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Miles

Miles uses his Leckey Mygo Stander to maintain muscle length and strength.

Miles uses his Leckey Mygo Stander to maintain muscle length and strength.

Miles is a seven year old boy from Vancouver, Canada, who has Spinal Muscle Atrophy (SMA). SMA is a degenerative condition that causes progressive muscle weakness.  Miles was using a custom made, power, sit to stand wheelchair but was having difficulty standing in it comfortably.

Clinical Background

Miles’ diagnosis means that he is increasingly losing muscle strength in his core (trunk) muscles and lower limbs. This causes muscle shortening at his hips (hip flexors), knees (hamstrings) and ankles (Achilles tendon). In turn this means that Miles’ hips and knees want to stay bent, causing his lumbar spine to overextend (lordosis), and his bottom to stick out, leaving Miles in a crouched posture.

Goals for Standing

• Maintain or improve range of movement at hips, knees and ankles
• Maintain or reduce lumbar lordosis
• Maintain or improve core muscle and lower limb strength
• Improve head control
• Increase opportunities for peer and social interaction
• Increase opportunities for improved academic performance
 

Considerations for Equipment

Miles requires a stander which can accommodate his contractures without compromising his overall posture, and provide him with a standing posture that he can tolerate.

Approach

Miles tested the Mygo Stander in school for about a month before his final fitting and provision.  The fitting was challenging due to the extent of Miles’ knee contractures.  The stander was set up in the supine configuration with the posterior support and pommel.

Although this accessory is typically used in the prone configuration, this was found to work best for Miles due to his tendency to crouch.  He also benefitted from having the support on which to lean his arms.  
 
The knee cups were rotated 180° which, because they are offset, raised them to the appropriate height.

Outcome

Miles has been using the stander since July 2012 with great success. 
Miles, who previously would protest against standing, asked to be placed into the Mygo stander and was happily tolerating standing in the Mygo Stander for at least 15-20 minutes.