Twenty-three children with cerebral palsy were photographed and video-filmed in six different sitting positions--including a hypothetical functional position--and the video-films and photographs were analysed. It was found that pathological movements were minimised and postural control and arm and hand function best when the child was sitting in a forward-tipped seat, with a firm backrest supporting the pelvis, arms supported against a table and feet permitted to move backward.
SUMMARY
Ten children with cerebral palsy (CP) were videotaped and photographed after the introduction to a functional sitting position (FSP–defined as a position in which children with CP could gain head‐, trunk‐ and foot‐control and the maximum degree of independent function when performing arm and hand movements during tasks) and again five years later. Head‐, trunk‐ and foot‐control, and arm‐and hand‐function were assessed from video‐tapes by the Sitting Assessment Scale. The eight children who had been using the l‐'SP throughout this period showed slight but significant improvement; the remaining two had deteriorated. Since all 10 children had undergone similar rehabilitation programmes, it is concluded that sitting in an FSP contributed to their improvement in the ability to use the hand and arm.
RÉSUMÉ
Un suivi de cinq tins dcar;une position assise fonctionnelle chcz des enfants IMC
Un examen video ct photographique a été effectue ehez dix enfants IMC apres la mise en place dcar;une position assise fonctionnelle (FSP définie comme une position oú les enfants IMC pouvaient acquérir un bon contrôle de la tête, du trone et des pieds, ct une fonclion indépendanle en réalisant des mouveinents des bras et des mains an cours dcar;une tâchc) et de même cinq ans plus tard. l.e contrôle de la tête, du trone et des pieds, et la fonclion des bras et des mains furent évalués a partir des bandes vidéo selon la Sitting Assesscment Scale, l.es huit enfants qui avaient utilisé la FSP tout au long de la période dcar;examen précsentefrent un progrès léger mais significant“; lcaron;etaat se deteriora pour les deux autres enfants. Puisque le programme de rééducation entrepris pour les dix enfants était identique. les auteurs concluent que la position assise en FSP contrbuc à leurs progrès dans lcar;utilisation du bras et de la main.
ZUSAMMENFASSUNG
Verlaufskontiolle einer funktioneUen Sitzposition bci Kiudern mit Cerebralparese über fünf Jalire
Zehn Kinder mit Cerebralparese (CP) wurden auf Video aufgenommen und fotografiert. nachdem sie in cine funktionelle Sitz‐position (FSP) eingefuhrt waren diese ist definicrt als eine Position, in der Kinder mil CP Kopf. Runipf und Füße unter Kontrolle haben und ein Maximum an Freiraum haben, wenn sic bei der Ausführung von Aufgaben Arm‐ und Handbewegungen machen–und dann ein zweites Mai nach fünf Jahren. Kopf‐. Rumpf‐ und Fußkontrolle. sowic Arm‐ und Handfunktion wurden anhand der Videobänder gemäß der Sitting Assessment Scale beurteilt Bei den acht Kinder, die die FSP während der gesamten Zeit beibehalten batten, zeigte sich einer leichte. aber signifikante Besserung; die beiden anderen batten sich verseltlechtert. Da alio Kinder ähnliche Rehabilitationsprogramme mit‐gemacht hatten. wird der Schluß gezogen, daß das Sitzen in einer FSP dazu beitrug, den Bewegungsfrciraum von Händen und Armen zu verbessern.
RESUMEN
Seguimiento durante cinco anyos de la sedestacion funcional en niños con parálisis infantil
Diez niños con parálisis cerebral (PC) fueron registrados en video y fotografiados ...
The purpose of this study was to investigate the reliability of two dependent measures, (1) counting of pathologic movements (CPM) and (2) the Sitting Assessments Scale (SAS). The measures were intended for use in clinical physiotherapy practice, to provide both quantifiable and qualitative information from videofilm concerning functional sitting in children with cerebral palsy (CP). Two separate groups of final term physiotherapy students (three students in each group) tested one technique each for interrater reliability. The SAS-measure also was tested for interrater reliability. Videofilm of twelve children with CP ranging in age from 2 to 16 years were assessed. The students' results were compared to earlier results by experiences physiotherapist. The results demonstrated excellent interrater reliability for SAS (p<0.001) and good interrater reliability for the CPM technique. The degree of user experience seems to play a role in the use of the CPM measure. Considering evaluation of postural control and functional performance over all, SAS appears to be superior to CPM.
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