Are seating systems with a medial knee support really helpful for hip displacement in children with spastic cerebral palsy GMFCS IV and V?

Publication date: Available online 10 August 2018

Source: Archives of Physical Medicine and Rehabilitation

Author(s): In Soo Kim, Donghwi Park, Jin Young Ko, Ju Seok Ryu

Abstract

Objective

To evaluate whether medial knee support in seating systems aggravates hip displacement in children with cerebral palsy.

Design

:Retrospective chart review

Setting

Rehabilitation department of tertiary university hospital

Participants

Children with cerebral palsy using seating systems (Intervention group, n=42; mean age 6.86y) and using regular wheelchairs (Control group, n=34; mean age 8.15y).

Interventions

The intervention group was provided with a seating system with medial knee support. We enrolled children who did not use a seating system in the control group, retrospectively.

Main Outcome Measure(s)

By radiographic images, Reimer's migration index, lateral center edge angle, and femur neck shaft angle were measured. We compared the demographic data, clinical variables, and radiographs between the two groups.

Results

In the intervention group, there was a significant deterioration in the Reimer's migration index, from 26.89% to 44.18% after using the system (p<0.001). The progression of migration index was 14.72 % and 7.82 % per year in the intervention and control groups, respectively (p=0.016).

Conclusion

We should consider the possibility that seating systems with medial knee support may exacerbate hip displacement in children with cerebral palsy.

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