Efficacy of an adaptive seating system that uses a sacral pad and kneeblock to control the pelvis

Adaptive seating systems that use a sacral pad and kneeblock to control the pelvis are commonly used throughout the UK to correct pelvic tilt, decrease pelvic rotation and abduct/de-rotate the hip joint for children with cerebral palsy. The purpose of this presentation is to present the detailed statistical and biomechanical results from a 3-year research project to investigate efficacy. A mixed method, case-controlled trial was performed, which consisted of 6 visits, with the active component (the kneeblock) removed for a period of one month between visits 3 and 4. Force exerted on the kneeblock, pressure exerted on the sacral pad and postural alignment was measured on each occasion. 30 children with severe 4-limb cerebral palsy completed the trial. No statistically significant change or correlations between force, pressure or postural alignment were found. Individual biomechanical analyses were performed, illustrating positive effects on hip abduction for some children, but an increase in tendency to develop secondary postural deformity. Adaptive seating systems that use a kneeblock and sacral pad may achieve hip rotation and abduction for children with cerebral palsy. However, no other improvements in posture were seen, and biomechanical analysis showed an increase in tendency of the children to develop secondary deformity. The clinical implications of these results will be discussed in detail.

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