Functional Seating to Enhance Mobility and Activity in a Child with Spastic Quadriplegic Cerebral Palsy
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Published:
Dec 24, 2025
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Abstract
Introduction: Cerebral palsy is a permanent disorder of movement and posture caused by non-progressive disturbances in the developing brain. Spastic quadriplegia is the most severe subtype, affecting all four limbs and the trunk, and is often associated with significant limitations in mobility, posture, and functional independence. Children with this condition frequently require specialized postural support to enhance stability and improve participation in daily activities. This case report describes the use of functional seating to address postural instability in a 7-year-old girl with spastic quadriplegia following perinatal hypoxic–ischemic injury.
Case Presentation: A multidisciplinary rehabilitation program was implemented using a customized functional seating system equipped with lateral trunk supports and contoured cushions to stabilize the pelvis, trunk, and neck. The child presented with global developmental delay and difficulty sitting, walking, and speaking. The intervention focused on optimizing postural alignment, reducing abnormal movement patterns, and facilitating safer mobility and daily participation. Challenges during positioning included markedly increased muscle tone, strong extension patterns, and involuntary movement, which required continuous adjustment of the seating configuration.
Discussion: Despite these challenges, the functional seating provided improved postural stability, enabling the child to maintain sitting for longer periods with better alignment. Enhanced stability supported improved motor control and increased participation in daily routines. The intervention also reduced caregiver burden by facilitating easier and safer handling during daily activities.
Conclusion: Functional seating is an effective adjunct to rehabilitation for children with spastic quadriplegia. When integrated into a tailored, multidisciplinary program, it enhances posture, supports mobility, and improves participation in daily activities, contributing to better overall quality of life.
Keyword: cerebral palsy, spastic quadriplegic, functional seating
Case Presentation: A multidisciplinary rehabilitation program was implemented using a customized functional seating system equipped with lateral trunk supports and contoured cushions to stabilize the pelvis, trunk, and neck. The child presented with global developmental delay and difficulty sitting, walking, and speaking. The intervention focused on optimizing postural alignment, reducing abnormal movement patterns, and facilitating safer mobility and daily participation. Challenges during positioning included markedly increased muscle tone, strong extension patterns, and involuntary movement, which required continuous adjustment of the seating configuration.
Discussion: Despite these challenges, the functional seating provided improved postural stability, enabling the child to maintain sitting for longer periods with better alignment. Enhanced stability supported improved motor control and increased participation in daily routines. The intervention also reduced caregiver burden by facilitating easier and safer handling during daily activities.
Conclusion: Functional seating is an effective adjunct to rehabilitation for children with spastic quadriplegia. When integrated into a tailored, multidisciplinary program, it enhances posture, supports mobility, and improves participation in daily activities, contributing to better overall quality of life.
Keyword: cerebral palsy, spastic quadriplegic, functional seating
Article Details
How to Cite
Paramita, I. A., & Annisa Aprilia. (2025). Functional Seating to Enhance Mobility and Activity in a Child with Spastic Quadriplegic Cerebral Palsy. Indonesian Journal of Physical Medicine and Rehabilitation, 14(2), 271 - 277. https://doi.org/10.36803/indojpmr.v14i2.532
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Case Report
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References
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8. Paleg, G.S.; Williams SA., Livingstone R. Supported Standing and Supported Stepping Devices for Children with Non-Ambulant Cerebral Palsy: An Interdependence and F-Words Focus. Int J Environ Res Public Heal. 2024;21(669).
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12. Akerblom B. Standing and Sitting Posture. Stockholm: AB Nordiska Bokhandeln.; 1948.
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14. Mandal AC. The seated man (homo sedens). The seated work position. Theory Pract Appl Ergon.1981;12:19–26.
15. Letts, M., Shapiro, K., Mulder, K., Klassen O. The yindblown hip syndrome in total body cerebral palsy. J Pediatr Orthop. 1984;4:55– 62.
16. Jones MW, Morgan E, Shelton JE TC. Cerebral palsy: introduction and diagnosis (part I). J Pediatr Heal Care. 2007;21:146–52.
2. Makki D, Duodu J NM. Prevalence and pattern of upper limb involvement in cerebral palsy. J Child Orthop. 2014;8(215):9.
3. Himmelmann K, Hagberg G UP. The changing panorama of cerebral palsy in Sweden. X. Prevalence and origin in the birth-year period 1999-2002. Cereb palsy Epidemiol Sweden Acta Paediatr. 2010;99(9):1337–43.
4. Salfi QN, Saharso D AA. Profile of cerebral palsy patients in Dr. Soetomo General Hospital Surabaya, Indonesia. Biomol Heal Sci J. 2019;2(1):13–6.
5. Novak I, Morgan C, Adde L, Blackman J, Boyd RN, Brunstrom- Hernandez J et al. Early, accurate diagnosis and early intervention in cerebral palsy: advances in diagnosis and treatment. JAMA Pediatr. 2017;171(9):897–907.
6. Magdy AE. Evaluation of risk factors for cerebral palsy. Egypt J Neurol Psychiatry Neurosurg. 2021;57(13).
7. Huntsman R, Lemire E, Norton J, Dzus A, Blakley P HS. The differential diagnosis of spastic diplegia. Arch Dis Child. 2015;(100):500–4.
8. Paleg, G.S.; Williams SA., Livingstone R. Supported Standing and Supported Stepping Devices for Children with Non-Ambulant Cerebral Palsy: An Interdependence and F-Words Focus. Int J Environ Res Public Heal. 2024;21(669).
9. Hay WW, Levin MJ, Deterding RR AM. Current Diagnosis & Treatment: Pediatrics (22nd ed). New York: McGraw-Hill Education; 2014.
10. Sadowska M, Sarecka-Hujar B KI. Cerebral Palsy: current opinions on definition, epidemiology, risk factors, classification and treatment options. Neuropsychiatr Dis Treat. 2020;16:1505–18.
11. Myhr, Ulla L von W. IMPROVEMENT OF FUNCTIONAL SITTING POSITION FOR CHILDREN WITH CEREBRAL PALSY. Dev Med Child Neurol. 1991;33:241–56.
12. Akerblom B. Standing and Sitting Posture. Stockholm: AB Nordiska Bokhandeln.; 1948.
13. McClenaghan BA. Sitting stability of selected subjects with cerebral palsy. Clin Biomech. 1989;4:213–6.
14. Mandal AC. The seated man (homo sedens). The seated work position. Theory Pract Appl Ergon.1981;12:19–26.
15. Letts, M., Shapiro, K., Mulder, K., Klassen O. The yindblown hip syndrome in total body cerebral palsy. J Pediatr Orthop. 1984;4:55– 62.
16. Jones MW, Morgan E, Shelton JE TC. Cerebral palsy: introduction and diagnosis (part I). J Pediatr Heal Care. 2007;21:146–52.