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Wheelchair positioning and breathing in children with cerebral palsy: study methods and lessons learned
1VA HSR&D/RR&D Center of Excellence, Tampa, FL, USA. Lelia.Barks@va.gov
Insights
This study explored how wheelchair features impact pulmonary function in children with cerebral palsy (CP). Feasible testing was achieved for half, with verbal children tolerating the protocol best.
Area of Science:
- Pediatric Rehabilitation
- Biomedical Engineering
- Pulmonary Medicine
Background:
- Poor trunk control in children with cerebral palsy (CP) is linked to spinal deformity and pulmonary compromise.
- While posture's effect on pulmonary function is known, the impact of wheelchair components remains unclear.
Purpose of the Study:
- To describe recruitment and retention of school-aged children with CP for a pulmonary function study.
- To evaluate the feasibility and participant response to a pulmonary measurement protocol in a wheelchair simulator.
Main Methods:
- A wheelchair simulator was used to test five seating parameters.
- Pulmonary mechanics were measured, and a process log documented challenges and responses.
- Participant recruitment and retention were assessed.
Main Results:
- Recruitment proved challenging, with a 50% retention rate.
- The protocol was feasible for 50% of participants, none of whom could undergo conventional pulmonary function testing.
- Facemask and simulator acceptability was 75%, higher in verbally communicative children; 75% experienced fatigue.
Conclusions:
- Pulmonary function measurement in wheelchairs presents feasibility challenges for children with CP.
- Verbal communication ability and facemask stability are critical factors for protocol success.
- Further research is needed to refine methods for assessing pulmonary function in this population.
Abstract:
In children with cerebral palsy (CP), poor trunk control can lead to spinal deformity, pulmonary compromise (Canet, Praud, & Bureau, 1998), and increased health risks and costs of long-term care (Braddock, 2002). Evidence links posture and pulmonary function, but the influence of wheelchair components on pulmonary function is unknown. This article reports on a study evaluating pulmonary measurement in wheelchairs and how it affected children with CP. The objectives of the study were to (a) describe recruitment and retention of school-aged children with CP and (b) discuss participants'response to the protocol. Using a wheelchair simulator, participants experienced five seating parameters while pulmonary mechanics measures were recorded. A process log captured participant recruitment and retention challenges and response to the protocol. Recruitment was challenging; retention was 50%. The protocol was feasible for 50% of participants, none of whom could participate in conventional pulmonary function testing. Among the study's participants, facemask and seating simulator acceptability were 75%, improving with participants'increased verbal communication abilities (verbal children tolerated the procedure best). The facemask was vulnerable to tilt; 75% of participants experienced fatigue.
