Optimal positioning for an adult athetoid cerebral palsy patient in a wheelchair.

The purpose of this case study was specifically to reinforce the necessity for proper positioning in a wheelchair for an adult athetoid cerebral palsy patient. A 36-year old female with cerebral palsy sat in the wheelchair with pelvic sliding, uneven weight distribution on the hips, hip adduction, and right lateral trunk tilt and rotation. The abnormal posture observed was first corrected by seating the patient well back in the wheelchair with the patient's weight evenly distributed between both hips. A seat belt, abduction pommel, trunk belt, seat cushion, and foot pad were inserted to help the patient maintain the corrected posture. Points to consider when ordering a wheelchair and adaptive equipment are reviewed. The optimal sitting position and positioning objectives and considerations, as well as the selection process are also presented. Participation of the patient and the caregivers in the selection and decision-making processes helps lead to successful results. A thorough assessment of the patient's prognosis and environment is important to prevent harmful, expensive, and disappointing results. On-going reviews of the patient and use of the equipment are helpful in preventing deformities and other problems. As we already know, increasing the patient's function and ability to move around and explore the environment can affect his/her attitude toward daily living as well as quality of life.