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.