GOmobility: Hart Walker Program

Using the Hart Walker Program

Suitability
To be suitable for a Hart Walker a child needs to fulfil the following criteria:

have a consistent, reciprocal stepping pattern when supported
be at least 3 years of age and measure no less than 90cms in total height
instep to hip joint length to be less than 72cms (for initial fitting)
be motivated to move.

Cost
The cost of the Hart Walker is $6,175. This amount will cover the Walker (including freight), first pair of Piedro Boots, the initial assessment and fitting with the physiotherapist and orthotist and adjustment sessions for the first 12 months. Methods of payment and/or fundraising can be discussed with Hart Walker Program staff.

Starting the Program
A child will enter the program and be given a listing number on receipt of a referral form, which is available from the Hart Walker Program. Suitability for a Hart Walker can be ascertained at any time by making an appointment to see one of the physiotherapists involved in the program or by sending in a video of the child standing and stepping.

If the Hart Walker is not suitable for a child, suggestions for other forms of walking frames will be given to parents.

Program Procedure
A child can be seen by a physiotherapist to ascertain suitability prior to a referral form being filled out or before funding is investigated.

Assessment - prior to the child being fitted, detailed measurements will be taken to enable the assembly of the Walker, photographs and video footage will also need to be taken and a physiotherapy assessment of joint range/muscle length and stepping ability will be carried out.

Fitting - this will be carried out once boots have arrived and payment has been made in full

Adjustments/Monitoring - will need to be done regularly (at least 3 times per year) to ensure the Walker is adjusted for the child's growth and increased strength and abilities.

The service is based in Sydney, at the McLeod Centre, Allambie Heights. The Hart Walker team also travel to rural areas of NSW to run clinics.

During the initial visit, parents will be required to sign a detailed consent form and instruction sheet. The consent form will also detail the number and frequency of the monitoring/adjustments sessions required for the successful implementation of the program.

The child's therapists will be encouraged to attend the fitting and adjustment sessions with the family to become familiar with the Hart Walker.

Monitoring/ Review
The frequency of monitoring will depend on the needs and progress of the child. The first visit after the fitting should occur within 4-6 weeks, then follow up visits every 3 months.

Once a child is making use of the Walker, it is essential to monitor their progress and to make any necessary ongoing adjustments for growth and as their strength, muscle control and stepping ability develop.

The frequency of this monitoring is governed by the child's individual needs and their own rate of progress, though we will take into consideration the family's location and availability. Clinics will be held in school holidays to make it easier for families to attend but appointments can be made at any time if parents are concerned with the fit of the Walker.

Video footage will also be used to continually assess the child's progress. This will be particularly important for children living outside the Sydney metropolitan area.

Leaving the Program
Once a child's leg length (instep to hip joint) reaches 86cms, the Walker will no longer be suitable as it will be too unstable.

When children outgrow the Hart Walker, Spastic Centre staff will work with the family to recommend the best form of equipment to assist and support the child for the future.