Postural asymmetries, pain, and ability to change position of children with cerebral palsy in sitting and supine: a cross-sectional study

Casey, Jackie; Rosenblad, Andreas; Rodby‐Bousquet, Elisabet

doi:10.1080/09638288.2020.1834628

Cited by 16 publications

(24 citation statements)

References 37 publications

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“…Recent work by Casey et al [1] shows an association between pain and postural asymmetries in children with cerebral palsy, and also that inability to change position increases the likelihood of having postural asymmetries. Our results indicate a clear association between postural asymmetries in sitting and lying with deformities/contractures of the spine, hips, and knees.…”

Section: Discussionmentioning

confidence: 99%

“…Secondary complications often experienced by children with cerebral palsy include a variety of postural asymmetries [1], deformities [2,3], and pain [4], all of which impact upon their ability to socially and physically participate in everyday life [5]. Such deformities can include scoliosis [6,7], hip dislocations [2], windswept deformity; as well as hip and knee contractures [8].…”

Section: Introductionmentioning

confidence: 99%

“…Many children with cerebral palsy have difficulties maintaining a symmetrical posture or independently changing position in sitting or lying, which may result in habitual asymmetric postures, potentially leading to deformities and contractures [1]. Adults with cerebral palsy who are unable to change position in lying also have an increased risk of windswept hips and scoliosis [10].…”

Section: Introductionmentioning

confidence: 99%

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Relationship between scoliosis, windswept hips and contractures with pain and asymmetries in sitting and supine in 2450 children with cerebral palsy

Casey

Ágústsson

Rosenblad

et al. 2021

Disability and Rehabilitation

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Purpose: This cross-sectional study of 2450 children with cerebral palsy aimed to analyse the prevalence and association of scoliosis, windswept hips, hip and knee contractures. Methods: Logistic regression was used to estimate associations with pain, postural asymmetries, and ability to change position for children at Gross Motor Function Classification System (GMFCS) levels I-V, aged 0-18 years. Results: Most children with a deformity or contracture had postural asymmetries in both sitting and supine positions; 10.5% had scoliosis, 8.7% windswept hips, 6.6% hip flexion and 19.2% knee contractures. Severe postural asymmetries increased the likelihood for scoliosis 9 times, for windswept hips 6 to 9 times, and for hip and knee flexion contractures 7 and 12 times respectively, adjusted for age, sex and GMFCS level. Hip flexion contractures and windswept hips increased the likelihood for pain by 1.5-1.6 times. Conclusion:The likelihood of having scoliosis, windswept hips and flexion contractures in the hips and knees increased if the child had postural asymmetries, and for increased age and higher GMFCS levels. Efforts should focus on preventing postural asymmetries from occurring or progressing, and on increasing the child's ability to change position. Reducing postural asymmetries may also reduce the likelihood of pain. ä IMPLICATIONS FOR REHABILITATIONThe risk of having scoliosis, windswept hip deformity and flexion contractures in the hips and knees increased if the child had postural asymmetries in sitting or lying. Efforts should focus on preventing or reducing postural asymmetries, and on increasing the child's ability to change position. Reducing postural asymmetries may also reduce the risk of pain.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Relationship between scoliosis, windswept hips and contractures with pain and asymmetries in sitting and supine in 2450 children with cerebral palsy

Casey

Ágústsson

Rosenblad

et al. 2021

Disability and Rehabilitation

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“…Alternatively, it might indicate that the asymmetries seen in young adults might be more reducible when provided with appropriate support, while the asymmetries in older adults might be more associated with non-correctable fixed deformities. A recent study of children with cerebral palsy shows an increasing trend, with more asymmetries in older children and adolescents than in younger children ( 7 ). However, the asymmetries were already seen in children before the age of 3 years ( 7 ).…”

Section: Discussionmentioning

confidence: 99%

“…Postural asymmetries are frequent and associated with a limited range of joint motion and an inability to change position (4,5). Asymmetric postures sustained for long periods of time are associated with deformities, contractures and pain, which most commonly affect the spine and the lower extremities (5)(6)(7)(8). Inability to move and having a sustained posture increases the likelihood for contractures, making each posture relative to the time spent in that position clinically important throughout a 24-h cycle (4,5,9).…”

Section: Introductionmentioning

confidence: 99%

Postural Asymmetries and Assistive Devices Used by Adults With Cerebral Palsy in Lying, Sitting, and Standing

Rodby‐Bousquet

2021

Front. Neurol.

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Purpose: To describe the use of assistive devices and postural asymmetries in lying, sitting and standing positions in adults with cerebral palsy, and to analyze postural asymmetries and any associations with their ability to maintain or change position and time in these positions.Methods: A cross-sectional study based on data from the Swedish Cerebral Palsy follow-up program of 1,547 adults aged 16–76 years, at Gross Motor Function Classification System (GMFCS) levels I (n = 330), II (n = 323), III (n = 235), IV (n = 298), and V (n = 361). Assistive devices such as wheelchairs, seating systems, adjustable beds, standing equipment and time in each position were reported. The Posture and Postural Ability Scale was used to identify asymmetries and rate the ability to maintain or change position. Binary logistic regression models were used to estimate odds ratios (OR) for postural asymmetries in supine, sitting and standing.Results: Assistive devices were used by 63% in sitting (range 5–100% GMFCS levels I–V), 42% in lying (4–92% levels I-V), and 32% in standing (2–70% levels II–V). Wheelchairs were used as seating systems by 57%. Most adults had postural asymmetries in supine (75%; range 35–100% levels I–V), sitting (81%; 50–99% levels I–V) and standing (88%; 65–100% levels I–V). Men were more likely than women to have postural asymmetries, and the likelihood of postural asymmetries increased with age, GMFCS levels and inability to change position. Inability to maintain position increased the probability of postural asymmetries in all positions from OR 2.6 in standing to OR 8.2 in lying and OR 13.1 in sitting.Conclusions: Almost twice as many adults used assistive devices in sitting than in lying or standing. Two thirds of the adults who used standing devices used it for <1 h per day, indicating that they might spend the remaining 23 out of 24 h per day either sitting or lying. Asymmetric postures were frequent across all ages and were highly associated with inability to change or maintain position.

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Relationship Between Postural Asymmetry, Balance, and Pain in Children With Spastic Cerebral Palsy

Shekari,

Sadeghian Afarani,

Fatorehchy

et al. 2024

Pediatric Neurology

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Postural asymmetries, pain, and ability to change position of children with cerebral palsy in sitting and supine: a cross-sectional study

Abstract: Postural asymmetries, pain, and ability to change position of children with cerebral palsy in sitting and supine: a cross-sectional study, Disability and Rehabilitation,

Cited by 16 publications

References 37 publications

Relationship between scoliosis, windswept hips and contractures with pain and asymmetries in sitting and supine in 2450 children with cerebral palsy

Relationship between scoliosis, windswept hips and contractures with pain and asymmetries in sitting and supine in 2450 children with cerebral palsy

Postural Asymmetries and Assistive Devices Used by Adults With Cerebral Palsy in Lying, Sitting, and Standing

Relationship Between Postural Asymmetry, Balance, and Pain in Children With Spastic Cerebral Palsy

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