Complex Positioning Technology

Glass Half Full

Inside the Episode

This episode is eligible for CEU credits!

This week, Natalie and Jessica interview Kourtni Reed about therapeutic approaches, equipment and technology that can assist with complex positioning programs.

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References

Agustsson, A. & Jonsdottir, G. (2018). Posture management 24/7. In M.L. Lange & J.L. Minkel (Eds.)

Blake, S.F., Logan, S., Humphreys, G., Matthews, J., Rogers, M., Thompson-Coon, J.,… Morris, (2015). Sleep positioning systems for children with cerebral palsy. Cochrane database of systematic reviews, 1-35. https://doi.org/10.1002/14651858.cd009257.pub2

Castle, D., Stubbs, B., Clayton, S. & Soundy, A. (2014). A 24-hour postural care service: Views, understanding and training needs of referring multidisciplinary staff. International Journal of Therapy and Rehabilitation, 21, 132- 139.

Gericke, T. (2006). Postural management for children with cerebral palsy: Consensus statement. Developmental Medicine & Child Neurology, 48, 244. DOI: 10.1017/S0012162206000685

Goldsmith, S. (2000). Postural care at night within a community setting. Physiotherapy 86 (10), 528- https://doi.org/10.1016/s0031-9406(05)60987-x

Hankinson, J. & Morton, R. (2002). Use of lying hip abduction system in children with bilateral cerebral palsy: A pilot study. Developmental Medicine and Child Neurology, 44 (3), 177-180. https://doi.org/10.1111/j.1469-8749.2002.tb00782.x

Hill, S. (2011). A one year postural care training programme for the workforce supporting the needs of those with complex and continuing healthcare needs: Project evaluation. Postural Care CIC, 1- 59.

Hill, S., & Goldsmith, J. (2010). Biomechanics and prevention of body shape distortion. Tizard Learning Disability Review, 15, 15-29. https://doi.org/10.5042/tldr.2010.0166

Innocente, R. (2014). Night-time positioning equipment: A review of practices. New Zealand Journal of Occupational Therapy, 61(1), 13-19.

Kittelson-Aldred, T., & Hoffman, L.A. (2017). Rehab management. 24-hour posture care management: Supporting people night and day. Retrieved from: http://www.rehabpub.com/2017/09/24- hour-posture-care-management-supporting-people-night-day/

Posture 24/7. (n.d.). What is 24 hour postural care? Retrieved from: https://posture24-7.org/what-is- 24-hour-postural-care/

Robertson, J., Baines, S., Emerson, E., & Hatton, C. (2016). Postural care for people with intellectual disabilities and severely impaired motor function: A scoping review. Journal of Applied Research in Intellectual Disabilities, 1-18. https://doi.org/10.1111/jar.12325

Rodby-Bousquet, E.,Czuba, T., Hagglund, G., & Westbom, L. (2013). Postural asymmetries in young adults with cerebral palsy. Developmental Medicine & Child Neurology, 55,1009-101. https://doi.org/10.1111/dmcn.12199

Sato, H., Iwasaki, T., Yokoyama, M., & Inoue, T. (2014). Monitoring of body position and motion in children with severe cerebral palsy for 24 hours. Disability and Rehabilitation, 36 (14), 1156-1160. https://doi.org/10.3109/09638288.2013.833308

Wynn, N., & Wickham, J. (2009). Night-time positioning for children with postural needs: What is the evidence to inform best practice? British Journal of Occupational Therapy, 543-550. https://doi.org/10.4276/030802209×12601857794817

Resources

Posture 24/7 This website includes information on 24-hour postural care, a list of the educational events such as webinars on this topic, and a resources tab that has so many great links including a list of low-tech equipment titled, “Useful Materials for Bed Positioning”.

Nighttime Postural Care Training is a website that includes a series of 6 lessons via video including one on the introduction to night-time postural care, risk factors, US Sleep Systems, set-up of the systems, positioning the person in the sleep system, and assessments and outcomes. The videos on this website include the Jenx Dreama, the Symmetrisleep, and SimpleStuff Works equipment which are formal commercial sleep positioning systems. Once at the website, please check-in before starting each lesson.

Seating and Wheeled Mobility: A Clinical Resource Guide

Also, you can check out and join a Facebook group created by Patricia Toole OTR/L, ATP, and her son Alex titled: Introduction to 24 Hour Postural Care. You can join the group for access to 7 practical lessons that will get you started with 24-hour postural intervention.

Examples of outcome measures that may be helpful in tracking the results/changes of this intervention include those that look at: body symmetry and posture, sleep, pain, quality of life, ease of caregiving, and oxygen saturation and breathing. To assess outcomes in body shape and posture there is the Goldsmith Indices of Body Symmetry, Critical chest measurements, The Posture and Postural Ability Scale, ROM, and tone. To assess outcomes in sleep there is the sleep disturbance scale for children, and the Pittsburgh Sleep Quality Index. To access outcomes in pain there is the Non-communicating Children’s Pain Checklist-Revised (NCCPC-R) and Paediatric Pain Profile. To assess outcomes in quality of life and ease of caregiving there is the Caregiver Priorities & Child Health Index of Life with Disabilities (CPCHILD).