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Sitting and standing performance in a total population of children with cerebral palsy: a cross-sectional study.

Rodby-Bousquet E, Hägglund G - BMC Musculoskelet Disord (2010)

Bottom Line: About 60% of children with CP, aged 3-18, use standard chairs, stand, stand up, and sit down without external support.Adding those using adaptive seating and external support, 99% of the children could sit, 96% could stand and 81% could stand up from a sitting position and 81% could sit down from a standing position.The GMFCS classification system is a good predictor of sitting and standing performance.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Orthopaedics, Lund University, University Hospital, Lund, Sweden. elisabet.rodby_bousquet@med.lu.se

ABSTRACT

Background: Knowledge of sitting and standing performance in a total population of children with cerebral palsy (CP) is of interest for health care planning and for prediction of future ability in the individual child. In 1994, a register and a health care programme for children with CP in southern Sweden was initiated. In the programme information on how the child usually sits, stands, stands up and sits down, together with use of support or assistive devices, is recorded annually.

Methods: A cross-sectional study was performed, analysing the most recent report of all children with CP born 1990-2005 and living in southern Sweden during 2008. All 562 children (326 boys, 236 girls) aged 3-18 years were included in the study. The degree of independence, use of support or assistive devices to sit, stand, stand up and sit down was analysed in relation to the Gross Motor Function Classification System (GMFCS), CP subtype and age.

Result: A majority of the children used standard chairs (57%), could stand independently (62%) and could stand up (62%) and sit down (63%) without external support. Adaptive seating was used by 42%, external support to stand was used by 31%, to stand up by 19%, and to sit down by 18%. The use of adaptive seating and assistive devices increased with GMFCS levels (p < 0.001) and there was a difference between CP subtypes (p < 0.001). The use of support was more frequent in preschool children aged 3-6 (p < 0.001).

Conclusion: About 60% of children with CP, aged 3-18, use standard chairs, stand, stand up, and sit down without external support. Adding those using adaptive seating and external support, 99% of the children could sit, 96% could stand and 81% could stand up from a sitting position and 81% could sit down from a standing position. The GMFCS classification system is a good predictor of sitting and standing performance.

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Related in: MedlinePlus

Type of chair used for sitting related to GMFCS level. Information missing in 3 of the 562 children aged 3-18 years. The use of adaptive seating increased with GMFCS-levels (p < 0.001), linear by linear association test.
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Figure 1: Type of chair used for sitting related to GMFCS level. Information missing in 3 of the 562 children aged 3-18 years. The use of adaptive seating increased with GMFCS-levels (p < 0.001), linear by linear association test.

Mentions: Of the 562 children, 321 (57%) used standard chairs and 236 (42%) used adaptive seating. Two children did not sit, and information was missing in three children. There was a significant increase in use of standard chairs with age (p < 0.001) (Table 2). The use of chairs correlated to GMFCS level (rs = 0.73, p < 0.001) (Table 3) and the use of adaptive seating increased with GMFCS levels (p < 0.001). Of the children at GMFCS level I, 90% use standard chairs, 68% at level II, 44% at level III, 5% at level IV and none of the children at level V (Figure 1). Kruskal-Wallis test showed a significant difference in the use of standard chairs between CP subtypes (p < 0.001). Post hoc analyses with Mann-Whitney showed a difference between all subtypes (p < 0.001) except for ataxic/spastic bilateral, ataxic/unclassified and spastic bilateral/unclassified. The use of standard chairs was most frequent in children with spastic unilateral CP (88%), followed by 60% of those with ataxic CP, 54% with spastic bilateral CP and least frequent in children with dyskinetic CP (11%). The reverse was seen for adaptive seating (Figure 2).


Sitting and standing performance in a total population of children with cerebral palsy: a cross-sectional study.

Rodby-Bousquet E, Hägglund G - BMC Musculoskelet Disord (2010)

Type of chair used for sitting related to GMFCS level. Information missing in 3 of the 562 children aged 3-18 years. The use of adaptive seating increased with GMFCS-levels (p < 0.001), linear by linear association test.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2908562&req=5

Figure 1: Type of chair used for sitting related to GMFCS level. Information missing in 3 of the 562 children aged 3-18 years. The use of adaptive seating increased with GMFCS-levels (p < 0.001), linear by linear association test.
Mentions: Of the 562 children, 321 (57%) used standard chairs and 236 (42%) used adaptive seating. Two children did not sit, and information was missing in three children. There was a significant increase in use of standard chairs with age (p < 0.001) (Table 2). The use of chairs correlated to GMFCS level (rs = 0.73, p < 0.001) (Table 3) and the use of adaptive seating increased with GMFCS levels (p < 0.001). Of the children at GMFCS level I, 90% use standard chairs, 68% at level II, 44% at level III, 5% at level IV and none of the children at level V (Figure 1). Kruskal-Wallis test showed a significant difference in the use of standard chairs between CP subtypes (p < 0.001). Post hoc analyses with Mann-Whitney showed a difference between all subtypes (p < 0.001) except for ataxic/spastic bilateral, ataxic/unclassified and spastic bilateral/unclassified. The use of standard chairs was most frequent in children with spastic unilateral CP (88%), followed by 60% of those with ataxic CP, 54% with spastic bilateral CP and least frequent in children with dyskinetic CP (11%). The reverse was seen for adaptive seating (Figure 2).

Bottom Line: About 60% of children with CP, aged 3-18, use standard chairs, stand, stand up, and sit down without external support.Adding those using adaptive seating and external support, 99% of the children could sit, 96% could stand and 81% could stand up from a sitting position and 81% could sit down from a standing position.The GMFCS classification system is a good predictor of sitting and standing performance.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Orthopaedics, Lund University, University Hospital, Lund, Sweden. elisabet.rodby_bousquet@med.lu.se

ABSTRACT

Background: Knowledge of sitting and standing performance in a total population of children with cerebral palsy (CP) is of interest for health care planning and for prediction of future ability in the individual child. In 1994, a register and a health care programme for children with CP in southern Sweden was initiated. In the programme information on how the child usually sits, stands, stands up and sits down, together with use of support or assistive devices, is recorded annually.

Methods: A cross-sectional study was performed, analysing the most recent report of all children with CP born 1990-2005 and living in southern Sweden during 2008. All 562 children (326 boys, 236 girls) aged 3-18 years were included in the study. The degree of independence, use of support or assistive devices to sit, stand, stand up and sit down was analysed in relation to the Gross Motor Function Classification System (GMFCS), CP subtype and age.

Result: A majority of the children used standard chairs (57%), could stand independently (62%) and could stand up (62%) and sit down (63%) without external support. Adaptive seating was used by 42%, external support to stand was used by 31%, to stand up by 19%, and to sit down by 18%. The use of adaptive seating and assistive devices increased with GMFCS levels (p < 0.001) and there was a difference between CP subtypes (p < 0.001). The use of support was more frequent in preschool children aged 3-6 (p < 0.001).

Conclusion: About 60% of children with CP, aged 3-18, use standard chairs, stand, stand up, and sit down without external support. Adding those using adaptive seating and external support, 99% of the children could sit, 96% could stand and 81% could stand up from a sitting position and 81% could sit down from a standing position. The GMFCS classification system is a good predictor of sitting and standing performance.

Show MeSH
Related in: MedlinePlus