The Effect of Seat Surface Inclination on Postural Control and Upper Extremity Function in Children with Cerebral Palsy- A Crossover Study
DOI:
https://doi.org/10.37506/1qvmgv74Keywords:
Cerebral palsy; postural control; upper extremity function; adaptive seating; seat inclination.Abstract
Background: Children with cerebral palsy spend prolonged periods in sitting, particularly in school settings. Adaptive
seating, including seat surface inclination, may influence postural control and upper extremity function.
Methods: A cross-over study was conducted on 25 children with spastic cerebral palsy (8–13 years). Postural control and
upper extremity function were assessed using the Sitting Assessment Scale, Seated Postural Control Measure, Functional
Assessment Battery Tool, and ABILHAND-Kids Questionnaire under neutral, anterior, and posterior seat inclination
conditions.
Results: Significant differences were observed across seating conditions in postural control, alignment, and selected
upper extremity functional outcomes (p < 0.05).
Conclusion: A 10° seat inclination significantly influenced seated postural control and upper extremity function in children
with spastic cerebral palsy.
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References
Bax M, Goldstein M, Rosenbaum P, Leviton A,
Paneth N, Dan B, Jacobsson B, Damiano D. Proposed
definition and classification of cerebral palsy, April
Developmental Medicine and Child Neurology. 2005
Aug;47(8):571-6.
Chauhan A, Singh M, Jaiswal N, Agarwal A, Sahu
JK, Singh M. Prevalence of cerebral palsy in Indian
children: a systematic review and meta-analysis. The
Indian Journal of Pediatrics. 2019 Dec;86(12):1124-30.
Oskoui M, Coutinho F, Dykeman J, Jetté N, Pringsheim
T. An update on the prevalence of cerebral palsy: a
systematic review and meta-analysis. Developmental
Medicine & Child Neurology. 2013 Jun;55(6):509-19.
Paulson A, Vargus-Adams J. Overview of four
functional classification systems commonly used in
cerebral palsy. Children. 2017 Apr;4(4):30.
Graham HK. Classifying cerebral palsy. Journal of
Pediatric Orthopaedics. 2005 Jan 1;25(1):127-8.
Banerjee TK, Hazra A, Biswas A, Ray J, Roy T, Raut
DK, Chaudhuri A, Das SK. Neurological disorders
in children and adolescents. The Indian Journal of
Pediatrics. 2009 Feb;76(2):139-46.
Singhi PD, Ray M, Suri G. Clinical spectrum of cerebral
palsy in North India—an analysis of 1000 cases. Journal
of Tropical Pediatrics. 2002 Jun 1;48(3):162-6.
Chung J, Evans J, Lee C, Lee J, Rabbani Y, Roxborough
L, Harris SR. Effectiveness of adaptive seating on
sitting posture and postural control in children with
;20(4):303-17.
Huang IC, Sugden D, Beveridge S. Assistive devices
and cerebral palsy: factors influencing the use of
assistive devices at home by children with cerebral
palsy. Child: care, health and Development. 2009
Jan;35(1):130-9.
Brogren E, Forssberg H, Hadders-Algra M. Influence of
two different sitting positions on postural adjustments
in children with spastic diplegia. Developmental
Medicine and Child Neurology. 2001 Aug;43(8):534-46.
Van Der Heide JC, Begeer C, Fock JM, Otten B,
Stremmelaar E, Van Eykern LA, Hadders-Algra M.
Postural control during reaching in preterm children
with cerebral palsy. Developmental Medicine and Child
Neurology. 2004 Apr;46(4):253-66.
Donker SF, Ledebt A, Roerdink M, Savelsbergh GJ,
Beek PJ. Children with cerebral palsy exhibit greater
and more regular postural sway than typically
developing children. Experimental Brain Research. 2008
Jan 1;184(3):363-70.
Carlberg EB, Hadders-Algra M. Postural dysfunction
in children with cerebral palsy: some implications
for therapeutic guidance. Neural Plasticity. 2005 Jan
;12(2-3):221-8.
Brogren E, Hadders-Algraa M, Forssberg H.
Postural control in sitting children with cerebral
palsy. Neuroscience &Biobehavioral Reviews. 1998 Mar
;22(4):591-6.
Schiariti V, Klassen AF, Cieza A, Sauve K, O’Donnell
M, Armstrong R, Mâsse LC. Comparing contents
of outcome measures in cerebral palsy using the
International Classification of Functioning (ICF-CY):
a systematic review. European Journal of Paediatric
Neurology. 2014 Jan 1;18(1):1-2.
Çankaya Ö, Seyhan K. ICF-CY-Based Physiotherapy
Management in Children with Cerebral Palsy. Cerebral
Palsy: Current Steps. 2016 Sep 21:79.
Arner M, Eliasson AC, Nicklasson S, Sommerstein K,
Hägglund G. Hand function in cerebral palsy. Report
of 367 children in a population-based longitudinal
health care program. The Journal of Hand Surgery. 2008
Oct 1;33(8):1337-47.
Arnould C, Penta M, Thonnard JL. Hand impairments
and their relationship with manual ability in children
with cerebral palsy. Journal of Rehabilitation Medicine.
Nov 5;39(9):708-14.
Fedrizzi E, Pagliano E, Andreucci E, Oleari G. Hand
function in children with hemiplegic cerebral palsy:
prospective follow-up and functional outcome
in adolescence. Developmental Medicine and Child
Neurology. 2003 Feb;45(2):85-91.
Mackey AH, Walt SE, Stott NS. Deficits in upper-limb
task performance in children with hemiplegic cerebral
palsy as defined by 3-dimensional kinematics.
Archives of physical medicine and Rehabilitation. 2006 Feb
;87(2):207-15.
Uvebrant P. Hemiplegic cerebral palsy aetiology and
outcome. Acta Paediatrica. 1988 May;77:1-00.
Lemmens RJ, Janssen-Potten YJ, Timmermans AA,
Defesche A, Smeets RJ, Seelen HA. Arm hand skilled
performance in cerebral palsy: activity preferences
and their movement components. BMC Neurology.
Dec;14(1):1-0.
Steenbergen B, Gordon AM. Activity limitation in
hemiplegic cerebral palsy: evidence for disorders in
motor planning. Developmental Medicine and Child
Neurology. 2006 Sep;48(9):780-3.
Arnould C, Bleyenheuft Y, Thonnard JL. Hand
functioning in children with cerebral palsy. Frontiers
in Neurology. 2014 Apr 9;5:48.
Costigan FA, Light J. Effect of seated position on upperextremity
access to augmentative communication
for children with cerebral palsy: Preliminary
investigation. American Journal of Occupational Therapy.
Jul 1;64(4):596-604.
Rodby-Bousquet E, Hägglund G. Sitting and standing
performance in a total population of children
with cerebral palsy: a cross-sectional study. BMC
Musculoskeletal Discord.2010 Jun 23;11:131. doi:
1186/1471-2474-11-131. PMID: 20573201; PMCID:
PMC2908562.
Zulkapli NZ, Saat NZ, Kamaralzaman S. Postural
control influence on upper extremity function among
children with cerebral palsy: a literature review. Jurnal
Sains Kesihatan Malaysia (Malaysian Journal of Health
Sciences). 2016 Jun 30;14(2).
Field DA, Roxborough LA. Responsiveness of the
Seated Postural Control Measure and the Level of
Sitting Scale in children with neuromotor disorders.
Disability and Rehabilitation: Assistive Technology. 2011
Nov 1;6(6):473-82.
Mcnamara L, Casey J. Seat inclinations affect the
function of children with cerebral palsy: a review
of the effect of different seat inclines. Disability and
Rehabilitation: Assistive Technology. 2007 Jan 1;2(6):
-18.
Angsupaisal M, Maathuis CG, Hadders-Algra M.
Adaptive seating systems in children with severe
cerebral palsy across International Classification
of Functioning, Disability and Health for Children
and Youth version domains: a systematic review.
Developmental Medicine & Child Neurology. 2015
Oct;57(10):919-30.
Stavness C. The effect of positioning for children with
cerebral palsy on upper-extremity function: a review
of the evidence. Physical & Occupational Therapy in
Pediatrics. 2006 Jan 1;26(3):39-53.
Green EM, Nelham RL. Development of sitting ability,
assessment of children with a motor handicap and
prescription of appropriate seating systems. Prosthetics
and orthotics International. 1991 Dec;15(3):203-16.
Nwaobi OM. Seating orientations and upper extremity
function in children with cerebral palsy. Physical
Therapy. 1987 Aug 1;67(8):1209-12.
Michael SM, Porter D, Pountney TE. Tilted seat position
for non-ambulant individuals with neurological and
neuromuscular impairment: a systematic review.
Clinical rehabilitation. 2007 Dec;21(12):1063-74.
Myhr U, von Wendt L. Improvement of functional
sitting position for children with cerebral palsy.
Developmental Medicine & Child Neurology. 1991
Mar;33(3):246-56.
Myhr U, von Wendt L. Influence of different sitting
positions and abduction orthoses on leg muscle
activity in children with cerebral palsy. Developmental
Medicine & Child Neurology. 1993 Oct;35(10):870-80.
Sochaniwskyj A, Koheil R, Bablich K, Milner M, Lotto
W. Dynamic monitoring of sitting posture for children
with spastic cerebral palsy. Clinical Biomechanics. 1991
Aug 1;6(3):161-7.
Reid DT. The effects of the saddle seat on seated
postural control and upper-extremity movement in
children with cerebral palsy. Developmental Medicine &
Child Neurology. 1996 Sep;38(9):805-15.
Cherng RJ, Lin HC, Ju YH, Ho CS. Effect of seat
surface inclination on postural stability and forward
reaching efficiency in children with spastic cerebral
palsy. Research in Developmental Disabilities. 2009 Nov
;30(6):1420-7.
Hadders-Algra M, Van der Heide JC, Fock JM,
Stremmelaar E, Van Eykern LA, Otten B. Effect of
seat surface inclination on postural control during
reaching in preterm children with cerebral palsy.
Physical Therapy. 2007 Jul 1;87(7):861-71.
McClenaghan BA, Thombs L, Milner M. Effects of
seat-surface inclination on postural stability and
function of the upper extremities of children with
cerebral palsy. Developmental Medicine & Child
Neurology. 1992 Jan;34(1):40-8.
Angsupaisal M. Adaptive seating and adaptive riding
in children with cerebral palsy: In children with
cerebral palsy.Research in Developmental Disabilities
Sep; 71:42–52
Matusiak-Wieczorek E, Dziankowska-Zaborszczyk E,
Synder M, Borowski A. The influence of hippotherapy
on the body posture in a sitting position among
children with cerebral palsy. International journal
of environmental research and public health. 2020
Jan;17(18):6846.
Myhr, U. Manual for the Sitting Assessment Scale;
Boden University College of Health Sciences: Boden,
Sweden, 1993.
Myhr U, von Wendt L. Reducing spasticity and
enhancing postural control for the creation of a
functional sitting position in children with cerebral
palsy: A pilot study. Physiotherapy Theory and Practice.
Jan 1;6(2):65-76.
Arnould C, Penta M, Renders A, Thonnard JL.
ABILHAND-Kids: a measure of manual ability in
children with cerebral palsy. Neurology. 2004 Sep
;63(6):1045-52.
Chow, Shao and Wang, Sample Size
Calculations in Clinical Research, https://www2.
ccrb.cuhk.edu.hk/stat/mean/tsmc_equivalence.
htmTaylor & Francis, NY. (2003) Pages 66-67
Sahinoğlu D, Coskun G, Bek N. Effects of different
seating equipment on postural control and upper
extremity function in children with cerebral
palsy. Prosthetics and orthotics International. 2017
Feb;41(1):85-94.
Fife SE, Roxborough LA, Armstrong RW, Harris SR,
Gregson JL, Field D. Development of a clinical measure
of postural control for assessment of adaptive seating
in children with neuromotor disabilities. Physical
Therapy. 1991 Dec 1;71(12):981-93.
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