Abstract：
OBJECTIVE: 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.
METHODS: 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.
METHODS: Two specialized wheelchair seating systems, CCS and MWS.
METHODS: 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 < .0001), seating type (χ2 = 52.5, p < .0001), and baseline scoliosis severity (χ2 = 41.6, p < .0001) were predictive of scoliosis progression. Condition was not a strong predictor (χ2 = 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.
METHODS: 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.
METHODS: Two specialized wheelchair seating systems, CCS and MWS.
METHODS: 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 < .0001), seating type (χ2 = 52.5, p < .0001), and baseline scoliosis severity (χ2 = 41.6, p < .0001) were predictive of scoliosis progression. Condition was not a strong predictor (χ2 = 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.
摘要：
目的：回顾性评估两种轮椅座椅系统的比较效果，定制外形轮椅座椅（CCS）和模块化轮椅座椅（MWS），关于患有神经肌肉和神经系统疾病的儿童的脊柱侧凸进展，并确定脊柱侧凸进展的任何预测因素。
方法：纵向，回顾性队列研究设置：国家卫生服务区域姿势和行动服务参与者：患有神经肌肉和神经系统疾病的非门诊儿科轮椅使用者(N=75；36男性，39名女性；座位干预时的平均年龄，10.50±3.97年）由南威尔士态势和机动性服务于2012年至2022年发布的CCS和MWS。
方法：两种专门的轮椅座椅系统，CCS和MWS。
方法：使用广义最小二乘（GLS）模型来估计座椅类型随时间对Cobb角的影响。
结果：在75名参与者中，51%有脑瘫。50个发行了CCS，25个发行了MWS。MWS组的基线Cobb角为32.9±18.9°，CCS组为48.0±31.0°。GLS模型证明了自坐位干预以来的时间(χ2=122，p<0.0001)，座椅类型（χ2=52.5，p<0.0001），和基线脊柱侧凸严重程度（χ2=41.6，p<0.0001）可预测脊柱侧凸进展。条件不是一个强有力的预测因子(χ2=9.96，p=.0069)，性别(χ2=5.67,p=.13)和干预年龄(χ2=4.47,p=.35)均无预测作用。随着时间的推移，医疗状况与座椅类型的估计对比表明，随着时间的推移，MWS和CCS之间的差异较小。与MWS相比，预测的脊柱侧凸速度随着时间的推移随着CCS的使用而减弱。虽然,脊柱侧凸恶化，无论干预。
结论：我们的研究结果表明，与MWS相比，患有神经和神经肌肉疾病的儿童轮椅使用者，CCS处方显示随着时间的推移脊柱侧凸进展有更大的缓解。
方法：纵向，回顾性队列研究设置：国家卫生服务区域姿势和行动服务参与者：患有神经肌肉和神经系统疾病的非门诊儿科轮椅使用者(N=75；36男性，39名女性；座位干预时的平均年龄，10.50±3.97年）由南威尔士态势和机动性服务于2012年至2022年发布的CCS和MWS。
方法：两种专门的轮椅座椅系统，CCS和MWS。
方法：使用广义最小二乘（GLS）模型来估计座椅类型随时间对Cobb角的影响。
结果：在75名参与者中，51%有脑瘫。50个发行了CCS，25个发行了MWS。MWS组的基线Cobb角为32.9±18.9°，CCS组为48.0±31.0°。GLS模型证明了自坐位干预以来的时间(χ2=122，p<0.0001)，座椅类型（χ2=52.5，p<0.0001），和基线脊柱侧凸严重程度（χ2=41.6，p<0.0001）可预测脊柱侧凸进展。条件不是一个强有力的预测因子(χ2=9.96，p=.0069)，性别(χ2=5.67,p=.13)和干预年龄(χ2=4.47,p=.35)均无预测作用。随着时间的推移，医疗状况与座椅类型的估计对比表明，随着时间的推移，MWS和CCS之间的差异较小。与MWS相比，预测的脊柱侧凸速度随着时间的推移随着CCS的使用而减弱。虽然,脊柱侧凸恶化，无论干预。
结论：我们的研究结果表明，与MWS相比，患有神经和神经肌肉疾病的儿童轮椅使用者，CCS处方显示随着时间的推移脊柱侧凸进展有更大的缓解。
