Aims Children with neurodisability and limited mobility are at an increased risk of postural deformity which impacts on their overall health and QOL. SS are used as part of an individualised posture management programme for children with restricted mobility. There is limited research evidence on the impact of SS on hip stability, body symmetry and QOL of the child and family. There are also financial implications associated with use of SS. We aim to assess the impact of SS in children seen in a single tertiary centre.
Methods Clinical data was retrospectively collated from all the children who had SS introduced between April 2010 to April 2011. Data collection included measurements of hip radiographs (HR), Goldsmiths indices for body symmetry (GI), hip abduction measurements (HAM) and QOL measure (CPChild questionnaire) at baseline and twelve months post-intervention. These evaluations are part of our routine care plans and trust hip surveillance protocol.
Results Of the 61 children offered SS, 58 agreed to use them. [M; F = 30:28; Median(range) age – 9.17(0.5 to 19.25) years]. The diagnosis was CP in 43(74.1%) children while 15/58(25.9%) were identified with non-CP causes including genetic (Retts, Lissencephaly,) and neurodegenerative condition (PEHO).
The clinical parameters improved or remained stable in the majority of children at twelve months (HR–92%; GI–65%, HAM–66%). In subgroup analysis the improvement/stability was analysed in CP vs. non-CP group in each of the clinical categories – HR [20/21(95.2%) v 5/6(83.3%),p = 0.33]; GI [18/22(81.8%) v 3/10(30%),p = 0.004], HAM [14/22(63.6%) v 4/5 (80%),p = 0.48]. Ten parents/carers completed serial QOL questionnaires. Overall scores were stable/improved in 66.7% children. Subcategory data showed improvement or stability in 5/5(100%), personal care/ADL, 3/5(60%) in positioning/transferring, 2/2(100%) in comfort/emotions, 7/10(70%) in health scores. No differences recorded between the two subgroups.
Conclusion In our patient group, we observed a trend towards improvement in clinical parameters and QOL following introduction of SS. The improvement was most significant in body symmetry (GI) in children with CP. Further research is required to assess long term benefits of SS.