Change og Musculoskeletal Deformity in Severely Disabled Children who had used Custom Molded Chair

초록

Introduction: A custom molded fitting special chair is an equipment for prevention of musculoskeletal deformities or unstable body posture caused by brain, spinal, and neuromuscular disease. We were followed up the indices of musculoskeleal deformity in severely disabled children who had used a special chair to investigate how this equipment has an effect. Subject & Method: We searched 36 severely disabled children (mean age: 8 yrs, 21 boys) who had used a custom molded fitting special chair continuously more than a year and who was performed radiographic examination of spine & pelvis before and after the use of the chair. There were 24 cerebral palsy and 12 non-cerebral palsy patients such as muscular disease or metabolic disease. The average period of application was 24 months. We measured the Cobbs' angle using the radiographic images of whole spine, angles of femur neck-shaft using the radiographic images of pelvis for the degree of coxa valga, and Reimers migration percentage used as an index of dislocation of hip joints. And we statistically analyzed the interval change of each index through radiographic images. Results: There was a significant difference in angles of femur neck-shaft, 163 degree before and 157 degree after the use of equipment (p<0.05) and 24 of 36 had been showed reduced angle. Cobbs' angles were increased from 12.2o to 14.2o, but it was not significant. 17 of 36 had been showed reduced Cobbs' angle. Reimers migration percentage of hip joints were increased from 30.0% to 35.8%, but it was not significant. 19 of 36 had been showed reduced degree of dislocation of hip joints. Conclusion: A significant improvement was not emerged for musculoskeletal deformity indices in severely disabled children. But there were not significant aggravation of Cobbs' angle or Reimers migration percentage in developing children, so we expect the use of the custom molded fitting special chair to prevent rapid aggravation of musculoskeletal deformity.