Jack C
Stabilising Jack C’s strong extensor pattern and improving function
Jack is an 11 year old boy with Pontocerebellar Hypoplasia, a genetic condition where the cerebellum fails to develop properly resulting in uncoordinated movement. Jack has frequent increases in extensor tone, fluctuating head control and spastic hip adduction. Jack’s existing chair is becoming too small for him, and he frequently gets his arms stuck by extending them behind the chair. He also has a tendency to get his head stuck around the headrest. In addition Jack’s parents are keen for a seating system in which Jack can be seen first!
Clinical Assessment
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Flexible pelvis, neutral and anterior tilt achievable
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Range of movement at hips in the normal range for the seated posture
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Tight flexion at hips required to contain extensor pattern (approx 80 degrees)
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Range of movement at the knees (hamstrings) slightly reduced – would benefit from having feet placed behind knees
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Slight rib flare to left ribs – Jack sleeps on his stomach
Approach
The main aim of the KIT Seating System for Jack is to contain his extensor spasms, thereby reducing overall tone, and improving function.
Outcome
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Jack used KIT Size one with a size 1 Pelvic Cradle. He was a little small for the KIT, but this could be accommodated by moving all 3 back supports forward on their brackets. With this configuration, Jack was able to sit well, using no chest harness. The tray simply provided a play surface for him. Allowing slight windsweeping to the left reduced the adductor tone in Jack’s right leg. Using the shoulder protraction wings kept Jack’s shoulders and head in midline. During assessment, he was not able to get his head or arms stuck.
