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Changes of musculoskeletal deformity in severely disabled children using the custom molded fitting chair
Myeong Ok Kim1, Jun Ho Lee, Ju Young Yu
1Department of Physical & Rehabilitation Medicine, Inha University School of Medicine, Incheon, Korea.
Insights
Custom molded chairs did not significantly improve musculoskeletal deformities in severely disabled children. However, these chairs may help prevent rapid worsening of conditions like scoliosis and hip dislocation.
Area of Science:
- Orthopedics
- Rehabilitation Medicine
- Pediatric Physical Therapy
Background:
- Severely disabled children often develop musculoskeletal deformities.
- Custom molded chairs are used to support posture and prevent deformity progression.
Purpose of the Study:
- To evaluate the effectiveness of custom molded fitting chairs in improving musculoskeletal indices.
- To compare pre- and post-chair status in severely disabled children.
Main Methods:
- Radiographic assessment of 34 severely disabled children (27 cerebral palsy, 7 other neurological conditions).
- Measurement of Cobb's angle, femoral neck-shaft angle, and Reimers migration percentage before and after chair use (average 24 months).
Main Results:
- Significant reduction observed in the femoral neck-shaft angle (163.4° to 158.2°, p<0.05).
- No statistically significant changes in Cobb's angle or Reimers migration percentage.
- 17/33 children showed reduced Cobb's angle; 19/37 showed reduced hip dislocation.
Conclusions:
- Custom molded chairs did not lead to significant improvements in overall musculoskeletal deformity indices.
- No significant aggravation of Cobb's angle or Reimers migration percentage was noted.
- Chairs may be beneficial in preventing the rapid progression of musculoskeletal deformities in this population.
Objective:
To know the effectiveness of a custom molded fitting chair between pre- and post-chair status through comparison of musculoskeletal indices in severely disabled children.
Methods:
We researched 34 severely disabled patients who had used a custom molded fitting chair continuously for more than a year. There were 27 cerebral palsy patients and 7 patients with other kinds of diseases that affect the brain such as chromosomal disease or metabolic disease. By radiographic studies, Cobb's angle, the femoral neck-shaft angle of the femur, and Reimers migration percentage were measured. The indices are analyzed before and after application.
Results:
The average period of application was 24 months. There was a significant reduction in the angles of femur neck-shaft, 163.4 degree before and 158.2 degree after the use of the chair (p<0.05), and 23 of 34 had demonstrated a reduced angle. Cobb's angle and Reimers migration percentage increased but the difference of pre- and post-chair status was not statistically significant. Seventeen of 33 children showed reduced Cobb's angle. Also, 19 of 37 showed a reduced degree of dislocation of the hip joints.
Conclusion:
In spite of the use of a custom molded fitting chair, a significant improvement did not emerge for musculoskeletal deformity indices in severely disabled children. However, there was no significant aggravation of Cobb's angle or Reimers migration percentage in developing children. Therefore, it is thought be helpful to prevent rapid aggravation of musculoskeletal deformities.
