Case Study 4;
| Name: | L.F. |
|---|---|
| Age: | 14 |
| Occupation: | School Student |
Symptoms
Cerebral palsy with some learning disability.
L.F. sits with his pelvis rotated backwards, producing a convex, or 'C shaped' spine with the resulting biomechanical disadvantages. The centre of gravity moves backward, the lumbar spine is kyphosed (flattened), and the shoulder girdle compensates by rotating forward with the shoulder blades pronounced, the chin protruding and the cervical spine lordosed beyond the natural, normal curve. This position, which results when L.F. sits in his wheelchair or a conventional seat, is likely to result in serious postural deformity as it is sustained for the entire time that L.F. is not in bed. L.F. also has tight hip adductor muscles common to this condition.
Introduction to the Saddle Seat
L.F. was advised to try the Bambach Saddle Seat by his occupational therapist. He tried a standard seat with a backrest and locking castors. The student advisor for children with special needs was in attendance and was insistent that L.F. try out the Bambach Saddle Seat in the science lab.
Result
When on the Bambach Saddle Seat L.F. is able to sit with his pelvis anchored in its upright neutral position, which allows him to have his centre of gravity over his ischial tuberosities (sitting bones). This allows his spine to attain and maintain its natural curves with lumbar lordosis rather than kyphosis. The result is that the shoulder girdle, cervical spine and shoulder blades are also in their neutral, and most stable, position. This greatly enhances functional ability for tasks such as computing, writing, drawing and reading. The position of his head and neck is much better for looking at a monitor as well as for using the keyboard. Most importantly, it is preventing postural deformity in the future.
In the science lab the comparison of L.F.'s ability to function on the Bambach Saddle Seat as opposed to the wheelchair is dramatic. It was remarkable how he could function almost normally in the Lab on the Bambach Saddle Seat, now being able to reach the sinks and other equipment without any help. The teacher advisor said that they had never seen L.F. so independent. L.F. is able to transfer to the Bambach Saddle Seat and back to his wheelchair with a minimum of help and with time he should attain independence in this regard.
As the Bambach Saddle Seat gradually helps the tight hip adductor muscles to stretch, standing will become easier and more secure and he will be in a better starting position, with reduced tone, to make transferring easier. The teacher's aide present for the trial said that in the four years that she had known L.F. she had never seen him so independent and confident and was amazed at the difference.
L.F. in his wheelchair, with obvious difficulty operating his computer. His visibility of, and his access to the equipment are very poor, as is his position which is typically the inactivating position forced by wheelchairs.
L.F. using the Bambach Saddle Seat at his computer. He is now in a fully active position with good posture, good functional ability to reach and manipulate the equipment. His thorax is open for improved lung function, and he has easy mobility using his feet on the floor (he doesn't need an electric motor).
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.
