By Dalia Zwick PT PhD
How posture goes wrong:
Body Shape Distortion in Cerebral Palsy
Distortions in posture and impaired movement are key challenges in the care of both children and adults with cerebral palsy. During early development, a child with CP inevitably stays in limited lying postures for long durations, due to difficulty changing positions. This often results in habitual asymmetrical posture that continues to cause distortions at the hip, pelvis, spine, knees and feet. These distortions are further influenced by factors such as abnormal reflexes, muscle tone (high or low), joint ligament type (loose or stiff), the force of gravity, and motor impairment, which might be asymmetrical as well. The resultant body distortion sequla was appropriately identified in an original article (1976): “Position as a cause of deformity in children with cerebral palsy.”
The purpose of this presentation is to further explore the mechanism within the “position leading to distortion” hypothesis. The presenter will elaborate on how and where distortions can be predicted, prevented and cared for by supported supine lying. To counteract asymmetrical postural distortions, it is proposed that therapeutic night positioning can be an effective intervention. The positioning technique is part of an educational initiative called Postural Care. Postural Care involves educating therapists, families and caregivers to safely and humanely apply therapeutic positioning. Postural Care highlights the benefit of relaxation and elongation of the body via gravity and targeted prop support.
The latest evidence-based literature on postural care interventions will be reviewed. Currently Postural Care programs are being successfully introduced in the US, Canada, Australia and at other locations.
The presenter is a Physical Therapist trained in Postural Care.
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