Investigating the influence of custom-contoured wheelchair seating on the progression of deformity for children with neurologic and neuromuscular disorders

Abstract

Purpose: To date, custom-contoured wheelchair seating (CCS) has received little attention in the research literature. This thesis set out to gain a better understanding of its clinical effectiveness and to investigate its comparative impact versus alternative seating on progression of scoliosis deformity. Methods: Firstly, a scoping review was conducted exploring the efficacy of CCS for: (1) posture and musculoskeletal deformity, (2) quantitative measures of body structure and functions including cardiopulmonary and upper limb function, motor control and tissue integrity, and (3) qualitative perceptions, opinions and quality of life indicators including comfort and satisfaction. Secondly, a retrospective cohort study was conducted for a convenience sample of 75 paediatric wheelchair users with neurologic and neuromuscular disorders (NMDs) prescribed CCS or modular wheelchair seating (MWS) by the South Wales Posture and Mobility Service. In the study, a generalised least squares (GLS) model was used to estimate the comparative impact of each seating system and determine predictors for scoliosis progression. Results: The review demonstrated immediate benefits of CCS to postural alignment; however, there was ambiguity in its impact on deformity progression. There was a lack of research investigating its use for cardiopulmonary and upper limb function, and tissue integrity management. Yet, it performed well in studies exploring user comfort and satisfaction. The GLS model demonstrated that seat type (χ2 =52.5, P

Date of Award	29 Jan 2025
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Antonio Eleuteri (Main Supervisor)