Continuous postural management and the prevention of deformity in children with cerebral palsy: an appraisal

Gough, Martin

doi:10.1111/j.1469-8749.2008.03160.x

Cited by 54 publications

(24 citation statements)

References 58 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Recent research has also gone beyond body structure to consider outcomes related to quality of life such as activity and participation (Sewell et al., , ). This is in line with the suggestion that focus in the use of postural care should consider the environment and participation in addition to body structure (Gough, ; McDonald et al., ).…”

Section: Discussionsupporting

confidence: 85%

Postural care for people with intellectual disabilities and severely impaired motor function: A scoping review

Robertson

Baines

Emerson

et al. 2016

Research Intellect Disabil

View full text Add to dashboard Cite

Background: Poor postural care can have severe and life-threatening complications.This scoping review aims to map and summarize existing evidence regarding postural care for people with intellectual disabilities and severely impaired motor function.Method: Studies were identified via electronic database searches (MEDLINE, CINAHL, PsycINFO and Web of Science) covering January 1990 to March 2016, and email requests to researcher networks. Results were collated via descriptive numerical summary of studies and thematic analysis. Results:Twenty-three studies were identified and summarized narratively in relation to three themes: characteristics and prevalence, interventions and service related issues. The evidence base is small with significant gaps. Lack of evidence for nighttime positioning equipment and 24-hr postural care needs to be addressed urgently. Conclusion:Future research should be clearly directed towards ascertaining how best postural care interventions can be employed to help improve the health and quality of life of people with intellectual disabilities. K E Y W O R D Sintellectual disabilities, postural care, scoping review |Published for the British Institute of Learning Disabilities ROBERTSON ET al. posture also underpin the ability to function and access the environment (Crawford & Stinson, 2015).Over the past 15 years, there has been increased awareness of the need to provide postural care over the entire 24-hr period. This usually involves adaptive seating and/or moulded wheelchairs; night-time positioning equipment (NTPE); moving and handling techniques; and advice and training across all settings that the person accesses (Crawford & Stinson, 2015). NTPE can be used during the substantial proportion of the day when the person is in bed and has been reported to be beneficial even for those with established body shape distortion (Goldsmith, 2000).It has been proposed that most people who lack the ability to change their position would benefit from 24-hr body positioning (Crawford & Stinson, 2015) and that 24-hr postural care strategies should be considered in physical therapy programmes to prevent or delay the development of contractures or skeletal deformities in children and young people at risk of developing these (National Institute for Health & Care Excellence, 2012). However, disabled children generally are not being provided with the specialist equipment they require (such as seating and postural support systems), with provision of equipment being patchy at best (Centre for Economics and Business Research, 2014). It is widely accepted that the current systems that provide equipment and related services to children fail (CSED Consultant's Report, 2010).The importance of the issue of postural care in relation to people with intellectual disabilities has been highlighted in a number of reports noting gaps in services and the need to provide postural care interventions to prevent postural deformities from developing (Heslop et al., 2013;Mansell, 2010;Michael, 2008, RCGP, 2012. No systematic...

show abstract

Section: Discussionsupporting

confidence: 85%

Postural care for people with intellectual disabilities and severely impaired motor function: A scoping review

Robertson

Baines

Emerson

et al. 2016

Research Intellect Disabil

View full text Add to dashboard Cite

show abstract

“…A further review found little evidence for any benefit of postural management but evidence of disadvantages, including pain. 31 We recommend that adverse effects and benefits of treatment are recorded and assessed to inform effective use of such treatments.…”

Section: Discussionmentioning

confidence: 99%

Pain in young people aged 13 to 17 years with cerebral palsy: cross-sectional, multicentre European study

Parkinson

Dickinson

Arnaud

et al. 2013

Archives of Disease in Childhood

147

204

View full text Add to dashboard Cite

ObjectiveTo determine the prevalence and associations of self- and parent-reported pain in young people with cerebral palsy (CP).Design and settingCross-sectional questionnaire survey conducted at home visits in nine regions in seven European countries. Participants were 13 to 17-year-olds (n=667) drawn from population CP registers in eight regions and from multiple sources in one region. 429 could self-report; parent-reports were obtained for 657. Data were collected on: severity, frequency, site and circumstances of pain in previous week; severity of pain associated with therapy in previous year.ResultsThe estimated population prevalence of any pain in previous week was 74% (95% CI 69% to 79%) for self-reported pain and 77% (95% CI 73% to 81%) for parent-reported pain. 40% experienced leg pains, 34% reported headaches and 45% of those who received physiotherapy experienced pain during therapy. Girls reported more pain than boys (OR=2.1, 95% CI 1.5 to 3.0) and young people reported more pain if they had emotional difficulties (comparing highest and lowest quartiles: OR=3.1, 95% CI 1.7 to 5.6). Parents reported more pain in children with emotional difficulties (OR=4.2, 95% CI 2.7 to 6.6), or with more impaired walking ability.ConclusionsPain in young people with CP is highly prevalent. Because pain causes immediate distress and is associated with lower subjective well-being and reduced participation, clinicians should routinely assess pain. Clinical interventions to reduce pain should be implemented and evaluated. The efficacy of medical and therapeutic interventions causing pain should be re-examined to establish if their benefit justifies the pain and fear of pain that accompany them.

show abstract

“…It is important to consider the effects of a postural management program that is too intense, that places too great a burden on the carers or family, and that lacks scientific evidence to support its use (Gough, 2009). One should take care in using words like "prevent" in the context of managing a scoliosis.…”

Section: Overviewmentioning

confidence: 99%

Posture Management

Long

2014

Clinical Engineering

View full text Add to dashboard Cite

Continuous postural management and the prevention of deformity in children with cerebral palsy: an appraisal

Cited by 54 publications

References 58 publications

Postural care for people with intellectual disabilities and severely impaired motor function: A scoping review

Postural care for people with intellectual disabilities and severely impaired motor function: A scoping review

Pain in young people aged 13 to 17 years with cerebral palsy: cross-sectional, multicentre European study

Posture Management

Contact Info

Product

Resources

About