Positive Seating

Positive seating (sloping the seat forward) does not help all, or even most. Children with cerebral palsy or developmental delay. But it does help some children with stiff, backward tilting hips, or those with low muscle tone who have trouble sitting upright. It is especially useful for children who can sit briefly without support, but who tend to droop forward with sagging head. Often it helps them to sit straighter and raise their head.

The concept of positive seating is still new to many rehabilitation workers and therapists. It ios often helpful for children who, for 2 different reasons, have difficulty sitting upright.

1.       As some children with spastic cerebral palsy have stiffness of the hips (pelvis) that prevents them from sitting with their back at right angles to their thighs. When they sit on a level (horizontal) seat, they tend to fall over backwards. Or they sit slouched with their back in a C-shaped curve.

 When the child sits on a forward-tilting seat, or wedge, this allows her back to rise straight upo from the hips. (The pelvis is rotated to an upright position.)On this forward-slanting seat, the child is more stable, less tense (which reduces spasticity), and often has better head, body and hand control.

 2.       Some children have low muscle tone, as in the floppy (flaccid) type of cerebral palsy, and in some mixed types. On a level seat, they tend to slump forward and have difficulty raising their heads.

 For such children, a forward tilting seat (positive seating) often does wonders. The forward slant causes the child to push with her legs to keep from sliding forward. This use of the leg muscles increases overall muscle tone, which (in some cases) allows the child to lift her head and hold a more upright posture.

Caution:

Each child is different. Results with positive seating vary from excellent to counterproductive. Be sure that-if muscle tone is increased – it gives the child greater control, rather than triggering a stiff, spastic reaction (as it does in some children)

Thanks,

Health, Dec- 2012