UAB therapists help children walk again — and run, skip and hop

A therapy created at UAB for adults is adapted to help a young boy with hemiparesis learn to ride a bike and more.

Like most of his friends, 7-year-old Ryan Mellis is trying to learn to ride his bike without training wheels — despite a condition called hemiparesis, a weakening of his left side that makes it difficult to use his arm and leg. Now a therapy developed at the University of Alabama at Birmingham is restoring his strength and helping him reach that milestone.

Ryan had a series of small strokes following a brain infection when he was 3. “Originally it affected his entire body, but strength in his right side returned more quickly than his left,” said Renea Mellis, Ryan’s mom.

Ryan and Renea, from Wilmington, N.C., are in Birmingham for a therapy called ACQUIREc, a form of the Constraint Induced Therapy developed at UAB by neuroscientist Edward Taub, Ph.D., to improve motor function in adults following a stroke. ACQUIREc, developed by Assistant Professor Stephanie Deluca, Ph.D., and colleagues in the UAB Civitan Sparks Clinics and the Department of Occupational Therapy, adapted the basic principles of CI Therapy for pediatric use.

“We can take the idea of intensive therapy and the behavioral principles of CI Therapy — including shaping skills that are true to the original model — and use them to create new therapy approaches,” DeLuca says.

"We can take the idea of intensive therapy and the behavioral principles of CI Therapy — including shaping skills that are true to the original model — and use them to create new therapy approaches."

Ryan works five hours a day for four weeks with occupational therapist Mary Rebekah Trucks. He’s been in Birmingham during the two previous summers for therapy on his arm, but this is the first time ACQUIREc has been used for his leg.

“During the past two years we’ve seen great differences with his fine-motor control, function and strength in his left arm,” Renea says. “He’s also more willing to use the arm because it is better. He sees the improvement, and it encourages him to use it more.”

Trucks expects similar improvement in Ryan’s ability to use his left leg. There are a number of tasks he must perform, such as riding a bike or kicking a soccer ball. To him, each task is a game. To Trucks, each game is designed to improve her young patient’s balance and the ability to bear weight on the left leg. And each success earns the child a prize.

“You are reinforcing the hard work,” Trucks says. “When the kids see progress, it encourages them to work harder. And the harder you work, the better you get.”

“Riding a bike, running, skipping, hopping — all the things that children do with their lower extremities are a struggle for our patients,” said DeLuca. “One of the first children who came through the program started to skip, and that seems like such a trivial thing to us. But to a kindergartener whose friends are skipping down the hallway, that’s a major achievement. It builds confidence that can’t be built by sitting on the sidelines.”

Renea Mellis says the goal is to help Ryan do whatever he wants to do as he grows up and keep him safe in the rough-and-tumble world of childhood. Trucks took the training wheels off Ryan’s bike two weeks into therapy. The first days were a challenge, with some falls and scraped knees. But as the time neared to go home, Ryan was able to ride by himself for short distances. Both Trucks and Renea have great expectations.

“The little things that seem so simple for us are so hard for him,” said Renea. “So when he gets it, it’s a very good day.”

To find out more about ACQUIREc, call 205-975-0466 or 1-800-822-2472 and select Option 8.

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