Seating and positioning to manage spasticity after brain injury

Abstract

Regaining function and independence after sustaining a brain injury is often complicated by abnormal muscle tone, particularly spasticity. A conservative, non-invasive, and relatively inexpensive treatment is therapeutic seating and positioning. To inhibit spasticity seating will need to address specific issues including: individualized optimum posture, neurophysiological techniques, primitive postural reflexes, abnormal movement patterns, proximal stability, pelvic stabilization, lower extremity position, upper trunk and head position, upper extremity position, orientation in space, dynamic equipment, sensory and visual disturbances, emotional and cognitive stress, physical work demand, discomfort and pain, and skin irritation. Despite the rehabilitation team's efforts to inhibit spasticity, it will persist in many clients with head injury. Therapeutic seating and positioning also offers several techniques for accommodating unavoidable spasticity and for dealing with the long-term sequelae. In particular, seating will reduce the risk of deformities, accommodate existing fixed deformities, provide safety modifications, use durable heavy-duty equipment, and provide additional training to caregivers.