When Pearl Zavala found out her infant son Juanito had cerebral palsy, she only knew he wasn't meeting the milestones his older sister had met. It dawned on her slowly the dramatic challenges caused by his diagnosis.
She began adapting her goals for Juanito. "I wanted him to be able to roll over, crawl, hold his bottle and be able to hold his head up," Pearl says. And when it came to walking, who could say what the future held.
Juanito is 11 now, an active fourth-grader in Hammond, Ind. He usually gets around in a wheelchair, but in the last few months his ability to walk with assistance has increased due to new technology at the Rehabilitation Institute of Chicago.
The Lokomat is robot-assisted technology that helps with walking. In the past several years, some adults who had suffered a stroke or spinal cord injury used the Lokomat for rehabilitation. Recently, RIC obtained pediatric legs that adapt the technology to children and is one of the first hospitals in the country to begin using the Lokomat for children with cerebral palsy.
Dr. Deborah Gaebler-Spira, director of the CP program at RIC, thinks the Lokomat is only the beginning.
"There's been so much technology and attention drawn to kids with CP that it's really a new era in treatment and management," she says. "There's been an explosion of different machines and we're adapting them to children and adults with difficulty with movement."
The Lokomat works by giving patients the opportunity to continually repeat a motion, while strengthening muscles and teaching more linear walking, Gaebler-Spira says. Exactly how effective the treatment is, which patients will benefit most and what the long-term benefits may be are all unknown, as hospitals begin using the equipment with pediatric patients. But for families and medical practitioners, the Lokomat offers the possibility of greater independence for children with CP.
"We're hoping to see improvement in children's endurance," says Tara Egan, a physical therapist at RIC. She's not looking for huge changes yet-just enough to allow kids to cross a street safely or walk from class to class in school. With Juanito, she has seen an increase in his step length and he is able to walk faster.
The biggest change Egan has seen in her pediatric patients isn't necessarily physical. It's the excitement and self-confidence they're experiencing when strapped into the machine. Many children with CP have been in therapy for years and as they get older, they're often not walking as much, she says.
"This is a kick start. (Juanito is) very motivated by this. He has had traditional therapy for so long that's he's not really inspired by it," Egan says. The virtual reality screen that lets kids choose a character who will move with their movements turns the therapy into a game that appeals to children, she says.
The Lokomat has also inspired parents.
"I was very excited. And the emotions when I saw the movements of his legs-it was really great," Pearl says. "After three or so sessions, I could see that he wasn't bending his knees as much, and at home there was more standing. He was stronger."
Juanito has finished his round of therapy with the Lokomat, and his mom continues to see improvement.
"I'm expecting a lot more. I really hope to see him more independent," Pearl says. "It's a wonderful experience. The Lokomat has brought hope for him. I feel like he really thinks he can fly."