Functional Seating to Enhance Mobility and Activity in a Child with Spastic Quadriplegic Cerebral Palsy

Abstract

Introduction: Cerebral palsy is a permanent disorder of movement and posture caused by non-progressive disturbances in the developing brain. Spastic quadriplegia is the most severe subtype, affecting all four limbs and the trunk, and is often associated with significant limitations in mobility, posture, and functional independence. Children with this condition frequently require specialized postural support to enhance stability and improve participation in daily activities. This case report describes the use of functional seating to address postural instability in a 7-year-old girl with spastic quadriplegia following perinatal hypoxic–ischemic injury.

Case Presentation: A multidisciplinary rehabilitation program was implemented using a customized functional seating system equipped with lateral trunk supports and contoured cushions to stabilize the pelvis, trunk, and neck. The child presented with global developmental delay and difficulty sitting, walking, and speaking. The intervention focused on optimizing postural alignment, reducing abnormal movement patterns, and facilitating safer mobility and daily participation. Challenges during positioning included markedly increased muscle tone, strong extension patterns, and involuntary movement, which required continuous adjustment of the seating configuration.

Discussion: Despite these challenges, the functional seating provided improved postural stability, enabling the child to maintain sitting for longer periods with better alignment. Enhanced stability supported improved motor control and increased participation in daily routines. The intervention also reduced caregiver burden by facilitating easier and safer handling during daily activities.

Conclusion: Functional seating is an effective adjunct to rehabilitation for children with spastic quadriplegia. When integrated into a tailored, multidisciplinary program, it enhances posture, supports mobility, and improves participation in daily activities, contributing to better overall quality of life.

Keyword: cerebral palsy, spastic quadriplegic, functional seating