| 0–11 months |
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1.
What are expected developmental milestones based on the early neurological exam related to motor skills?
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2.
If early mobility is delayed, do mobility devices improve developmental outcomes such as cognitive performance, social skills, and visual attention? Types of early mobility devices would include caster carts, pediatric cars, and age-appropriate manual wheelchairs.
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3.
Do such mobility devices help with contracture prevention?
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| 1 year–5 years 11 months |
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1.
Does being overweight or obese impede the development of mobility?
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2.
Does a positioning/stretching program prevent contractures and how long does it need to be implemented?
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3.
What is the usual trajectory of gait development by neurologic level, including specific gait parameters such as cadence and efficiency?
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4.
What is the role of treadmill training on gait development and fitness?
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5.
What are the long-term consequences of walking with or without orthoses/crutches on the joints in the lower extremities and the spine?
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| 6–12 years 11 months |
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1.
What is the usual trajectory of mobility-based acquisition of skills on neurologic function?
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2.
What are the factors that influence the transition from ambulation to wheelchair mobility for different neurologic levels?
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3.
What are typical gait parameters and patterns for different neurologic levels?
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4.
What is the role of gait analysis to monitor gait and make recommendations to optimize function?
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5.
Is there a benefit of early use of forearm crutches or KAFOs to protect the knee joint from abnormal forces?
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6.
What is the impact of scoliosis on gait, transfers and wheeled mobility? Does spine surgery impact any of these variables?
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7.
In wheelchair users, are there signs of early shoulder or wrist wear and tear? Does early wheeling adversely or protectively affect upper extremity and trunk development?
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8.
What factors positively encourage independent mobility?
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| 13–17 years 11 months |
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1.
What is the role of gait analysis to monitor gait and recommend interventions?
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2.
Should forearm crutches or KAFOs be used to protect the knee when torque has been identified? When should they be instituted? Does early use prevent damage to the knee joint and prevent pain from developing?
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3.
What is the impact of scoliosis on gait, transfers, and wheeled mobility? Does spine surgery impact any of these variables?
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4.
What is the impact of linear growth on walking ability?
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5.
What factors influence the child’s preference of wheelchair mobility over walking (for instance, energy efficiency, balance, and speed)?
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6.
What is the rate and pattern of loss of ambulation for community and household ambulators by neurologic level? Are there other main causes for loss of mobility besides pain, progressive weakness, growth, and obesity?
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7.
Are there benefits to using standing devices on ROM, bone health, and quality of life?
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| 18 years |
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1.
What is the rate and pattern of loss of ambulation, ability to effect transfers and wheeled mobility? What causes loss of mobility function (for instance, pain, obesity, aging, and fitness)?
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2.
Is there a role for gait analysis to monitor gait and optimize function (for instance, to assess joint torque and shear forces)?
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3.
What is the role of forearm crutches or KAFOs to protect the knee when valgus forces at the knee may cause long term knee pain?
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4.
Are there benefits to standing devices and walking therapy as an adult?
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5.
What is the role of physical therapy and fitness programs in maintaining mobility?
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6.
What factors impact mobility long-term (i.e., improving technique, shoulder strengthening, engaging in fitness programs, and other activities)?
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