Holmes K J, Michael S M, Thorpe S L, Solomonidis S E
Oxford Centre for Enablement, Nuffield Orthopedic Centre, Headington, Oxford OX3 7LD, UK.
Clin Biomech (Bristol). 2003 Jul;18(6):480-7. doi: 10.1016/s0268-0033(03)00075-5.
To investigate the effects of special seating on lateral spinal curvature in the non-ambulant spastic cerebral palsy population with scoliosis.
Prospective study with matched pairs (same subject pre- and post-intervention).
It is thought that special seating can improve the sitting posture of individuals with spastic cerebral palsy. However, there is little known about how the seating can affect a scoliosis.
The shape of the spine was measured with subjects sitting in an assessment chair with a clear backrest. The measurement recorded was the "spinous process angle", an approximation to the Cobb angle. The forces exerted on the subject by the chair were measured by electrical resistance strain gauged transducers attached to the lateral support pads and seat base. Measurements were taken with three alternative arrangements of lateral support pads: upper body unsupported in configuration 1; two lateral pads at the same height in configuration 2; body supported by a 3-point force system in configuration 3.
Configuration 3 gave a mean correction of +35% in the spinous process angle compared to configuration 1 (P=0.000) and the forces applied through the two lateral thoracic pads were, on average, of similar magnitude (mean values of 51 and 47 N). In comparison, for configuration 2 the mean correction was only +18.7% (P=0.004) and on average the pad on the concave side of the scoliosis applied a much larger force to the chest wall than the pad on the convex side (mean values of 36 and 17 N respectively).
Significant static correction of the scoliotic spine can be achieved with an arrangement of lateral pads on a seating system that applies a 3-point force system to the sides of the body.
The results suggest that the position of the lateral pads on a special seating system is important and, by the careful configuration of these supports, significant correction of a scoliosis can be obtained for a person with spastic cerebral palsy. Also the methodology and equipment from this study are potentially useful for the assessment and fitting of special seating for individuals with scoliosis.
探讨特殊座椅对非行走型痉挛性脑瘫合并脊柱侧凸患者脊柱侧凸的影响。
配对前瞻性研究（同一受试者干预前后）。
人们认为特殊座椅可改善痉挛性脑瘫患者的坐姿。然而，对于这种座椅如何影响脊柱侧凸却知之甚少。
让受试者坐在有清晰靠背的评估椅上测量脊柱形状。记录的测量值是“棘突角”，近似于 Cobb 角。通过连接到侧支撑垫和座椅底座的电阻应变片式传感器测量座椅对受试者施加的力。使用三种不同的侧支撑垫布置进行测量：在配置 1 中上身无支撑；在配置 2 中两个侧垫高度相同；在配置 3 中身体由三点力系统支撑。
与配置 1 相比，配置 3 使棘突角平均矫正了 +35%（P = 0.000），并且通过两个侧胸垫施加的力平均大小相似（平均值分别为 51 和 47 N）。相比之下，对于配置 2，平均矫正仅为 +18.7%（P = 0.004），并且平均而言，脊柱侧凸凹侧的垫子对胸壁施加的力比凸侧的垫子大得多（平均值分别为 36 和 17 N）。
通过在座椅系统上布置侧垫，对身体两侧施加三点力系统，可实现脊柱侧凸的显著静态矫正。
结果表明特殊座椅系统上侧垫的位置很重要，通过仔细配置这些支撑，可以为痉挛性脑瘫患者获得脊柱侧凸的显著矫正。此外，本研究的方法和设备对于脊柱侧凸患者特殊座椅的评估和适配可能有用。
