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Are Seating Systems With a Medial Knee Support Really Helpful for Hip Displacement in Children With Spastic Cerebral

In Soo Kim1, Donghwi Park2, Jin Young Ko3

  • 1Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, South Korea.

Archives of Physical Medicine and Rehabilitation
|August 14, 2018
PubMed

Insights

Medial knee support in seating systems may worsen hip displacement in children with cerebral palsy (CP). This study found a significant increase in Reimer's migration index in children using these specialized systems.

Area of Science:

  • Orthopedics
  • Pediatric Rehabilitation
  • Biomedical Engineering

Background:

  • Cerebral palsy (CP) often leads to hip displacement.
  • Seating systems are crucial for mobility and posture in children with CP.
  • The impact of specific seating system features, like medial knee support (MKS), on hip stability is not fully understood.

Purpose of the Study:

  • To investigate whether medial knee support (MKS) integrated into seating systems exacerbates hip displacement in children with cerebral palsy (CP).

Main Methods:

  • Retrospective chart review of 76 children with CP.
  • Comparison between an intervention group (n=42) using seating systems with MKS and a control group (n=34) using regular wheelchairs.
  • Radiographic assessment of hip displacement using Reimer's migration index (MI), lateral center edge angle (CEA), and femur neck shaft angle (NSA).

Main Results:

  • The intervention group showed a significant deterioration in Reimer's migration index (MI) from 26.89% to 44.18% after using the seating system (P<.001).
  • The annual progression of MI was substantially higher in the intervention group (14.72%) compared to the control group (7.82%) (P=.016).

Conclusions:

  • Seating systems incorporating medial knee support (MKS) may contribute to the worsening of hip displacement in children with cerebral palsy (CP).
  • Clinical consideration of MKS in seating for CP management is warranted to mitigate potential adverse effects on hip stability.
Abstract

Keywords:
Cerebral palsyHip dislocationRehabilitationTechnologyWheelchair

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