| Abstract | 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. |
| Authors | David Porter, Shona Michael, Craig Kirkwood
(Affiliation: School of Health & Social Care, Oxford Brookes University, Oxford, UK. dporter at brookes.ac.uk)
|
| Journal | Clinical rehabilitation
(Clin Rehabil)
Vol. 21
Issue 12
Pg. 1087-96
(Dec 2007)
ISSN: 0269-2155 England |
| PMID | 18042604
(Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
|
| Topics |
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Cerebral Palsy
(complications, physiopathology)
- Child
- Cohort Studies
- Female
- Hemiplegia
(physiopathology)
- Hip Dislocation
(etiology, physiopathology)
- Hip Joint
(physiopathology)
- Humans
- Male
- Middle Aged
- Pelvis
(physiopathology)
- Posture
- Scoliosis
(etiology, physiopathology)
|
