Are Seating Systems With a Medial Knee Support Really Helpful for Hip Displacement in Children With Spastic Cerebral Palsy GMFCS IV and V?

Abstract

ObjectiveTo evaluate whether medial knee support (MKS) in seating systems aggravates hip displacement in children with cerebral palsy (CP). DesignRetrospective chart review. SettingRehabilitation department of tertiary university hospital. ParticipantsChildren with CP (N=76) using seating systems (intervention group, n=42; mean age 6.86y) and using regular wheelchairs (control group, n=34; mean age 8.15y). InterventionsThe intervention group was provided with a seating system with MKS. We enrolled children who did not use a seating system in the control group, retrospectively. Main Outcome MeasuresBy radiographic images, Reimer’s migration index (MI), lateral center edge angle (CEA), and femur neck shaft angle (NSA) were measured. We compared the demographic data, clinical variables, and radiographs between the 2 groups. ResultsIn the intervention group, there was a significant deterioration in the MI, from 26.89% to 44.18% after using the system (P<.001). The progression of MI was 14.72% and 7.82% per year in the intervention and control groups, respectively (P=.016). ConclusionWe should consider the possibility that seating systems with MKS may exacerbate hip displacement in children with CP.