Case Study 2;
| Name: | E.H, |
|---|---|
| Age: | 11 |
| Occupation: | School Student |
Symptoms
Spastic quadriplegia cerebral palsy.
E.H.'s condition is moderate to severe. He has some spasticity with increased extensor tone. There is a tendency for his pelvis and trunk to rotate obliquely with a drop to the left side, which tends to make him slide off a conventional seat. E.H. experiences some restriction in the activities he would like to undertake but determinedly states that he is normal and that his biggest problem is 'other people's attitudes'.
Introduction to the Saddle Seat
E.H. was told about the Bambach Saddle Seat by the occupational therapist who treats him. When his mother saw how E.H.'s posture improved when sitting on the Bambach Saddle Seat, she encouraged him to use it. Mrs H. had some reservations about backup service and the ability of the seat to be modified to fit the special physical environmental needs of each child. Reassured that the seat is fully supported, with readily available service and parts, she purchased a seat for E.H. the occupational therapist used her knowledge of the seat and the DVD provided by the manufacturer to educate E.H. about its use and adjustment. E.H. uses a reduced abduction seat with a sheepskin cover, 3 locking and 2 standard castors, and an 80mm drop through stem.
Result
The Bambach Saddle Seat anchors E.H.'s pelvis, allowing him to assume and hold a correct, upright posture. It prevents him from sliding forward and twisting obliquely, so he no longer slumps forward and to the left. The Bambach Saddle Seat offers a firm symmetrical posture with a clear and easily maintained midline. The position of abduction and extension of the hips helps to break down adductor spasm. This posture allows E.H. to sit for functional tasks with better performance of such skills as writing and computer use.
E.H.'s head and neck are in a more normal position in the Bambach Saddle Seat.
Apart from the dramatic improvement in posture and resulting functional improvements, E.H. likes the seat because it allows him to look more 'normal'.
EH is using the corrective seat made for him. Even in this specially designed seat his spine is not upright with its natural curves. Functional tasks are more difficult and his muscles are not balanced. If he were using the standard seating provided by schools he would be much worse off.
EH on his Bambach Saddle Seat, posture now upright, showing improved functional ability, with a better relationship
to his work and looking and feeling more 'normal'. Note the reduction of strain in his sternocleidomastoid (neck
flexor).
Bambach understands the problems associated with Cerebral Palsy
- Loss of selective movement and lack of muscle co-ordination
- Difficulty with fine motor skills
- Tremor
- Increased muscle tone and reflexes (spasticity)
- Abnormal muscle tone
- Assymetric gait (walk)
- Decreased co-contraction of muscle groups
- Musculoskeletal problems such as scoliosis, muscle contracture and hip dislocation
The Bambach design and Cerebral Palsy
The Bambach saddle seat was designed by an Australian Occupational Therapist as a result of her observation following years spent working with 'Riding for the Disabled'.
She found that disabled individuals suffering from neurological conditions such as CP often had great difficulty in maintaining a healthy posture and assumed a 'collapsed' or 'slouched' posture when seated in a conventional wheelchair and required considerable support (or strapping) to remain sitting.
These same individuals when sat on horseback were however capable of sitting independently and unsupported and showed remarkably improved functional abilities as a result of being put on a horse on a saddle.
