Effects of different seating equipment on postural control and upper extremity function in children with cerebral palsy


Sahinoglu D., COŞKUN G., BEK N.

Prosthetics and Orthotics International, vol.41, no.1, pp.85-94, 2017 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 41 Issue: 1
  • Publication Date: 2017
  • Doi Number: 10.1177/0309364616637490
  • Journal Name: Prosthetics and Orthotics International
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.85-94
  • Keywords: Children with cerebral palsy, adaptive seating, orthosis, FUNCTION CLASSIFICATION-SYSTEM, SITTING POSTURE, RELIABILITY, STABILITY, DEVICES
  • Lokman Hekim University Affiliated: No

Abstract

© International Society for Prosthetics and Orthotics International 2015.Background: Adaptive seating supports for cerebral palsy are recommended to develop and maintain optimum posture, and functional use of upper extremities. Objectives: To compare the effectiveness of different seating adaptations regarding postural alignment and related functions and to investigate the effects of these seating adaptations on different motor levels. Study design: Prospective study. Methods: A total of 20 children with spastic cerebral palsy (Gross Motor Function Classification System 3-5) were included. Postural control and function (Seated Postural Control Measure, Sitting Assessment Scale) were measured in three different systems: standard chair, adjustable seating system and custom-made orthosis. Results: In results of all participants ungrouped, there was a significant difference in most parameters of both measurement tools in favor of custom-made orthosis and adjustable seating system when compared to standard chair (p < 0.0017). There was a difference among interventions in most of the Seated Postural Control Measure results in Level 4 when subjects were grouped according to Gross Motor Function Classification System levels. A difference was observed between standard chair and adjustable seating system in foot control, arm control, and total Sitting Assessment Scale scores; and between standard chair and custom-made orthosis in trunk control, arm control, and total Sitting Assessment Scale score in Level 4. There was no difference in adjustable seating system and custom-made orthosis in Sitting Assessment Scale in this group of children (p < 0.017). Conclusion: Although custom-made orthosis fabrication is time consuming, it is still recommended since it is custom made, easy to use, and low-cost. On the other hand, the adjustable seating system can be modified according to a patient's height and weight. Clinical relevance It was found that Gross Motor Function Classification System Level 4 children benefitted most from the seating support systems. It was presented that standard chair is sufficient in providing postural alignment. Both custom-made orthosis and adjustable seating system have pros and cons and the best solution for each will be dependent on a number of factors.