmentally delayed children need to learn where they are in space in relation to other objects, such as the floor or mirror for example, which could be placed near the child to help them learn depth perception.
Many developmentally delayed children also suffer from sensory perception problems. For example, many have visual problems which make ambulating about the house in a conventional walker dangerous. They can fall down a step or bump into furniture, often hurting themselves. Unlike most other devices used by developmentally delayed children, the device of the present invention provides an opportunity for the impaired child to learn how to control his/her own body without being strapped in or down to a hard, rigid cage or walker, which must then be carried about with them.
Feeling their own bodies move and touching the floor gives these children "proprioceptive input", which is desperately craved by many developmentally delayed children. They enjoy the sensation of bouncing and spinning because it provides vestibular input into the brain, which causes them to become more alert and able to respond more appropriately to their environment .
Furthermore, there are many adaptive devices that provide a developmentally delayed or physically impaired person with the opportunity to assume proper body alignment. Standing boards, walker type devices and even seating equipment can provide a challenged person with a rigid surface that their bodies can be strapped to for support. Many of these devices come with optional supports for the trunk area as well as the neck and head. However, the individual using this type of equipment is "all strapped up" and does not have much of an opportunity to explore various movement sensations and learn necessary reactive skills that would not only build muscle strength but would also help the person to learn necessary balance skills needed to prevent a fall.
This therapeutic exercise device which uses a body suit, suspension straps and an overhead supportive track/glider system, provides the challenged person with an opportunity to not only assume various body positions, but also provides the freedom of movement necessary to build muscle strength while learning balance skills.
However, for those individuals who have not yet achieved head and trunk control, it may be necessary to provide additional support through the use of a detachable neck collar which can be attached to the body suit. With this additional support, the severely impaired person is then more likely to have greater control over head and trunk movements yet without being strapped against a rigid surface. The collar can be made of foam or a similar material that would provide flexible support. The lower rim of the collar may also include a more rigid support such as a rubber or plastic reinforcement band which can add some rigidity to the collar
yet still allow for flexibility. To completely restrict movement and provide full support to the neck and head is not always desirable as the main object of this device is to provide an opportunity for range of motion and an opportunity for the individual to learn and develop skills necessary for independent movement or at least increased mobility. Yet, in some cases, if an individual requires some additional support of the neck and trunk area, this detachable collar would provide that support if needed and can then be removed once strengthening as been achieved. The collar attaches to the suit at around the neck area by snap on fasteners or perhaps a hook and loop attachment. In either case, the collar would also come with a removable "casing" that can be laundered. Similar to a pillow case and pillow, the outer "case" of the collar can be removed and washed. This way, the foam inner support would not undergo the wear and tear of laundering. The attachment of the support collar to the suit can be of a snap on nature such as is used to close a jean jacket or perhaps may also include but not be limited to a hook and loop closure. The shape of the collar can be horseshoe shaped. It would come up higher in the back to prevent the person from "hyper extending" the neck backward but would then taper down around the sides and to the front leaving an opening by the neck area to accommodate breathing or tracheostomy tubes .
Furthermore, in another alternate embodiment, the body suit to this system can be made adjustably available in different styles to accommodate usage in the home as well as in centers or school . Those for the home can be lighter in weight and form fitted to each person. Those used in centers can be made to adjust in size to accommodate persons within particular size ranges. It can be made of a heavier material such as a quilting or padding with a nylon exterior to provide strength to the garment. The adjustable suit can be made up of "quadrants" both in the front and the rear which can be drawn together or distanced in order to adjust the suit to fit the user. The quadrants would be connected by a more flexible material such
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Fig. 8 is a front view of a standing child using the present invention;
Fig. 9 is a rear view of sitting child using the present invention; Fig. 10 is a side view of crawling child using the present invention;
Fig. 11 is a flowchart illustrating modes of use for the apparatus of the present invention;
Fig. 12 is a perspective view of an alternate embodiment for a non-rotating arm assembly of the present invention;
Fig. 13 is a perspective view of a second alternate embodiment for a rotating arm assembly with a locking feature of the present invention;
Fig. 14 is a perspective view of a third alternate embodiment for a disk-mounted arm assembly of the present invention;
Fig. 15 is a cross sectional view of the locking bearing for the assembly as in Fig. 13;
Fig. 16 is a perspective view of a fourth embodiment for a wall-mounted unit of the present invention;
Fig. 17 is a perspective view of a fifth alternate embodiment for a ceiling-mounted support track apparatus of the present invention;
Fig. 18 is a front view of a sixth alternate embodiment for a handheld system with a grasping suspension frame for supporting a standing child using the present invention;
Fig. 19 is a perspective view of a seventh alternate embodiment for a handheld system having grasping suspension loop strap handles for supporting a sitting child using the present invention; and,
Fig. 20 is a side view of seventh alternate embodiment having a grasping suspension bar comprising a hanό_held system for supporting a crawling child using the present invention.
Fig. 21 is a perspective view of a kit used with the present invention.
Figure 22 is an exploded perspective view of a neck support collar used with the present invention;
Figure 23 is a perspective view showing the neck support collar as in Figure 22 being worn upon a person;
Figure 24 is a front elevational view of an alternate embodiment for a height and girth adjustable body suit of the present invention, shown worn by a person;
Figure 25 is a rear perspective view of the alternate embodiment for a height and girth adjustable body suit of the present invention, shown worn by a person; as viewed from the right side; and, Figure 26 is a close-up detail view of the girth adjustment buckle thereof. DETAILED DESCRIPTION OF THE PRESENT INVENTION
The frame 1 of the gliding support device of the present invention shown in Figure 1 is intended for home use. As such, it is constructed of lightweight steel or aluminum tubing with features for ease of transporting and assembly. Although many different structural configurations are applicable, in the preferred embodiment, the two top end sections are pre-assembled and include welded parts for maximum rigidity. They each have a bent tubing member 2, cross brace 3, rail end extensions 5, rail attachment member 6 and angled brace 4. The structure is completed by adding rails 7 and legs 12 which have a telescopic fit in end sections 2 and are adjustable for height with the aid of spring pins 13 which fit in the desired adjustment hole. A trolley subassembly 8 completes the home support track.
Figure 2 shows details of trolley 8 including frame 20, support rollers 23 (which roll on the top surface of rails 7), adjustable height rod 11, collar 21, and spring pin 22 for adjusting height.
Also included is an adjustable drag feature, which includes brake pads 24, mounted on short lengths of leaf spring. The pressure of pads 24 against the inner side of rollers 23 can be adjusted from no contact to a preset maximum by adjusting wing nut 25.
Since the rollers 23 have ball bearings, for certain stages in child development and for certain exercises, the momentum of suspended child can be disconcerting if high
speeds are achieved. This drag adjustment can control the maximum speed and also the amount of effort required for the child to move. This latter factor can be used in supervised settings to improve exercise effort. An extension spring 9 is used to suspend attachment arms
10, which will be used to attach the child's body suit straps. Arms 10 can rotate freely at the bottom spring 9 attachment .
Figure 3 shows an alternate embodiment of the support track apparatus for a health center or a therapeutic center.
The physical size as well as the structural strength is superior to the home version. This apparatus can also be used for rehabilitation of adults with a variety of injuries such as spinal surgery recovery. Frame 31 includes square metal structural tubing with angled braces 32. Telescoping bottom leg sections 33 are used to adjust frame height by using spring pins 13 in appropriate adjustment holes. The top surfaces 38 of longitudinal members are used to support the rollers 37 of a gantry carriage 34 with cross rails 36. Trolley subassembly 35 rolls on rails
36. The suspension arms 10 can be positioned over any spot within the contours of frame 31 through the combination of longitudinal rolling on surfaces 38 and crosswise rolling on rails 36. Mechanical stops (not shown) can be clamped onto rails 36 or 38 to limit the travel in either orthogonal direction as desired.
Figure 4 is a side view of trolley subassembly 35 with the access panel removed to show the components within.
Rollers 37 as well as rollers 44 can be equipped with adjustable drag brakes (not shown) as discussed for the previous embodiment. Trolley 35 is equipped with a remote controlled electric winch to raise or lower attachment arms
10.
Figure 5 is an electrical block diagram of this subassembly. The winch consists of drum 46 with spur gear engaging worm pinion 47 driven by gear motor 45. The worm 47 pitch is selected to prevent overrunning so that cable 40 cannot be pulled out further once motor 45 has stopped. A
rechargeable battery 48, similar to nickel cadmium types used in industrial portable drills, supplies power to receiver/driver 49 which, in turn, controls and powers motor
45. A wall mounted battery charger 52 is plugged into socket
55 during non-use hours to recharge battery 48 (e.g. - over night). A long cord 53 is used to facilitate this. A radio frequency communications protocol is used from remote control
58 to receiver 56 so that the therapist's eyes need not be moved from the patient during height adjustment.
Remote control 58 has only two buttons, UP and DOWN. If an infrared control link were used as in TV remote controls, a general line of sight aiming would have to be used. The radio frequency link is Omni-directional and is not impaired by structural members that would interfere with an infrared signal.
Driver 57 spins motor 45 in the desired direction upon command from remote control 58 to raise or lower cable 40.
Cable ferrule 41 has a loop to accept extension spring 42 as well as concentrically located adjustable damping element 43, which can either be a pneumatic dashpot or a hydraulic shock absorber. These velocity sensitive elements are used to adjust the amount of "bounce" as desired. Bounce is often used as an incentive to initiate movement, but too much bounce can cause injury.
Figures 6 and 7 show the front and back of body suit 60 respectively. It is made of sturdy machine washable cotton fabric and is a custom fit for the child. A zipper 67 opens the back for easy donning and removal. Reinforcing webbing 61 is added where the sturdy connector clips 62 are fastened with their own webbing tabs 63.
Depending on the size of body suit 60, the middle pair of clips 62 on the front and the back may be eliminated if the spacing is too constrained. Also there may be no lower pair of front clips (as on the back side) since these would cause a danger of toppling if used.
The lower back pair is only used for the creeping or
"quadruped" position. The upper clips 62 on the front and
back are used to position for sitting, kneeling or standing positions. The neck opening 64, arm holes 65 and leg openings
66 complete the design which distributes the point stresses of straps attached to clips 62 over a large area. Figure 8 shows a child 70 wearing body suit 60 suspended by straps 71 attached to support arms or frame 10. The suspension is similar to that used by a marionette. Straps 71 are of nylon webbing with length adjuster buckles (not shown) or if more "bounce" is desired, an elastic material may be used for straps 71.
Figure 9 shows child 70 in a suspended seating position. Figure 10 shows the use of the back attachments to support the child in a creeping position.
Figure 11 shows a flow chart of the method of the present invention.
Figure 12 shows a portable suspension frame 101 having attached at the top a pair of rails 107 along which support trolley 108 rolls back and forth on trolley wheels 106. In turn, support extension 109 extends downward from height adjustment collar 121 attached to support trolley 108, with height adjustment pin 122 securing support extension 109 at a desired height so as regulate the height of frame hanger 110 attached to support extension 109 at the bottom end thereof. Frame hanger 110 is attached to the bottom of support extension 109. Frame hanger 110 has a plurality of downwardly extending strap restraints 112, which may be buckles, snap closures, or other suitable fastening means for straps to be hung therefrom.
Figure 13 shows portable support frame 201 that is similar to that of support frame 101 shown in Figure 12, but Figure 13 has swivel collar 216, with removable securing pin 214, allowing support extension 209 to rotate. Support trolley 208 rolls on trolley wheels 206 along rails 207. Support trolley 208 is attached to downwardly extending support extension 209 by means of height adjustment collar 221 having height adjustment securing pin 222 to fix the height of support trolley 208 at a desired level on support extension 209.
Frame hanger 210 is rotatably attached to support extension 109 by swiveling collar 216 with removable locking pin 214. Frame hanger 210 has a plurality of downwardly extending strap restraints 212, which may be buckles, snap closures, or other suitable fastening means for straps to be hung therefrom.
Figure 14 shows suspension frame 301 having a support trolley 308 having a pair of rails 307 similar to the structures shown in Figures 12 and 13. In Figure 14 support trolley 308 rolls along rails 307 by means of trolley wheels 306. Support trolley 308 is in turn attached to downwardly extending support extension 309 by height adjustment collar 321 with height adjustment pin 322 fixing support trolley 308 in position relative to support extension 309. At the bottom end of support extension 309 hanger disk 310 is a round-shaped member having a plurality of strap restraints 312 downwardly extending therefrom, which strap restraints 312 may be buckles, snap closures, or other suitable fastening means for straps to be hung therefrom. Hanger disk 310 is rotatably attached to the bottom of support extension 309 by swiveling collar 316 and locking pin 314.
Figure 15 shows a cut-away detail of the attachment of support extension 209 of frame 201 at its attachment to swiveling collar bearing 216 with locking pin 214 as shown in Figure 13, along lines 15-15 therein. Swiveling collar 216 is comprised of inner collar 218 having locking aperture 218a for accepting locking pin 214. Outer collar 219 fits around inner collar 218, and outer collar 219 has locking aperture 219a, which, when in positional register with aperture 218a, permits insertion of locking pin 214 so as to lock inner collar 218 to outer collar 219. Rotation is permitted by ball bearings 225.
Figure 16 shows a wall-mounted support frame embodiment 401 of the present invention having a support trolley 408 having a pair of rails 407 similar to the structures shown in Figures 12 and 13. In Figure 16 support trolley 408 rolls along rails 407 by means of trolley wheels 406. Support
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suitable fastening means for straps to be hung therefrom.
Straps 571 extend downward from strap restraints 512 and attach to additional strap restraints 512 on body suit 560, so as to position a child with desirable support for therapy. Figure 17 depicts a supported child wearing optional cervical collar 520, to stabilize the head and neck during movement of the child within body suit 560.
Figure 18 shows hand-held frame embodiment 601 having hand-held frame hanger 610 that in turn has a plurality strap restraints 612 downwardly extending therefrom, which strap restraints 612 may be buckles, snap closures, or other suitable fastening means for straps to be hung therefrom.
Straps 671 extend downward from strap restraints 612 and attach to strap restraints 612 on body suit 660, so as to position a child with desirable support for therapy.
Figure 19 shows frame support embodiment 701 having a pair of hand-held strap loop handles 772 from which a plurality of straps 771 extend downwardly therefrom. Straps
771 in turn attach to strap restraints 712 on body suit 760, so as to position a child 770 with desirable support for therapy.
Figure 20 shows hand-held frame support embodiment 801 having a graspable bar supporting a pair of hand-held strap loop handles 872 from which a plurality of straps 871 extend downwardly therefrom. Straps 871 in turn attach to strap restraints 812 on body suit 860, so as to position a child
870 with desirable support for therapy. At least one strap restrain 812 on body suit 860 is attached in the area of the hips of child 870 so as to position a child 770 with desirable support for crawling and creeping.
Figure 21 shows a kit 900 for a support frame embodiment with convenient packaging including receptacle 903 for support frame members, mirror 905, disk hanger 910, straps
971, body suit 960, toy box 927 and activity net 929 to hold toys. Mirror 905 is preferably a safety mirror with soft edges can be placed beyond one set of legs of a frame, such as legs 12 of frame 1 shown in Figure 1, to attract the child to advance forward when crawling. On the other hand, at the
other end of frame 1, kit 900 can also include activity net
929, which can be strung between two further legs 12 at an opposite end of frame 1, to hold toys from toy box 927, which might also attract the child's attention as an incentive to crawl towards the toys .
Figures 22 and 23 shows a neck support collar 1072 used and being worn upon a person who has not yet achieved head and trunk control. Collar 1072 provides additional support to the head and neck region of the person. Neck collar 1072 is attached to the body suit 1060 at an upper end thereof. With the additional support provided by neck collar 1072, the severely impaired person better controls head and trunk movements. Neck collar 1072 may be fabricated of foam or a similar material that would provide flexible support. The lower rim 1073 of the collar 1072 may also include a more rigid support such as a rubber or plastic reinforcement band which can add some rigidity to the collar 1072 yet still allow for flexibility. Collar 1072 is detachable and can be removed once strengthening as been achieved. The collar 1072 attaches to the suit 1060 at around the neck area by snap on fasteners or perhaps a hook and loop attachment 1074. In either case, the collar includes a removable casing that can be laundered. Similar to a pillow case and pillow, the outer case 1079 of the collar 1072 can be removed and washed preventing the foam inner support 1075 from damage due to wear and tear from use and cleaning. The attachment of the support collar 1072 to the suit 1060 can be a snap on fastener or a hook and loop closure. The shape of the collar 1072 can be horseshoe shaped. Its higher back extension 1076 prevents the person from hyper extending the neck backward but tapers down around the sides 1077 and to the front 1078 leaving an opening 1079 by the neck area to accommodate breathing or tracheostomy tubes or other obstructive medical prostheses . Figures 24-26 show an alternate embodiment for a height and girth adjustable body suit 1160, shown worn by a person; For height adjustment body suit 1160 has elastic, expandable belt 1171 to accommodate increase in growth of the person
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trained therapist. The right hand branch is a sensory stimulation use of the equipment.
EXAMPLE OF USE AND OPERATION
An experienced therapist observed two children using the apparatus of the present invention similar to that shown in
Figures 1-2 and 6-10. One child had low tone and generalized weakness while the other child was with cerebral palsy and showed signs of spastic quadruparesis . The therapist was impressed by the versatility of the apparatus as she watched one child transition from quadruped to sitting to standing positions with "minimal and easy adjustments". She observed the "fluidity of movement" the child was able to demonstrate with the apparatus. The equipment allowed the child to experiment with a variety of movement strategies and options to interact with her environment. In addition to observing, the therapist also worked with the child with spastic quadruparesis using the apparatus of the present invention. The therapist concluded that she was able to modulate her own handling and positioning techniques since the apparatus provided "additional hands" to support the child thus creating greater positioning options. Unlike interaction with rigid surfaces, "the child was able to move, and then experience the consequences of his movement within a safe parameter" . The aforementioned embodiments are merely illustrative of several configurations for the present invention. For example the non-rotational support arm extension 109 can be used with either the various frames of Figures 12, 14, 15 or 16 or it can be used with any of the hand-held embodiments of Figures 17-19. Likewise these embodiments can be used with or without a spring, such as shown in Figure 1. Similarly, a rotatable support arm extension be made optionally non- rotatable, such as with a pin shown in Figure 13. The same is true for the hand-held embodiments of Figures 17-19. Therefore, it is further noted that other modifications may be made to the present invention, without departing from the scope of the invention, as noted in the appended Claims.