La part positionnelle de la personne polyhandicapée en grande dépendance

The fragility of overall highly dependent polyhandicapped people against respiratory conditions is well known. An illness that is benign for an ordinary subject can lead to complications for them. By interacting with other pathological elements, it can easily evolve towards chronic respiratory failure. Complications supine wherein are maintained in these individuals, because of their engine failure, in part explain the constitution of these tables. To treat these complications, of which the constant positional seems to be the main case, it seems logical to bring changes of position to the patient. The approach that made it possible to install polyhandicapped sitting went in the right direction: the taking into account of their postural requirements. And there, some complications supine, as hypoventilation, were mitigated. But sitting position is not favorable to the chest deformities and muscle deficits. It can even cause and exacerbate distortions, if the installation which allows, is not sufficiently tailored to the individual neuro-orthopedic needs. The first action of the other positions, lateral and ventral especially on respiratory function, for example, seems to bring other perspectives, those of a positional treatment of respiratory ailments multiple disabilities. Then, and if in addition the approach is global, the idea of a specific treatment, basic treatment of respiratory problems severely multiple disabilities, appears.