polio
“WILL MY CHILD EVER BE ABLE TO WALK?”
This is often one of the first questions asked by the
parents of a disabled child. It is an important question.
However, we must help parents realize that other things in
life can be more important than walking (see p. 93).
If the child whose legs are severely paralyzed by polio is
to walk, generally she will need at least 2 things:
1. fairly strong shoulders and arms for crutch use
2. fairly straight legs (hips, knees, and feet). (It is important to correct contractures so
that the legs are straight or nearly straight before trying to adapt braces for walking.)
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To evaluate a child’s possibility for walking, always test arm and shoulder strength:
Have her try
to lift her body
weight off the
ground with
her arms, like
this
If she can easily lift up and
down several limes, she has a
GOOD chance of being able
to walk using crutches.
If her arms and
shoulders are so weak
she cannot begin
to lift herself, her
chances for crutch-
walking are POOR.
If her shoulder and arm strength
is FAIR, and the child can almost
lift herself, daily exercise lifting
her weight like this may increase
strength enough to make crutch
use possible.
Having the child lift
herself while holding a
bar like this will
also help strengthen
her hands and wrists for
crutch use.
If the child cannot
lift herself because
of weak elbows, put
simple splints on
her arms to see if
she can lift herself
with these.
Pushing herself in a wheelchair or wheelboard (trolley) is a
practical way to strengthen shoulders, arms, and hands
If she can lift herself
with the elbow
splints, maybe she
can use crutches
that give elbow
support.
If she is fat,
she should
lose weight.
This will make
walking on
weak limbs
much easier.
Now check how straight the legs will go. (See range-of-motion testing, p. 27.)
If the hips, knees, and feet
can be placed in fairly straight
positions, chances for walking
soon with braces are good
(if arm strength is good).
But if the child has much
contracture of the hips, knees,
or feet, these will need to be
straightened before she will be
able to walk.
Sometimes, if
contractures are
severe in one leg
only, the child
can learn to walk
on the other
leg only, with
crutches. But it
is best with both
legs, whenever
possible.
For correction of contractures,
see Chapters 8 and 59.
disabled village children