A 6-year-old child with spastic diplegia is walking in parallel bars and presents with increased trunk and hip flexion. Which assistive device is MOST appropriate?

A 6-year-old child with spastic diplegia is walking in parallel bars and presents with increased trunk and hip flexion. Which assistive device is MOST appropriate?

• A. Standard walker
• B. Forearm crutches
• C. Posterior rolling walker
• D. Bilateral quad canes

Answer: (C)

When a child with spastic diplegia shows increased trunk and hip flexion during walking, the goal is to promote an upright trunk position and safe, controlled forward progression. A posterior rolling walker achieves this by offering support from behind while allowing the child to move forward with the walker’s wheels. This setup encourages an upright alignment of the spine and hips, reducing the tendency to slump into flexion, and it provides stable, continuous gait training in parallel bars without requiring excessive balance or arm strength. Other options place demands that are less suitable here. A standard walker in front can promote forward trunk lean and may not offer the same posterior support that helps maintain upright posture. Forearm crutches require substantial balance and shoulder–grip control, which can be challenging for a child with CP and may not improve trunk alignment. Bilateral quad canes provide limited stability and are not ideal for a young child who needs more robust support and control during gait training.

When a child with spastic diplegia shows increased trunk and hip flexion during walking, the goal is to promote an upright trunk position and safe, controlled forward progression. A posterior rolling walker achieves this by offering support from behind while allowing the child to move forward with the walker’s wheels. This setup encourages an upright alignment of the spine and hips, reducing the tendency to slump into flexion, and it provides stable, continuous gait training in parallel bars without requiring excessive balance or arm strength.

Other options place demands that are less suitable here. A standard walker in front can promote forward trunk lean and may not offer the same posterior support that helps maintain upright posture. Forearm crutches require substantial balance and shoulder–grip control, which can be challenging for a child with CP and may not improve trunk alignment. Bilateral quad canes provide limited stability and are not ideal for a young child who needs more robust support and control during gait training.