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Original research| Volume 100, ISSUE 2, P247-253, February 2019

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Are Seating Systems With a Medial Knee Support Really Helpful for Hip Displacement in Children With Spastic Cerebral Palsy GMFCS IV and V?

  • In Soo Kim
    Affiliations
    Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, South Korea
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  • Donghwi Park
    Affiliations
    Department of Rehabilitation Medicine, Daegu Fatima Hospital, Daegu, South Korea
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  • Jin Young Ko
    Affiliations
    Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Gyeonggi-do, South Korea
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  • Ju Seok Ryu
    Correspondence
    Corresponding author Ju Seok Ryu, MD, PhD, Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, South Korea, 463-707.
    Affiliations
    Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, South Korea

    Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Gyeonggi-do, South Korea
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Published:August 10, 2018DOI:https://doi.org/10.1016/j.apmr.2018.07.423

      Abstract

      Objective

      To evaluate whether medial knee support (MKS) in seating systems aggravates hip displacement in children with cerebral palsy (CP).

      Design

      Retrospective chart review.

      Setting

      Rehabilitation department of tertiary university hospital.

      Participants

      Children with CP (N=76) using seating systems (intervention group, n=42; mean age 6.86y) and using regular wheelchairs (control group, n=34; mean age 8.15y).

      Interventions

      The intervention group was provided with a seating system with MKS. We enrolled children who did not use a seating system in the control group, retrospectively.

      Main Outcome Measures

      By radiographic images, Reimer’s migration index (MI), lateral center edge angle (CEA), and femur neck shaft angle (NSA) were measured. We compared the demographic data, clinical variables, and radiographs between the 2 groups.

      Results

      In the intervention group, there was a significant deterioration in the MI, from 26.89% to 44.18% after using the system (P<.001). The progression of MI was 14.72% and 7.82% per year in the intervention and control groups, respectively (P=.016).

      Conclusion

      We should consider the possibility that seating systems with MKS may exacerbate hip displacement in children with CP.

      Keywords

      List of abbreviations:

      CEA (lateral center edge angle), CP (cerebral palsy), GMFCS (Gross Motor Function Classification System), MI (Reimer’s migration index), MKS (medial knee support), NSA (femur neck shaft angle)
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