In clinical practice working as a physiotherapist among children with disabilities, I experienced a non-violent fracture in a child with severe cerebral palsy (CP).

That experience made me aware of the fact that these children can develop a fragile skeleton over time, partly due to disuse, because children with severe CP cannot attain an upright position or run and jump like other children.

A standing shell is commonly used in Sweden to allow children with severe CP to attain an upright position. One aim of this is to prevent osteoporosis, and the recommended time in the standing shell is one to two hours daily. This recommended time is often hard to achieve in clinical practice, because even though the children often like to be in an upright position, they seldom want to stand strapped in a standing shell for such a long time.

Through additional studies in special pedagogy I learned the importance of giving the children an opportunity to influence their own activity and increase their cognitive development through action, especially through acts that demonstrate cause and effect. I found no studies to support the hypothesis that standing in a standing shell for one or two hours would increase bone density, and I wanted to find out whether it would, and this was the start of my research studies at Karolinska Institutet, Stockholm, Sweden. I also wanted to make standing in a standing shell more effective and enjoyable for the children which is the reason why I developed Hoppolek.

Now the real challenge starts; to make Hoppolek available to the children who need it!

Best regards!

Ylva Dalén