This Article Immediate free access via SAGE Open Free Full Text (Free PDF) Free References Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Porter, D. Articles by Kirkwood, C. Search for Related Content PubMed PubMed Citation Articles by Porter, D. Articles by Kirkwood, C. Pubmed/NCBI databases Medline Plus Health Information Cerebral Palsy Scoliosis Social Bookmarking                         What's this?

Patterns of postural deformity in non-ambulant people with cerebral palsy: what is the relationship between the direction of scoliosis, direction of pelvic obliquity, direction of windswept hip deformity and side of hip dislocation?

School of Health & Social Care, Oxford Brookes University, Oxford, dporter{at}brookes.ac.uk

Shona Michael

Medical Physics & Engineering, Leeds University Teaching Hospitals NHS Trust, Leeds

Craig Kirkwood

Tayside Assistive Technology Service, Acute Services Division NHS Tayside, Dundee, UK

Objective: To investigate: (a) associations between the direction of scoliosis, direction of pelvic obliquity, direction of windswept deformity and side of hip subluxation/ dislocation in non-ambulant people with cerebral palsy; and (b) the lateral distribution of these postural asymmetries.

Design: Cross-sectional observational study.

Setting: Posture management services in three centres in the UK.

Subjects: Non-ambulant people at level five on the gross motor function classification system for cerebral palsy.

Main measures: Direction of pelvic obliquity and lateral spinal curvature determined from physical examination, direction of windswept hip deformity derived from range of hip abduction/adduction, and presence/side of unilateral hip subluxation defined by hip migration percentage.

Results: A total of 747 participants were included in the study, aged 6—80 years (median 18 years 10 months). Associations between the direction of scoliosis and direction of pelvic obliquity, and between the direction of windswept hip deformity and side hip subluxation/dislocation were confirmed. A significant association was also seen between the direction of scoliosis and the direction of the windswept hip deformity (P<0.001) such that the convexity of the lateral spinal curve was more likely to be opposite to the direction of windsweeping. Furthermore, significantly more windswept deformities to the right (P = 0.007), hips subluxed on the left (P = 0.002) and lateral lumbar/lower thoracic spinal curves convex to the left (P = 0.03) were observed.

Conclusions: The individual asymmetrical postural deformities are not unrelated in terms of direction and not equally distributed to the left/right. A pattern of postural deformity was observed.

Clinical Rehabilitation, Vol. 21, No. 12, 1087-1096 (2007)
DOI: 10.1177/0269215507080121


SAGE Open article

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?