Seating system for scoliosis in nonambulatory children with cerebral palsy: a randomized controlled trial

Abstract

OBJECTIVE: This study aimed to investigate the effect of an adaptive seating system on pelvic obliquity and spinal coronal/sagittal balance in children with nonambulatory cerebral palsy and scoliosis. METHODS: This was a single-blind, prospective, randomized interventional study. Nonambulatory children aged 6-15 years with cerebral palsy and scoliosis were included. The seating system was used for 4 h/day, and exercises were performed 3 days/week for 12 weeks. The Cobb angle, spinopelvic parameters, pelvic obliquity, Reimer's migration index, and Sitting Assessment Scale were measured before and after treatments. RESULTS: A total of 29 participants were randomized into two groups, namely, the seating system+exercise group (SSE-group; n=15) and the exercise group (E-group; n=14). There was no significant change in Cobb angle and Reimer's migration index for both hips in SSE-group, but there was a significant increase in E-group (p=0.002, 0.049, and 0.003, respectively). The sagittal vertical axis, pelvic incidence, and pelvic obliquity decreased in SSE-group. However, there was no difference in the other sagittal parameters and Sitting Assessment Scale-total scores among groups. CONCLUSION: The adaptive seating system was found to be superior in reducing the progression of Cobb angle and hip subluxation/dislocation, decreasing pelvic obliquity, and improving the sagittal balance of the spine/pelvis compared with exercise therapy.