Case Study 3;
| Name: | K.A. |
|---|---|
| Age: | 14 |
| Occupation: | School Student |
Symptoms
K.A. has mild cerebral palsy resulting in low tone in most muscles. She was recently diagnosed with a scoliosis after a history of increasing pain and weakness in her legs, which finally made it very difficult for her to walk. She finds most tasks more difficult to accomplish than other students do, but she approaches her school and other activities with a positive, constructive attitude. Because of her low muscle tone, K.A.'s posture is significantly affected by her seating. The school seating provided results in K.A.'s sitting asymmetrically; this is allowing her spine to form a scoliosis, which is now causing her pain and weakness; it is also becoming an intractable condition.
Introduction to the Saddle Seat
The occupational therapist and the school adviser for children with special needs at K.A.'s school recommended the Bambach Saddle Seat to K.A.'s parents as a seat that could correct her posture and help her to maintain a correct position whilst seated to work. K.A. uses a standard seat with a backrest but a cutdown model may be tried. A foot ring is needed to accommodate K.A.'s feet while she is working at high benches in the art room.
Result
K.A. was very doubtful about the seat but said that, once she tried it, she liked it and prefers it to her school seat. She said she feels comfortable on the saddle seat:
"I don't have to lean over as far to reach my work and my hand does not get as tired when I am writing."
The foot ring works well when K.A. has to work at a high bench. The occupational therapist said that her lumbar spine is in a much better position on the Bambach Saddle Seat and the scoliosis is not as obvious. Her body is symmetrical on the saddle seat with her feet on the floor in plantar contact taking some weight when she leans forward. Her feet and legs are being used in this position which helps to strengthen them as well as giving her mobility.
Functional tasks, such as writing, drawing and reading, are now easier and less fatiguing. The therapist feels the Bambach Saddle Seat will improve K.A.'s lung function as well as encouraging her back and abdominal muscles to strengthen.
K.A. asked to borrow the trial seat for her end of year exams, as she found that her concentration for study was better using the Bambach Saddle Seat and that she worked more efficiently.
K.A. in classroom chair sits with rounded upper and lower spinal curves, her head protruding, shoulders slumped. There is a risk of worsening her scoliosis. Poor postural stability and postural stress causes K.A. to slump making it difficult to concentrate on her work and to perform fine motor skills. She tires easily.
K.A. on a Bambach Saddle Seat, her spinal curves maintained in a correct position. She does not 'slump' over her work due to fatique, and with her improved head and shoulder position her handwriting has improved as has her concentration; her level of fatigue is lower. K.A. is able to achieve and maintain symmetry, so the risk of worsening her scoliosis is diminished.
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.
