In Soo Kim1, Donghwi Park2, Jin Young Ko3, Ju Seok Ryu4. 1. Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, South Korea. 2. Department of Rehabilitation Medicine, Daegu Fatima Hospital, Daegu, South Korea. 3. Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Gyeonggi-do, South Korea. 4. 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. Electronic address: jseok337@snu.ac.kr.
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.
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.