Intérêt de l'appui antérieur en station assise pour le redressement et la tenue de tête du sujet atteint d'infirmité motrice cérébrale ou polyhandicapé

Because of their brain damage, patients with cerebral palsy or severely disabled have abnormal postural and antigravity regulation. This results in a postural and movement disorder. In the sitting position, excessive muscle contractions combined with the difficulty in maintaining an upright posture and the balance against gravity disrupt body alignments. Over the months and years, orthopedic disorders develop. Depending on the severity of the primary motor disorder and secondary deformities, the sitting posture becomes difficult or impossible. Sitting corrective devices allow relaxation of the patient and improve the quality of his body's alignments. The difficulty is to facilitate motor skills of the patient without deteriorating his posture, particularly in patients with severe cerebral palsy. Active trunk extension is facilitated by the organization of anterior support. The improved posture control and grasp in turn enables better surrounding interaction and functional performance. After a postural analysis, we will propose the use of support at different levels, depending on the patient's capabilities, the functional project and situation. We will focus here on this application in the different sitting positions: on the floor with straight legs, kneeling, or sitting with legs dangling.