Abstract
BackgroundKnowledge of sitting and standing performance in a total population of children with cerebral palsy (CP) is of interest for health care planning and for prediction of future ability in the individual child. In 1994, a register and a health care programme for children with CP in southern Sweden was initiated. In the programme information on how the child usually sits, stands, stands up and sits down, together with use of support or assistive devices, is recorded annually.MethodsA cross-sectional study was performed, analysing the most recent report of all children with CP born 1990-2005 and living in southern Sweden during 2008. All 562 children (326 boys, 236 girls) aged 3-18 years were included in the study. The degree of independence, use of support or assistive devices to sit, stand, stand up and sit down was analysed in relation to the Gross Motor Function Classification System (GMFCS), CP subtype and age.ResultA majority of the children used standard chairs (57%), could stand independently (62%) and could stand up (62%) and sit down (63%) without external support. Adaptive seating was used by 42%, external support to stand was used by 31%, to stand up by 19%, and to sit down by 18%. The use of adaptive seating and assistive devices increased with GMFCS levels (p < 0.001) and there was a difference between CP subtypes (p < 0.001). The use of support was more frequent in preschool children aged 3-6 (p < 0.001).ConclusionAbout 60% of children with CP, aged 3-18, use standard chairs, stand, stand up, and sit down without external support. Adding those using adaptive seating and external support, 99% of the children could sit, 96% could stand and 81% could stand up from a sitting position and 81% could sit down from a standing position. The GMFCS classification system is a good predictor of sitting and standing performance.
Highlights
Knowledge of sitting and standing performance in a total population of children with cerebral palsy (CP)is of interest for health care planning and for prediction of future ability in the individual child
The use of adaptive seating and assistive devices increased with Gross Motor Function Classification System (GMFCS) levels (p < 0.001) and there was a difference between CP subtypes (p < 0.001)
Level (Table 3) and the use of adaptive seating increased with GMFCS levels (p < 0.001)
Summary
Knowledge of sitting and standing performance in a total population of children with cerebral palsy (CP)is of interest for health care planning and for prediction of future ability in the individual child. Knowledge of sitting and standing performance in a total population of children with cerebral palsy (CP). Reduced postural ability is often a key problem and they may need postural support or assistive devices to stabilize the body against gravity in order to maintain a sitting or standing position [5,6,7,8,9,10,11,12,13,14,15,16]. A crouched standing posture leads to a reduced hip and knee extension that worsens over time, Department of Orthopaedics, Lund University, University Hospital, Lund, Sweden due to gravity and the altered position of the body segments in relation to each other [17]. Adaptive seating reduces the need for assistance from a caregiver [1921] and may facilitate daily activities and functions such as playing [22], eating [20,21,22,23,24], breathing [25] and arm and hand function [8,26,27]
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