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In summary, we can classify different kids who have Cerebral Palsy by the types of movement
the child makes, by the part of the body that is affected, or both.
By type of movement
Spastic Rigid
Athetoid Unable to control muscle movement
Hypotonic Floppy child
Ataxia Balance and coordination problems
By affected body part
Hemiplegia Involving one arm and one leg on the same side
Diplegia Involving both legs typically, or both arms rarely
Tetraplegia Involving all four extremities, trunk and neck muscles
Providing proper seating and positioning for these children is a challenge. It will vary widely
depending on the type of Cerebral Palsy and the degree of involvement. Will basic planar
suffice, or will the child need more accurate positioning to control the hips and trunk? Will
contoured seating be sufficient, or do we need to look at a custom seating system? Do we
need to be concerned about pressure sores or skin integrity in the more involved children?
Some of these children will present with seizure activity. A large number will have strong ex-
tension/thrusting behaviors. How do we manage them?
You will also need to look at what type of mobility these children will need. Do they have the
ability to self propel (independent), or will they need someone to push them (dependent)? Will
they need special life support equipment? If so, how do we accommodate this equipment on
their respective mobility bases?
We will also need to remember activities of daily living (ADLs) and other occupations. ADLs
are feeding, dressing, bathing, toileting, grooming, and other self-care activities. Other
important occupations that improve overall quality of life include play, community mobility, edu-
cation, sleep, socialization, and leisure. Will we need to consider four or five different pieces of
equipment, or can we find one piece of equipment that can serve two or three of these roles
while still providing the seating and positioning needed?
The “high guard” position of the Hip extension is usually
arms is often accompanied by head and accompanied by lower extremity
neck hyperextension extensions, adduction and Internal rotation