Margarita has a left pelvic obliquity, dislocated hips and her left hip is internally rotated. Her right leg is shorter than her left leg. Occasionally she scissors her legs.
Margarita’s tone is higher at her pelvis and shoulders, with arms held semi-flexed and pronated. She can hold small toys for a short time using her hands.
In the prone position (on her tummy) Margarita can turn her head to sounds and visual stimuli, but is unable to fix her gaze.
Margarita can make eye contact and smile, but has no speech. Her swallow is poor.
In sitting, the main problems are extension spasms in Margarita’s arms and legs. The seating system needs to:
Prevent hyper extension of the head, trunk and legs
Support the pelvis and shoulder area to improve selective use of the arms
Facilitate and shorten the time needed for feeding
Increase the tolerance for the sitting position
Improve interaction with family and kindergarten staff
The Leckey Squiggles Seating System was chosen because of the high level of postural support it offers, and its ability to adapt to the child’s needs. In particular:
The pelvic harness positioned Margarita’s pelvis right back in the seat, preventing posterior pelvic tilt, extension of her legs, and reducing her pelvic obliquity
The head support provided sub-occipital support, positioning Margarita’s head in a more relaxed position where she had better eye contact
The trunk and lateral supports reduced the hyperextension in Margarita’s trunk and shoulders, allowing her to have a wider range of movement in her arms and make more selective movements
The footrest provided full contact neutral positioning of Margarita’s feet
Since using the Squiggles Seating System, Margarita’s therapist commented, “Margarita has increased her tolerance for a sitting position, and significantly increased the amount of time she can sit. She has better head control by using the head support – the position and movement of her head has improved. She can therefore make eye contact that facilitates communication with her environment. With the support of the shoulder girdle, we got relaxed hands that are no longer constantly fisted, allowing the promotion of grip. It is also important to note that the hydraulic hi-low function of the seating system allowed Margarita to participate in group work because she was at the same table level as the other girls during activities” (Margarita’s physiotherapist).