Special seating considerations for the child with a spinal cord injury

Abstract

Although wheelchair and seating set-up for the paediatric population is a specialty itself, the child who has sustained a spinal cord injury has several distinct orthopaedic needs that must be addressed; specifically, the issues of neuromuscular scoliosis and hip subluxation. These two factors, as well as the biomechanics and kinematics of wheelchair propulsion, will be discussed. This article reviews current published research regarding orthopaedic needs in paediatric spinal cord injury, wheelchair pushrim biomechanics in adults with spinal cord injury and clinical experience. It concludes that preventative measures such as proper seating, positioning and wheelchair set-up should be taken early on to decrease the chance of, or at least slow the rate of development of a scoliotic curve, hip subluxation or an upper extremity over-use injury.