A comparison of flat and ramped, contoured cushions as adaptive seating interventions for children with neurological disorders

Figures & data

Figure 1. An illustration of a flat and a contoured seat cushion. The contoured seat cushion utilised in this study had a ramp which was equivalent to 15°.

Table 1. Demographic details of the participants.

	Number of participants, n=35	Percentage
Diagnosis
Cerebral palsy (mixed/dystonic/spasticity)	n = 30	86
Muscular dystrophy	n = 4	11
SMA	n = 1	3
Gender
Female	n = 17	49
Male	n = 18	51
Intellectual disability present
Yes	n = 30	86
No	n = 5	14
Verbal communication
Yes	n = 28	80
No	n = 7	20
GMFCS level
IV	n = 0	86
V	n = 30	14
N/A (however, all required high-level seating support)	n = 5
Age
Minimum	n = 4.0 years
Maximum	n = 11.6 years
Mean	n = 7.0 years
Functional level
Head control in seating	n = 35	100
MACS* level
III	n = 5	14
IV	n = 10	29
V	n = 15	43
Not classified	n = 5	14

Note: SMA, spinal muscular atrophy.

*Manual Ability Classification System.

Table 2. Accelerometry data – degrees of movement at the sternum.

Euler angle	Contoured		Flat		p-Value
	Mean	SD	Mean	SD
X (roll)	0.64	0.51	0.62	0.44	0.87
Y (pitch)	1.20	0.79	1.48	1.38	0.28
Z (yaw)	1.71	2.41	1.40	1.25	0.44

Table 3. Pressure mapping data.

Measure	Flat		Contoured		p-Value	95% Confidence interval	p-Value	95% Confidence interval
	Seat	Back	Seat	Back	Seat	Seat	Back	Back
Average pressure (mm Hg)	35.4	17.6	34.7	18.8	0.45	−1.06–2.36	0.07	−2.56–0.12
Peak pressure (mm Hg)	141.7	57.7	144.2	58.8	0.64	−13.03–8.07	0.81	−10.61–8.28
Contact area (cm^2)	59.7	23.1	64.6	26.2	0.02*	−8.73–0.97	0.004*	−5.05–1.08

*Significance value p < .05.

Table 4. Seated postural alignment.

Angle	Flat		Contoured		95% Confidence interval		Sig.
	Mean	SD	Mean	SD	Lower	Upper
Pelvic obliquity	8.5	4.9	4.0	4.1	−6.26	−2.76	.00
Trunk lateral shift	11.2	7.8	6.2	6.3	−6.86	−3.03	.00
Shoulder height	11.8	7.2	8.1	6.9	−5.96	−1.44	.00
Right hip rotation	12.8	6.7	7.2	4.7	−8.05	−3.13	.00
Left hip rotation	14.6	15.8	6.8	5.6	−13.03	−2.55	.01
Pelvic tilt	14.3	8.2	7.2	7.1	−8.94	−5.27	.00
Right hip flex	18.2	15.6	10.9	14.2	−10.49	−4.15	.00
Left hip flex	16.2	10.9	6.9	4.8	−13.08	−5.59	.00
Right knee flex	14.2	8.3	12.2	19.5	−9.44	5.55	.60
Left knee flex	14.9	8.9	11.5	14.4	−9.24	2.49	.25
Right ankle dorsi/plantar flexion	11.2	15.7	8.2	14.8	−10.73	4.72	.44
Left ankle dorsi/plantar flexion	12.0	15.7	11.1	19.8	−10.04	8.14	.83
Right hip add/abduction	13.1	6.8	9.6	6.7	−6.06	−1.01	.01
Left hip add/abduction	14.3	8.1	9.6	8.8	−7.58	−1.90	.00

Note: All measurements are in degrees; statistical significance tested with a two-tailed t-test.