Case Study: A 22-week Premature Baby Learns to Walk!
By: Rima Lintakas, DPT - Physical Therapist
Baby Jane, has been seen for weekly physical therapy sessions for ~13 months via a combination of in-home sessions and live-video-visits. Baby Jane was born prematurely at 22 weeks, weighing 1lb 1oz with multiple medical conditions including bronchopulmonary dysplasia (BPD), slight brain bleed, atrial septal defect (ASD), and retinopathy of prematurity (ROP). Baby Jane has had many surgeries/procedures including placement of G-tube and trach, corrective surgery for ASD, bronchoscopies, and trachea dilations.
During the initial 9 months of physical therapy, many different strengthening, coordination, and balance exercises were performed. Baby Jane learned to creep (crawl on all-4s) over soft obstacles to increase arm/shoulder strength as well as coordination between sides. Once Baby Jane started to pull to stand and cruise (holding onto the couch and walking sideways), she practiced stepping over obstacles, stepping up to/down from objects, and climbing onto/down from the couch to work on coordination and standing balance as well as strength. Baby Jane practiced sitting in a chair and standing up by pushing with her hands on the armrests, then leaning forward to reach the couch to work on bodily forward momentum which would be needed for walking, as well as strength and standing balance. We collaborated and co-treated with the occupational therapist to address the upper body and shoulder strength.
During the course of therapy, we assessed Baby Jane for Assistive Technology, specifically Ankle-Foot-Orthoses (AFOs), to help correct her foot posture in standing (hyperextended knees, pronated feet). She was approved for AFOs, however the actual delivery of AFOs was delayed. We worked around the problem by recommending a pair of high-topped, supportive shoes until the AFOs were received. After one day of wearing the new shoes and at 30 months of age, Baby Jane started taking 5-6 steps independently and was walking consistently around home and outside within 2 weeks. With therapists’ team work together Baby Jane achieved her goal of walking at 30 months of age.