Hip subluxation and dislocation in cerebral palsy – a prospective study on the effectiveness of postural management programmes

Abstract

The early provision of postural management equipment has a role to play in reducing the number of hip problems and therefore the need for treatment of hip subluxation/dislocation in cerebral palsy at five years of age.

Monitoring of body position and motion in children with severe cerebral palsy for 24 hours

“…Thus, symmetrical support of the posture using night-time postural equipment [21,22] has been recommended for children with CP to prevent the development of deformities based on evidence from clinical experience [21]. We did not assess head and trunk symmetry in this study; however, the occurrence of prolonged immobilized posture during night-time sleep, which was objectively measured in this study, would support the idea of using the equipment to prevent immobility-related problems such as contractures or hip dislocations for children with CP [21,23,24].…”

Hip displacement in relation to age and gross motor function in children with cerebral palsy

“…The use of postural management equipment has been reported to reduce the risk of displacement [27]. A preventative effect of weight bearing in abduction and extension has also been suggested [28].…”

Standing Programs to Promote Hip Flexibility in Children With Spastic Diplegic Cerebral Palsy

“…Other authors reported that postural management of children with CP when using equipment could maintain muscle length and joint range of movement to promote acetabular growth and to prevent hip subluxation. 21,28,36 We are evaluating the radiologic findings with the same study group that is the subject of this report, and preliminary results suggest that the migration percentage of these children remained within stable limits at 5 years of age.…”

“…6,15,19,20 Other techniques, such as positioning, provide a way of administering stretch for extended periods. 21 Children with spastic diplegic CP commonly have muscle shortening and decreased ROM of the lower limb muscles. Soft tissue abnormalities include muscular imbalance between the stronger flexors, adductors and internal rotators of the hip, and the weaker hip extensors, external rotators, and abductors.…”