Seating and positioning system in wheelchairs of people with disabilities: a retrospective study.

OBJECTIVE: To characterize and quantify the seating and positioning items in wheelchairs prescribed and dispensed from 2005-2018 in relation to the necessities of the diagnoses served. METHODS: A convenience cross-sectional sample survey was used in the setting of an occupational therapy service from a specialized orthopaedic hospital. Records of people with disabilities who use a wheelchair (n = 1730) were surveyed for the following data: sociodemographic information (gender and age), diagnosis, whether a new wheelchair was received, whether wheelchair seating and positioning system were received, and the prescribed items. RESULTS: Of the 1730 users, 73.7% received a new wheelchair and 26.3% already had one donated by other services and/or purchased by the patient. Almost all the wheelchairs needed seating and positioning system in their structure (82.3%), and only 307 wheelchairs (17.7%) did not require any. The most frequent item was the hip belt (82.3%), followed by the removable solid wooden seat, and removable solid wooden backrest (81.3 and 80.9%, respectively). CONCLUSIONS: It is noted that the sample studied required many seating and positioning items for their wheelchairs. Despite the high demand for these assistive technological resources, research in this area is scarce. Little is known about which seating and positioning system is ideal for each user profile, which makes it difficult to organize the services that act in the provision of such equipment and the professional practice based on evidence.Implications for RehabilitationSeating and positioning system in wheelchair provide the user with the postural control necessary for daily activities, the maintenance of independence, and interaction with the environment.Indicating the best seating and positioning system is one of the most challenging tasks for healthcare professionals specializing in its prescription because it can be difficult to assess which components best meet the needs of an individual.The research proposed by this study has produced important evidences for the clinical practice of professionals that act on the prescription of wheelchairs and seating and positioning items for people with disabilities, presenting data that contribute to a better indication of these equipment's.

MANAGEMENT OF INFANTILE BLOUNT'S DISEASE WITH MOLDED ORTHOSES: A NEW PERSPECTIVE.

OBJECTIVE: : This retrospective study evaluated treatment with individually contoured molded bracing at early stages of the disease. METHODS: : We evaluated the medical records of patients undergoing treatment of Blount's disease with molded orthoses for medial decompression between 2010 and 2014. The deformity angle (Drennan's metaphyseal-diaphyseal angle) and Langenskiöld classification were measured before and after treatment by a pediatric orthopedic surgeon with over 5 years of practice, blinded for the study and patients. RESULTS: : The mean age was 2.57 years old. Four patients were female and six male. Half of the total sample had bilateral disease. The average deformity angle showed a statistically significant reduction after treatment (p <0.001). Gender and laterality did not statistically influence the change of the deformity angle after treatment (p> 0.05). CONCLUSION: : The nightly use of molded orthoses for medial decompression was effective in reducing the metaphyseal-diaphyseal angle in Blount's disease in children under 3 years of age, regardless of gender and bilateral disease. Patients over 3 years old did not benefit from bracing. Level of Evidence IV, Case Series.