What is the iKAN brace?

This unique, fully adjustable HKAFO Brace is designed to assist your child to stand or walk while maintaining correct postural alignment. Available in 2 sizes, it accommodates children aged 4 to 14 years who are unable to walk or stand on their own. 

What is a HKAFO brace?

It is a Hip-knee-ankle-foot orthosis meaning it controls the movement at all three joints. The hip control is important because it allows to support the child in upright posture, supporting the chest in the front as well. 

At All About Kids Rehab (and All About Family Physio), we partnered with the IKAN brace because it supported our core values:

1. Empowering Children

Paediatric physiotherapy is about supporting our children and their families. We are dedicated to innovating, learning, and providing the best expertise all for our kiddos.The iKAN brace is a fantastic way to empower children to engage, participate, and train to be stronger. 

2. Optimal postural alignment for breathing and for functional

Julie Wiebe (https://www.juliewiebept.com/) and Shelley Mannell (https://heartspacept.com/) will tell you that an optimal postural alignment with a neutral ribcage directly over a neutral pelvis allows the diaphragm, the deepest abdominal muscle, and the pelvic floor to function optimally to breathe. (reference: https://heartspacept.thinkific.com/courses/dynamic-core-for-kids-online)
Watch Shelley Mannell briefly discuss the importance of posture for the diaphragm:
https://www.youtube.com/watch?v=n1GS9PVBc0w&list=PLknA3tAt_3NpocZrq0AkqBvOmRbaQM57v&ab_channel=ShelleyMannell
Therasuit Method is a paediatric physiotherapy approach that requires optimal alignment, and the equipment creates it like no extra set of hands ever could. At All About Kids Rehab, we always encourage the correct alignment to set up the correct muscles to strengthen.
http://www.suittherapy.com/therasuit-method-
The iKAN brace is an excellent application of this theory!

3. Uniquely adjustable to the individual

All three joints (hip, knee, ankle) can be locked or unlocked for a certain range of motion, specific to the child and the activity. These decisions should be made with a registered physiotherapist who works with them. The limitations for range of motion ensure the safety of the child when practicing activities in standing or walking. The adjustability also allows physiotherapists to isolate muscles effectively. 

4. Can be used functionally

It can be used as a standing or sitting frame at a table/counter to engage with peers or play.

It has adjustable hinges to go from standing to sitting. 
Images from https://www.ikanbrace.com/gallery)

It can be used to assist walking without parents or guardians straining their bodies.
https://fb.watch/v/3nWWGgTEM/
It has removable handles which allow it to be used in walking devices.
https://www.youtube.com/watch?v=J1ppjHO34v4&ab_channel=QHPOffice

At All About Kids Rehabilitation Centre, we focus on functional goals and always ensure our interventions always reflect functional use. The specific selection of exercises, the positioning, and even the order of the exercises reflect a functional goal, as per Therasuit Method. The iKAN brace is used for great functional goals like independent or supervised sitting and standing (to play, eat, or work), walking. However, the functional uses are endless; you can practice a sit to stand, a push up, going up/down steps, etc.

Why use the iKAN brace to support a child in standing?

– Physiological Benefits:

Children are prescribed standing frames because weight-bearing in a standing position improves blood circulation, supports digestion and bowel function, supports bone density, promotes hip stability, and prevents contractures by allowing muscles and tendons to be stretched. (paleg, macias)
See recommendations:
https://cerebralpalsy.org.au/our-research/about-cerebral-palsy/interventions-and-therapies/standing-frames-for-children-and-adults/#sup3 

– Physiotherapy Uses:

If the goal is to eventually stand independently or supported outside of the iKAN brace, it provides optimal alignment to engage the muscles necessary:

• Strengthen the muscles of the legs, thighs, and surrounding the hip
• Strengthen and practice trunk control 
• Strengthen the pelvic floor muscles

If unexpected to stand or walk, it still serves purposes like providing an optimal postural alignment to work on:

• breathing with spine, ribcage, pelvis aligned
• head and neck control- reaching, gripping, throwing, pushing

These are goals we might have for positioning a child into standing using the Therasuit Method bungee suspension system in the clinic at All About Kids Rehab (and All About Family Physio). Additionally, the iKAN brace may be used in combination with the Therasuit cage.

Why use the iKAN brace to support a child in walking?

Using the iKAN brace to assist a child in walking is a safe and accurate method to:

• Practice reciprocal movement 
• Practice weight shifting 
• Provide vestibular input
• Improve vision
• Cardiovascular and pulmonary fitness 
• Increasing metabolic rate (verschuren muscle)
• Reducing sedentary behaviour to promote health (ver exercise)

Sources:

https://www.ikanbrace.com/ikan-braces

http://www.suittherapy.com/therasuit-method- 

https://www.juliewiebept.com/

https://heartspacept.com/

https://heartspacept.thinkific.com/courses/dynamic-core-for-kids-online)

https://cerebralpalsy.org.au/our-research/about-cerebral-palsy/interventions-and-therapies/standing-frames-for-children-and-adults/#sup3

Verschuren, A., Peterson, M. D., Leferink, S., & Darrah, J. (2014). Muscle Activation and Energy-Requirements for Varying Postures in Children and Adolescents with Cerebral Palsy. The Journal of Pediatrics, 165 (5), 1011-1016.

Verschuren, O., Peterson, M. D., Balemans, A. C. J., & Hurvitz, E. A. (2015). Exercise and physical activity recommendations for people with cerebral palsy. Developmental Medicine and Child Neurology, 58(8), 798-808.

Paleg, G. S., Smith, B. A., & Glickman, L. B. (2013). Systematic review and evidence-based clinical recommendations for dosing of pediatric supported standing programs. Pediatric Physical Therapy, 25(3), 232-47. See abstract

Macias-Merlo, L., Bagur-Calafat, C., Girabent-Farres, M., & Stuberg, W. A. (2015). Standing Programs to Promote Hip Flexibility in Children With Spastic Diplegic Cerebral Palsy. Pediatric Physical Therapy, 27(3), 243-9. See abstract