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Arch Phys Med Rehabil. 2019 Feb;100(2):247-253. doi: 10.1016/j.apmr.2018.07.423. Epub 2018 Aug 10.

Are Seating Systems With a Medial Knee Support Really Helpful for Hip Displacement in Children With Spastic Cerebral Palsy GMFCS IV and V?

Author information

1
Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, South Korea.
2
Department of Rehabilitation Medicine, Daegu Fatima Hospital, Daegu, South Korea.
3
Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Gyeonggi-do, South Korea.
4
Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, South Korea; Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Gyeonggi-do, South Korea. Electronic address: jseok337@snu.ac.kr.

Abstract

OBJECTIVE:

To evaluate whether medial knee support (MKS) in seating systems aggravates hip displacement in children with cerebral palsy (CP).

DESIGN:

Retrospective chart review.

SETTING:

Rehabilitation department of tertiary university hospital.

PARTICIPANTS:

Children with CP (N=76) using seating systems (intervention group, n=42; mean age 6.86y) and using regular wheelchairs (control group, n=34; mean age 8.15y).

INTERVENTIONS:

The intervention group was provided with a seating system with MKS. We enrolled children who did not use a seating system in the control group, retrospectively.

MAIN OUTCOME MEASURES:

By radiographic images, Reimer's migration index (MI), lateral center edge angle (CEA), and femur neck shaft angle (NSA) were measured. We compared the demographic data, clinical variables, and radiographs between the 2 groups.

RESULTS:

In the intervention group, there was a significant deterioration in the MI, from 26.89% to 44.18% after using the system (P<.001). The progression of MI was 14.72% and 7.82% per year in the intervention and control groups, respectively (P=.016).

CONCLUSION:

We should consider the possibility that seating systems with MKS may exacerbate hip displacement in children with CP.

KEYWORDS:

Cerebral palsy; Hip dislocation; Rehabilitation; Technology; Wheelchair

PMID:
30102899
DOI:
10.1016/j.apmr.2018.07.423
[Indexed for MEDLINE]

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