Management of seating posture of children with cerebral palsy by using thoracic-lumbar-sacral orthosis with non-rigid SIDO frame

Purpose. To investigate the effects of a special seating device: Thoracic-lumbar-sacral orthosis with non-rigid SIDO® frame (TLSO-SIDO®) in non-ambulant children with cerebral palsy.

Method. A prospective study with matched pairs (the same subject pre- and post-intervention) was carried out. A comparison of the lateral view of thoracic-lumbar spine X-ray before and after TLSO-SIDO® application was made. The assessment of changes in daily activities, posture was recorded by questionnaires. A total of 47 children with cerebral palsy at a mean age of 53.2 months ± 30.1 SD were involved in the study; 15 (35.71%) of the 42 children showed significant problems in feeding at the beginning of the study period, they were identified as a special subgroup with feeding difficulties.

Results. The mean pre-TLSO-SIDO® thoracic kyphosis was 53.7 ± 16.2 in Cobb angle, while the post-TLSO-SIDO® thoracic kyphosis was 47.2 ± 12.1. The lumbar lordosis was 21.3 ± 13 and in the TLSO-SIDO® 17.8 ± 11.9. The majority of the children have shown improvement in the feeding items and in posture (trunk, head and extremities). The overall satisfaction of the parents with the TLSO-SIDO® was very good, namely 3.972 ± 0.796 on the 5-point analogue scale. We did not find a direct correlation with the improvement in the separate items and the overall satisfaction.

Conclusion. It is extremely difficult to measure the effect of the postural management on the development of children with cerebral palsy. According to the results of the study, regular application of the TLSO-SIDO® in children with spastic cerebral palsy had a beneficial effect on feeding problems and on posture.