Leckey Blog

24 hour PAM: Adding Activity into 24hr PM - A New Era in Supporting Children’s Development, Health, and Participation

For many years, 24-hour postural management has been at the heart of children’s therapy programmes, ensuring that every position a child adopts throughout the day, and night supports healthy alignment, comfort, and function. While this approach remains essential, as a therapy community we are now expanding our focus to reflect new evidence and national guidance - so why the shift?

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Introducing the PAM Wheel: Making Posture and Activity Management Easier

By the time many children reach the age of two years old, they may already have five or six pieces of bulky, supportive equipment - each one essential for their comfort, development, and participation in family life.

To make this easier, we’ve developed the Posture and Activity Management (PAM) Wheel — a practical, visual, and easy-to-use tool to help families and therapy teams manage a child’s postural and activity equipment.

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Taking a stance on Abducted Standing: Updated recommendations for children with Cerebral Palsy

Hip displacement is a common concern for children with cerebral palsy, particularly those with limited mobility. While abducted standing has traditionally been used to support hip development, newer evidence supports more moderate, child-centred approaches. This article outlines updated recommendations that balance clinical evidence with comfort, feasibility, and individual needs.

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How Much Weight Does a Child Really Bear in a Standing Frame?   

Understanding how much weight a child truly bears in a standing frame is key to making informed clinical decisions. Whether the goal is bone health, joint alignment, or postural control, the angle of the standing frame makes a measurable difference - but perhaps not in the way many assume. 

This blog reviews the physics behind weight bearing in standing frames, explains how gravity and angle interact and highlights what this means for safe effective standing therapy.

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Why I Don’t Recommend Groin Harnesses for Positioning: Supporting a Child Who Slides Forward in Their Seat

As a new clinician, I remember being quite shocked when I encountered groin harnesses being used to keep children upright in their seats. The approach felt undignified and uncomfortable. Yet, faced with overburdened therapists and care teams, I accepted them as a regrettable necessity. My perspective has since shifted and I now believe groin harnesses are not the right solution for preventing forward sliding and should be phased out in favour of more effective strategies.

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Why prescribers need to understand and respect length-tension dynamics and the implications for seating

For individuals with physical disabilities, especially children with conditions like Cerebral Palsy, the way muscles are positioned during sitting can significantly impact comfort, function, and long term health. This blog explores the critical role of the length - tension relationship in muscle function, the risks of prolonged positioning at end range, and why prescribers must consider these factors when recommending supportive seating.

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