Upper Extremity Positioning - The Missing Seating Intervention

Candy Foo

PMG Conference 2024

Monday, 15th July to Weds 17th July 2024 in Telford. Our annual conference provides an educational programme, industry exhibition and networking events for professionals working in the field of posture and wheeled mobility. We wish to thank our 2023 sponsors, RHealthcare and Seating Matters, for their generous support.

Night time postural management (2007)

Ginny Humphreys, Head of Therapy, Vranch House School and Centre, Exeter

Download Humphreys Final Report

What is the effect of postural management at night on hip stability and quality of sleep in children with bilateral cerebral palsy (CP) and how do the children and their parents view it?

This study will use up to 15 case studies of young children who are at the point of being prescribed a sleep system by their local therapist. It will employ mixed methods to address the following questions:

Does postural management at night affect hip migration percentage?

Does the length of time (number of hours) spent within the sleep system make a difference to hip migration?

Does the sleep system affect quality of sleep in terms of number of disturbances?

What are the parents lived experiences of their child using a sleep system?

What are the children's views of using a sleep system?

Currently only one pilot study has concentrated exclusively on looking at the effects of sleep systems on hip migration and this study used only one type of sleep system. There are no studies seeking the views of children who use sleep systems. These children may have communication and or cognitive impairments, and the study design will take account of this. There is no in-depth qualitative study on how parents cope with their child using a sleep system.

The methods will be:

Measurement of hip migration percentage on X-ray before intervention and after one year.

Record the number of hours spent in sleep system using a sleep diary.

Record the number of disturbances per night using the sleep diary.

Parents' sleep diary recording the highs and lows. Free writing or recording on tape.

Semi-structured interviews / questionnaires / focus group to discover parents' views.

Group interview for children with verbal communication and alternative methods for discovering the views of children with communication and or cognitive impairments, e.g. "being with", observation of the experience of the child, gathering information from the child's best advocate.

The results of the study will add to the evidence about the benefits or not of night-time postural management and the prevention of hip migration. It will inform those looking after the children, the therapy community, and manufacturers of sleep systems what the user experience is in terms of the child and the parents.

The study is being supervised by University of Brighton as part of a Professional Doctorate.


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