Changes in postural alignment when using kneeblocks for children with severe motor disorders

Abstract

Purpose. Children with severe motor disorders often use adaptive seating devices to improve their postural alignment with aim of helping to prevent the development of deformity. Little objective evidence exists about their effectiveness, and this study sought to measure changes in postural alignment when using/not using the active element in one adaptive seating system.Method. A seating system that uses a sacral pad and kneeblock was examined. This seating device aims to neutralize the angular deviation of the hips and pelvis in order to give a stable base for functional sitting. Change in postural alignment was measured in 23 children with severe motor impairment (GMFCS 5) when using and when not using the kneeblock devices, immediately, and after a delay of one month.Results. We found that the removal or replacement of kneeblocks effected hip abduction and rotation on one side only, but no other immediate effect on joint angles and overall body posture.Conclusions. The postural management of children with neurological conditions requires further objective outcome measurement on which to base clinical practice, and improvement of posture is one of a number of factors which should be considered when providing adaptive seating to this group of children.