Five facts about … physiotherapy for people with a disability - Australian Physiotherapy Association

4. Postural care: prevention is better than cure

Postural care is protecting the body shape of children and adults with movement problems. Supported lying is described as ‘aligning the body in a comfortable non-destructive position in bed’ (Stephens et al 2018). The current evidence base for supported lying is limited, but growing.

The aim of postural care is to prevent the body from distorting through development of joint contractures, hip migration, scoliosis and bony malformations caused by the effects of immobility, asymmetry and, importantly, the impact of gravity.

The ramifications of these issues can be life-shortening as well as leading to considerable pain and discomfort. Applying a person/family-centred approach, utilising the often-forgotten hours a child or adult remains in bed overnight, and with a thorough understanding of how the body distorts, application of supported lying principles can achieve much.

Understanding the rotational distortions of the chest and how to de- rotate the sterno-spinal line, body shape distortion may be prevented, minimised or even restored by family/carer-led, gentle postural care. Corrective surgery may be avoided or delayed, while recovery from surgery is likely to be enhanced. Postural care is complementary to current services and interventions, it does not replace them. Prevention is the key, but it is never too late.

References

Stephens, M., Bartley, C.A., and Priestley, C. (2018).  Evaluation of night time therapeutic positioning system for adults with complex postural problems.  Monograph.  http://usir.salford.as.c.uk/48470/

Humphreys G., et al (2018) Sleep positioning systems for children and adults with a neurodisability: A systematic review.  British Journal of Occupational Therapy, 1-10

Hill S., and Goldsmith,. J (2010).  Biomechanics and prevention of body shape distortion.  Tizard Learning Disability Review, I 15 (2), pp. 15-32.

Innocente, R. (2014).  Night-time positioning equipment:  A review of practices.  New Zealand Journal of Occupational Therapy, 61 (1), pp. 13-19

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