Vertical positioning advantages in children with cerebral palsy

Stanisław Faliszewski, Ewa Kamińska, Marzena Wiernicka, Wanda Stryła

Stanisław Faliszewski, Ewa Kamińska, Marzena Wiernicka, Wanda Stryła – Vertical positioning advantages in children with cerebral palsy. Fizjoterapia Polska 2006; 6(2); 167-171


A primary aim of this paper is an introduction of the concrete arguments to physiotherapists, physicians, parents and other pro-fessionals who deal with rehabilitation of children with cerebral palsy, about the importance and the necessity of application into practice vertical positioning method based on the age of a child, not on the achievements of gross motor activity, at any stage of a physical therapy process. Two basic types of vertical positioning method may be distinguished depending on the condition of a patient: the passive and the active vertical positioning method. The difficulty in the active vertical positioning method, that is in the ability of taking up the standing position unaided, opposing the force of gravity, is the major rehabilitation problem of children suffering from cerebral palsy. It is manifested by the inability to take up the standing position unaided at all or the delay in it in the proportion to the vertical positioning standard (about the 16th month of a lifetime) and it results in many disadvantageous changes mentioned in this article. The passive vertical positioning with the help of vertical positioners seems to be the only alternative in this situation. The passive vertical positioning method is above all, the overcoming of incorrect postural-motor patterns in children. The vertical positioning method enables the suppression of intensified spastic tension. The passive vertical positioning facilitates the performance of different ADL, e. g. eating, doing homework, reading, the use of a computer, and has an influence on the course of physiological processes. The Neurodevelopment Treatment method acknowledges it to be a priority while using techniques of the stimulation during the physical therapy process. The only contraindication to the passive vertical positioning can be the prolonged reluctance of a child to such form of taking up the standing position. The advantages connected with vertical positioning by use of vertical positioning table of children with cerebral palsy (passive method) are considered from the sensomotor, psychological, physiological and anatomical points of view and ability to regain particular motor functions. Disadvantageous effects of a short and long-time immobilisation at horizontal position as result of hypokinesis and hypogravity are taken into account as well. The results of the reaserch carried out on people remaining in a recumbent position shortly or prolongedly in consequence of diseases and injuries as well as on healthy people, prove that bed rest cause essential disadvantageous physiological changes.

Key words:
vertical positioning, cerebral palsy, hypogravia, hypodynamia
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