Adaptive seating for children with cerebral palsy classified as Gross Motor Function Classification System (GMFCS) levels IV and V at General Justice Gizenga Mpanza Regional Hospital in KwaZulu-Natal, South Africa: a mixed methods study

Background Children with cerebral palsy (CP) classified as Gross Motor Function Classification System (GMFCS) levels IV and V experience severe functional limitations and are unable to sit independently. Access to appropriate adaptive seating devices in low- and middle-income countries (LMICs) remains limited due to financial and resource constraints.Aim To evaluate the effect of commercially available car seats as adaptive seating device on sitting posture in children with CP (GMFCS IV-V), and to explore caregiver experiences regarding its impact on function and caregiving.Setting General Justice Gizenga Mpanza Regional Hospital, KwaZulu-Natal, South Africa.Methods An explanatory sequential mixed-methods design was employed. Sitting posture was assessed before and after intervention using the Posture and Posture Ability Scale and semi structured interviews were conducted with caregivers.Results Baseline PPAS scores indicated poor posture (mean 15.00%). Post-intervention scores improved significantly (mean 80.83%; p < 0.001). Caregivers reported improvements in posture, feeding, comfort, participation, and reduced physical strain, alongside increased independence in caregiving.Conclusion The use of a commercially available car seats as adaptive seating device significantly improved sitting posture and was perceived to enhance functional abilities and caregiving experiences.Contribution This study provides evidence supporting the use of commercially available car seats as a feasible alternative to specialised adaptive seating devices in LMICs.