Effect of wheelchair seating systems on scoliosis progression for children with neurological and neuromuscular disorders: a retrospective study of Custom-Contoured Wheelchair Seating and Modular Wheelchair Seating – PubMed

Objectives:

To retrospectively evaluate the comparative effect of two wheelchair seating systems, Custom-Contoured Wheelchair Seating (CCS) and Modular Wheelchair Seating (MWS), on scoliosis progression in children with neuromuscular and neurological disorders and to determine any predictors for scoliosis progression.

Design:

Longitudinal, retrospective cohort study SETTING: National Health Service regional posture and mobility service PARTICIPANTS: Non-ambulant paediatric wheelchair users with neuromuscular and neurological disorders (N = 75; 36 male, 39 female; mean age at seating intervention, 10.50 ± 3.97 years) issued CCS and MWS by the South Wales Posture and Mobility Service from 2012 to 2022.

Interventions:

Two specialized wheelchair seating systems, CCS and MWS.

Main outcome measures:

A generalized least squares (GLS) model was used to estimate the effect of seat type on Cobb angle over time.

Results:

Of the 75 participants enrolled, 51% had cerebral palsy. Fifty were issued CCS and 25 were issued MWS. Baseline Cobb angle was 32.9±18.9° for the MWS group and 48.0±31.0° for the CCS group. The GLS model demonstrated that time since seating intervention (χ² = 122, p 2 = 52.5, p 2 = 41.6, p 2 = 9.96, p = .0069), and sex (χ² = 5.67, p = .13) and age at intervention (χ² = 4.47, p = .35) were not predictive. Estimated contrasts of medical condition with seat type over time demonstrated smaller differences between MWS and CCS over time. Predicted scoliosis velocity was found to attenuate with use of CCS over time compared to MWS, although, scoliosis deteriorated regardless of intervention.

Conclusions:

Our findings showed paediatric wheelchair users with neurological and neuromuscular disorders prescribed CCS showed greater mitigation of scoliosis progression over time compared to those issued MWS.