What does ACCEPT means?

Adaptive Climbing for CErebral Palsy Training

The goal of the project

We will design and build a first prototype of ACCEPT, a climbing wall adapted, i.e. designed specifically for the purpose, and sensorized, to assist in the rehabilitation and analyze the rehabilitation progress of children with Cerebral Palsy (CP) and more generally of children with motor problems. ACCEPT is designed and optimized in every detail to reduce inequalities and promote the health and well-being of vulnerable segments of the population.

What is CP?

CP is a syndrome caused by intrauterine pathology or complications during or after childbirth; it often manifests as dysfunction of the upper, lower, or ipsilateral limbs, sometimes associated with other motor or cognitive dysfunction. It is the most common childhood neuromotor disease: it is estimated that there are more than 17 million people with CP worldwide.

Children with CP in many cases can recover part of their neuromotor skills with intensive rehabilitation work, especially if this starts during the first years of age. Adapted sport is a more effective and engaging alternative to rehabilitation in health facilities: FightTheStroke, our partner foundation in this project that works in the field of care and protection of children with CP, has shown that intensive motor activity (>60h in 8 days) can lead to the achievement of functional goals otherwise achieved in more than 6 months of traditional rehabilitation in a hospital setting.

Building on this evidence, the project focuses on climbing, and aims to study and implement a first prototype of an adapted, sensorized, reconfigurable, and interactive wall (ACCEPT) designed to address the rehabilitation needs of children between the ages of 6 and 13 with CP.
Climbing has already been effectively tested for this purpose (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5472985/) and ACCEPT aims to deepen and broaden the study and disseminate climbing as a tool to improve the health conditions of people with a disability, proposing a solution that is both training, inclusion, and a tool to analyze the progress of rehabilitation.

Why building ACCEPT

According to the latest Healthy People report (https://www.healthypeople.gov/), 56% of people with disabilities do not engage in any physical activity in their free time, compared to 36% among adults without disabilities. Comparable percentages can be found in the 2018 Istat data. Promoting moderate levels of physical activity among people with disabilities is an important goal for public policy globally, as regular physical activity improves well-being and contributes to the delay of chronic disease, comorbid with a diagnosis of cerebral palsy. However, this goal is hindered by a multifactorial set of barriers typical of this population (economic, emotional, and psychological issues, necessary equipment, and information retrieval). ACCEPT aims to create a specific tool to rehabilitate the motor functions of children with CP, but also to initiate the practice of adapted sports through a recreational and democratic activity.

Sport climbing is a physically demanding activity that requires, among other skills, concentration, motor planning and sequential thinking. It is also an activity that can be carried out on structures of modest size and economic commitment by the host center, and in its simplest form does not require any specific equipment by the child. ACCEPT responds to the need to rehabilitate but also to practice sport in an inclusive way, in paths with difficulty adaptable to the participants: from normal subjects up to a possible replicability even in children with autism, where climbing allows independent movements and therefore does not imply physical contact.

The ACCEPT wall will be equipped, in particular, with sensors capable of measuring parameters of strength and joint position and of processing a report for the evaluation of motor performance. This element has the dual objective of providing medical staff with a tool to help measure progress and, together with the presence of feedback, a way to gratify children with respect to the results achieved and stimulate them to overcome their limits ('reinforcement learning').

How the project will develop

ACCEPT, in prototype version, will remain in use at FightTheStroke, and will be hosted in the spaces of PlayMore (sports center in Milan Moscova area) even after the end of the project. ACCEPT will be realized in a second phase as a scalable product and will be installed in gyms and schools in other neighborhoods, hospitals and rehabilitation centers, thanks to its modular structure and low implementation costs. It will be able to give life to new places of aggregation (e.g. inclusive playgrounds), thus stimulating the penetration of a sport recently included among the Olympic disciplines and therefore of great attractiveness for the new generations. Open test days of the ACCEPT wall are already planned in a more mature phase of the project, in collaboration with the sponsoring companies.

Partners and sponsors of the project

Among the partners

• FightTheStroke, a foundation protecting the rights of youth with CP and their families, which will provide support in testing and recruiting children with CP.
• PlayMore, a social enterprise born to promote sport, health and integration, beyond all differences and prejudices, that will provide the spaces for the prototype use, and will keep it available to the public also outside the testing moments.
• FASI – Italian Federation of Sports Climbing, as a consultant and in preparation of exercises.

The project has been sponsored as well by Montura, PBN, Scarpa, Vibram.