SIOUX CITY | Norah Treiber was born with her arms tightly locked against her tiny body.
For the first five months of her life, Norah couldn't move her arms. Now, after two months of physical and occupational therapy at Therapy Station, the 1-year-old Sioux City girl can pick up her toys and raise them to waist level. She can somewhat feed herself.
"She still finds a way to do what she wants to do," Liz Treiber Murdach said as her daughter, dressed in a pink shirt and striped leggings, scurried across the floor like a spider during a physical therapy session.
Norah loosely grasped a strawberry wafer cookie in her limp hand and tried to boost her arm up with her leg. When the cookie landed in her lap, Norah wailed and kicked her feet.
Norah has arthrogryposis, a condition that caused many of her joints to be crooked or stiff at birth. Although she won't put any weight on her feet, Treiber Murdach said Norah's legs aren't affected.
Physical therapy has improved Norah's joint mobility, but Treiber Murdach wants her daughter to be as "normal" as she can be. She applied for Magic Arms, a 3D-printed, gravity-balancing exoskeletal device, that Norah expects to receive in the coming months.
According to Magic Arms for the World's website, 150 children with muscular dystrophy, cerebral palsy and other muscular disorders are waiting for the device that costs about $10,000 including fittings and travel. Treiber Murdach regularly drives her daughter five hours to Minneapolis for appointments.
"She's made amazing progress, however, we're kind of at a point where her muscles won't allow her to do the things that normal kids do like feeding themselves, putting on their own socks, giving a hug," she said. "I don't want her to feel like she's any different than anyone else. I would do anything to make her life easier or more normal."
NOT A SIMPLE FIX
Treiber Murdach didn't know anything was wrong with Norah until a nurse set her daughter on her chest in the delivery room at UnityPoint Health -- St. Luke's on Jan. 19, 2014.
A diagnosis of amyoplasia, the most common type of arthrogryposis, came 36 hours later at the University of Nebraska Medical Center in Omaha.
There is no specific gene known to cause the disorder. It's not a progressive condition, either. Severe joint contractures and muscle weakness, hallmarks of the amyoplasia, are most severe at birth.
"I don't know that they had ever seen it in a newborn at St. Luke's," Treiber Murdach said. "My initial thought was it was something pretty simple that was gonna be easily fixed. Maybe she laid wrong when I was pregnant."
Northwest Area Education Agency therapists started coming to Treiber Murdach's home to work with Norah. Treiber Murdach stretched Norah's limbs many times during the day.
When Norah turned 3-months-old, she got her first set of splints at Shriners Hospitals for Children -- Twin Cities. She wore the hard plastic splints on her elbows while she slept. At 6 months, Norah received a second pair of splints that stretched from the bottom of her elbows to the middle of her hands to straighten her fingers and wrists.
Two months ago, physical therapist Andrea Wood started working with Norah at Therapy Station, 1301 W. First St.
"With physical and occupational therapy we can increase her strength and range of motion by working on her fine motor skills and also help her with weight bearing and eventually get her up and walking," Wood said.
DETERMINED LITTLE GIRL
Norah pushes a pink ball, grasps the rungs of a colorful ladder and follows an electronic puppy while fastened in a walker during physical therapy.
"She enjoys following that around and touching and feeling the dog. It gets her to actually be motivated to walk and use the walker while she's playing," Wood said. "We need to motivate her enough so we can make progress during therapy and make it fun for her."
Norah struggled to keep her balance while sitting upright, grab a sippy cup and pick up her blocks when she first arrived at Therapy Station. Today, she can do those things with less help. She's more independent when eating, drinking and playing with her 4-year-old sister, Grace.
"She's come a long way," Treiber Murdach said. "She's figured out how to grasp food between her pointer finger and middle finger and then use her leg to kind of get it to her mouth. It takes a lot out of her, but she's definitely a very determined little girl."
Magic Arms are new to the area. Wood said she has never worked with the device before.
Wood will attend an appointment with Norah on April 21 in Minneapolis to learn how Magic Arms operate. She needs to know how to place the device on Norah and recognize when it has become too small for her.
To prepare Norah for her Magic Arms, Wood is helping her improve the range of motion in her shoulders, elbows and hands as well as strengthening her core.
"The Magic Arms will be a little bit heavier on her," Wood said. "She'll need her abdominal and trunk strength to be able to sit up and keep her balance."