5
The medial support would need to be modified to provide consistent support to
the medial aspect of the knees and upper legs during any extension movement of
the legs.
Great care should be taken to set the seat depth up to the best position to
achieve pelvic stability, with the pelvis in a neutral tilt position.
The footrests should be positioned so that their hips knees and feet are in midline
orientation, with hips, knees and feet flexed to 90
o
, to increase stability and
encourage relaxed control.
The use of dynamic footrests should be monitored for approximately 8 weeks of
regular use to establish their effectiveness, when it should be possible to observe
improved pelvic stability and less use of total body extension.
At this time there is little published evidence to establish the effectiveness of
dynamic backrests or footplates for people with spastic CP, so it is important to
audit their use to establish the effect on postural control and function.
References:
Nwaobi OM, Brubaker C, Cusick B, Sussman MD (1983) Electromyographical Investigation of
Extensor Activity in Cerebral Palsied Children in Different Seating Positions. Developmental Medicine
and Child Neurology 25: 175-183.
Nwaobi OM (1987) Seating Orientations and Upper Extremity Function in Children with Cerebral
Palsy. Physical Therapy 67 (8): 1209-1212.
