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The Effects of a Contoured Foam Seat on Postural Alignment and Upper-Extremity Function in Infants With Neuromotor Impairments

K Washington, PT, PhD, is Clinical Assistant Professor, Division of Physical Therapy, Department of Rehabilitation Medicine, Box 356490, University of Washington, Seattle, WA 98195 (USA) (kwpt{at}u.washington.edu).
JC Deitz, OTR/L, PhD, FAOTA, is Professor, Division of Occupational Therapy, Department of Rehabilitation Medicine, University of Washington
OR White, PhD, is Professor, Special Education Area, College of Education, University of Washington
IS Schwartz, PhD, is Professor, Special Education Area, College of Education, University of Washington

Address all correspondence to Dr Washington

Background and Purpose. Physical therapists and occupational therapists frequently use adaptive seating devices to improve stability in sitting for children with neuromotor impairments. The purpose of this study was to examine the effects of a contoured foam seat (CFS) on postural alignment and on the ability of infants with neuromotor impairments to engage with toys. Parental perceptions regarding the use and effects of the CFS also were assessed via semistructured interviews. Subjects. Subjects were 4 infants, ages 9 to 18 months, who were unable to sit independently. Method. A time-series, alternating-treatments design was used, with data collected under 3 conditions: (1) a regular highchair, (2) a regular highchair with a thin foam liner, and (3) a CFS used as an insert in a regular highchair. The primary dependent measures were postural alignment and engagement with toys. Engagement with toys was defined as percentage of intervals with 2 hands on a toy and percentage of intervals with no hands on a highchair tray and 1 or 2 hands on a toy. Results. Results showed a sustained effect of the CFS on improving postural alignment for all subjects. Effects of the CFS on increasing the number of intervals of bimanual play were not demonstrated for any subjects, although some improvement in the infant's ability to free the arms from support was observed for 2 subjects. Mothers reported acceptability of the CFS for everyday use and described benefits for themselves and their infants. Discussion and Conclusion. The results support the use of a CFS for improving postural alignment. Future research on adaptive seating should focus on interventions and outcomes that help children participate in functional activities relevant to them and their families.

Key Words: Adaptive seating • Cerebral palsy • Infants