Physio Information

Knee Blocks

These are useful to keep the child’s pelvis back in the chair. Many children with spasticity, when they are placed in sitting in a chair, lift their head to see what is going on and this causes their hips also to extend and they push their bottoms forward in the chair. It is tempting to put a pommel between their legs to stop them from doing this but a pommel cannot fix them fully without being very uncomfortable. Besides it gives the child something to push against and reinforces the total extension. Knee blocks prevent any movement at all without being uncomfortable. They give the child a good base from which to balance and move trunk and head. What is more they do not allow the pelvis to be asymmetric. This is very important for preventing subluxation of the hip joint in the leg that might be more adducted and inwardly rotated because of retraction of the pelvis on that side.

Prone Angle (Forward Tilting) Chair

This chair has a sloping seat that tilts the child forwards. Curved blocks hold him comfortably just below his knee joints and keep his pelvis from pulling back on either side. The high table lifts his body up just high enough so that he can control his head but not so much that he falls back. This kind of chair may help a child who pushes back, using spasticity, when he is supported in sitting. It gives him the experience of being in a sitting position without being held too tightly. Every time he lifts his head to watch what is going on around him he will actively extend his spine. This active extension is quite different from using spasticity and will help to give him better control of his trunk in time. Children who push back with spasticity also raise their arms up and back. This can prevent them from learning to use their hands for reaching and grasping. In the prone angle chair, because they are not using spasticity, their arms come down and they can see their hands and begin to manipulate toys.

Ride On Seat

Athetoid children with dystonic spasms are extremely difficult to put in any position except on their backs on the floor. Mothers mostly carry them until they become too big and heavy and then there is no choice except on the floor. The trouble is being on the floor makes them push more and more back into extension and then they become even harder to handle. This kind of ride on seat supports the child in a forward sitting position and prevents him from pushing back. He also has the possibility of putting his feet flat on the floor and maybe moving along bit by bit. The benefit to the child and his family is huge if he can be left even for a short time on his own in a sitting position. He can learn to hold his head upright and see the world around him. Friends and family will be able to relate to him in a better way. He may in time learn to move himself around and have a little independence and all the time his body is learning what it feels like to be in a more useful position.

Prone Angle (Forward Tilting) Standing Frame

It is necessary for all young children to be in standing whether or not they can balance or even take weight by themselves on their legs. Being in standing makes their bones strong, helps good development of their hip joints and gives them the experience of being upright which all children enjoy. The reason for placing a child in a prone angle standing frame rather than an upright or backward tilting one is that it encourages active extension of the child’s head, trunk, hips and knees. Every time the child lifts his head to see what is going on around him his whole body will also extend. As long as his feet are flat on the foot board and his body is in alignment with his hips held forward, this extension is normal and will reduce his spasticity. In an upright or backward tilting standing frame the child is more likely to be encouraged to flex forwards.

Frames made by staff at
Sour Community Disability Programme