This is, to our knowledge, the firs

This is, to our knowledge, the first study of postural asymmetries
in a total population of adults with CP.
Postural asymmetries were present in adults at all
GMFCS level, but more frequent at lower levels of motor
function and varied in different positions. Normally a
standing position requires more postural ability, and those
at GMFCS level I to III demonstrated more asymmetries
in standing compared to sitting and supine lying. However
the reverse was seen at GMFCS level V with a higher proportion
of postural asymmetries in supine and sitting compared
to supported standing, indicating a lack of postural
support while lying and sitting.
The time spent in different positions may have a great
impact on the development of contractures and deformities.
In this study no one who used standing support
stood more than 1 to 2 hours per day. This implies that
22 to 24 out of the 24 hours per day were spent in a
more asymmetric position in sitting or lying for those at
GMFCS level V. In addition they could not change their
position while lying or sitting. Of those who were unable
to change position in lying half had only one lying position,
indicating that they were not assisted in changing
position. Porter et al.4,8 showed that preferred lying postures
influence the direction of deformity with windsweeping,
hip dislocation, and spinal curve in children
with CP unable to move out of their preferred posture. A
study by Pountney et al.15 on posture management to
prevent hip dislocation supports the importance of maintaining
symmetry without compromising function for
those unable to change position. This highlights the need
for a proper assessment of posture, and provision of postural
support when needed, to prevent a sustained asymmetric
posture.