Lessons learned from studying the functional impact of adaptive seating interventions for children with cerebral palsy

Abstract

Little empirical evidence exists about the effectiveness of assistive technology interventions for children with cerebral palsy (CP) to inform clinical practice. This article reviews what we know about the functional impact of adaptive seating interventions -a common assistive technology type recommended for children with CP. A contemporary assistive technology outcomes framework is considered as a way to model the temporality and measure the effects of seating interventions and moderating cofactors. Three research studies are profiled to illustrate different research methods, measurement approaches, and follow-up periods to learn about adaptive seating outcomes. Recommendations for future research include the adoption of common measurement indicators, consideration of quality assessment criteria, and the use of varied methodologies to generate new knowledge about functional outcomes. It is suggested that the proposed strategies will lead to new understandings, clinical applications, and ultimately improvements in the everyday lives of children with CP and their families.Children with cerebral palsy (CP) use assistive technology devices and specialized assistive technology services to enhance everyday functioning, though researchers and clinicians know little about the impact of these common interventions.1 The cost, complexity, and variety in product and related service options, and uncertainty about assistive technology effectiveness, efficiency, and satisfaction, suggest a compelling need for empirical evidence to inform clinical practice and shared decision making with children and families.The International Classification of Functioning, Disability and Health (ICF), 2 and its derived classification for children and youth (ICF-CY), 3 provide a theoretical framework to study the assessment, selection, delivery, and impact of assistive technology interventions. The ICF framework conceptualizes assistive technology as an environmental resource that interacts with the child's health condition and other contextual factors to influence functioning at the levels of the body (body function and structures), the individual child (activity), and the child as a member of society (participation).Given the broad scope and goals of different assistive technology interventions, the following narrative review focuses on the progress, challenges, and lessons learned by our research team measuring functional outcomes consistent with the ICF framework and associated with adaptive seating -a common form of assistive technology recommended by clinicians for children with CP. EVIDENCE OF THE FUNCTIONAL IMPACT OF ADAPTIVE SEATING INTERVENTIONSPediatric occupational and physical therapists recommend adaptive seating devices and services to improve the activity performance of children with CP in a variety of settings. Adaptive seating devices include wheelchair seating systems, and special purpose positioning products such as adaptive car seats, bath seats, and toileting systems; whereas, adaptive seating interventions include both t...

Effect of early intervention in infants at very high risk of cerebral palsy: a systematic review

“…The environment involves family empowerment and the application of assistive devices, such as adaptive seating systems and power mobility. These assistive devices may help the infant in its discovery of the world and its interaction with other people, thereby promoting cognitive and personal development . We have summarized our suggestions for future research in Appendix S3 (online supporting information).…”

“…These assistive devices may help the infant in its discovery of the world and its interaction with other people, thereby promoting cognitive and personal development. [98][99][100][101] We have summarized our suggestions for future research in Appendix S3 (online supporting information). fonds, Phelps Stichting, Revalidatie Nederland and the Nederlands Vereniging van Revalidatieartsen.…”

Serebral Palsili Çocuklarda Adaptif Cihaz Kullanımını Etkileyen Faktörler

“…15 Cihazlarla ilgili maliyet, çeşitlilik, etkinlik, memnuniyet konusundaki belirsizlikler SP'li çocuklara AC önerisinde bulunmak için güçlü kanıtlar sunmamaktadır. 16…”

Parental views regarding seating and participation for young children with cerebral palsy

“…They concluded however that seating provision is complex and practitioners are advised to find out what is meaningful and important for children and their families when considering outcomes (Stier et al, 2016). These studies provide informative findings which consider the impact that adaptive seating may have on everyday functioning for children with cerebral palsy, however the evidence base remains limited (Novak et al, 2013;Ryan, 2016). Hammel et al (2013) explored the perceptions of adults who use adaptive seating and found that they are viewed as helpful to enhance choice, control and social integration.…”

“…There is recognition that research regarding seating and children with cerebral palsy should be co-developed with people who use such equipment so as to better understand their perspectives (Ryan, 2016). Therefore it is important to understand the views of children with cerebral palsy and their parents who use seating systems.…”