Postural asymmetries, pain, and ability to change position of children with cerebral palsy in sitting and supine : a cross-sectional study

Purpose To examine any associations between postural asymmetries, postural ability, and pain for children with cerebral palsy in sitting and supine positions. Methods A cross-sectional study of 2,735 children with cerebral palsy, 0-18 years old, reported into the Swedish CPUP registry. Postural asymmetries, postural ability, the gross motor function classification system levels I–V, sex, age and report of pain were used to determine any relationship between these variables. Results Over half the children had postural asymmetries in sitting (n = 1,646; 60.2%) or supine (n = 1,467; 53.6%). These increased with age and as motor function decreased. Children were twice as likely to have pain if they had an asymmetric posture (OR 2.1–2.7), regardless of age, sex and motor function. Children unable to maintain or change position independently were at higher risk for postural asymmetries in both supine (OR 2.6–7.8) and sitting positions (OR 1.5–4.2). Conclusions An association was found between having an asymmetric posture and ability to change position in sitting and/or lying; and with pain. The results indicate the need to assess posture and provide interventions to address asymmetric posture and pain. Implications for rehabilitation Postural asymmetries are present in children with cerebral palsy at all levels of gross motor function. Postural asymmetries increase with age and are associated with pain. Assessment of posture should be included in surveillance programs to enable early detection and treatment