Abstract
Objective. To investigate the effects of special seating on lateral spinal curvature in the
non-ambulant spastic cerebral palsy population with scoliosis.
Design. Prospective study with matched pairs (same subject pre- and post-intervention).
Background. It is thought that special seating can improve the sitting posture of individuals
with spastic cerebral palsy. However, there is little known about how the seating
can affect a scoliosis.
Method. The shape of the spine was measured with subjects sitting in an assessment chair
with a clear backrest. The measurement recorded was the “spinous process angle”, an
approximation to the Cobb angle. The forces exerted on the subject by the chair were
measured by electrical resistance strain gauged transducers attached to the lateral
support pads and seat base. Measurements were taken with three alternative arrangements
of lateral support pads: upper body unsupported in configuration 1; two lateral pads
at the same height in configuration 2; body supported by a 3-point force system in
configuration 3.
Results. Configuration 3 gave a mean correction of +35% in the spinous process angle compared
to configuration 1 (P=0.000) and the forces applied through the two lateral thoracic pads were, on average,
of similar magnitude (mean values of 51 and 47 N). In comparison, for configuration
2 the mean correction was only +18.7% (P=0.004) and on average the pad on the concave side of the scoliosis applied a much
larger force to the chest wall than the pad on the convex side (mean values of 36
and 17 N respectively).
Conclusions. Significant static correction of the scoliotic spine can be achieved with an arrangement
of lateral pads on a seating system that applies a 3-point force system to the sides
of the body.Relevance
The results suggest that the position of the lateral pads on a special seating system
is important and, by the careful configuration of these supports, significant correction
of a scoliosis can be obtained for a person with spastic cerebral palsy. Also the
methodology and equipment from this study are potentially useful for the assessment
and fitting of special seating for individuals with scoliosis.
Keywords
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References
- Rib cage-spine coupling patterns involved in brace treatment of adolescent idiopathic scoliosis.Spine. 1997; 22: 629-635
- The biomechanical effectiveness of the Boston Brace in the management of adolescent idiopathic scoliosis.Spine. 1998; 14: 636-642
- Comparison between clinical Cobb angles and measurements performed on vertebral bodies, pedicle centroids and spinous processes.Ann. Chir. 1999; 53: 792-797
- Cobb angle versus spinous process angle in adolescent idiopathic scoliosis. The relationship of the anterior and posterior deformities.Spine. 1990; 15: 874-879
- Spine care of the patient with Duchenne muscular dystrophy.Spine. 1999; 4 (State of the art reviews): 161-172
- A mathematical expression of three-dimensional configuration of the scoliotic spine.J. Biomech. Eng. 1996; 118: 247-252
- Operative treatment of spinal deformities in patients with cerebral palsy or mental retardation.J. Bone Joint Surg. 1983; 65: 43-55
- Scoliosis in the institutionalised cerebral palsy population.Spine. 1981; 6: 583-590
- Natural history of scoliosis in spastic cerebral palsy.Lancet. 1998; 351: 1687-1692
- Analysis of the interaction between vertebral lateral deviation and axial rotation in scoliosis.J. Biomech. 1991; 24: 753-759
- Three-dimensional spinal deformity in scoliosis associated with cerebral palsy and with progressive muscular dystrophy.Spine. 1993; 18: 2290-2294
- The pattern of spinal deformity in Duchenne muscular dystrophy.J. Bone Joint Surg. 1976; 58-A: 1976
Article info
Publication history
Accepted:
April 2,
2003
Received:
May 15,
2002
Identification
Copyright
© 2003 Published by Elsevier Inc.
