Non-ambulatory children with cerebral palsy are at risk for hip displacement due to strong muscle forces of hip adduction, flexion, and internal rotation. Available research points to the benefits of standing abducted in preventing hip migration and subsequent dislocation. TO recent study in it Journal of Pediatric Physiotherapy further adds to this current knowledge base.
This study draws data from the Swedish CPUP (Cerebral Palsy Uppfoljning) registry, a hip surveillance program that follows children with cerebral palsy in Sweden from birth to adulthood. The children chosen for the study were between three and seventeen years old, were classified as GMFCS level IV or V, and used standing for ten hours per week with abduction of between fifteen and thirty degrees for each leg. Additionally, they were divided into two groups: one in which participants underwent adductor-psoas tenotomy surgery and the other in which participants did not. The control group performed a zero to ten degree abduction position for each leg and were matched by age and surgery category.
Over the course of seven years, all children who stood for a total of ten hours per week in hip abduction of between fifteen and thirty degrees showed a reduction in the percentage of hip migration, regardless of the category of hip abduction. surgery. The greatest reduction in the percentage of hip migration (eighteen percent) occurred in the group that performed abduction standing after surgery. An additional finding of the study group was that range of motion at the hip and knee was maintained.
On the other hand, the percentage of migration in the control groups increased.
Hip monitoring and intervention in children with cerebral palsy who cannot walk is a work in progress, but certainly, abduction standing is effective, at least up to seven years, as measured in the study. Therefore, providing children with optimal time in adaptive positioning with abduction during the day contributes to these positive outcomes.
