24 Hour Postural Care
What is Postural Management?
Postural Management is the term used to describe the 24-hour physical management of a child who has a physical disability and limited independent movement. 
Under normal circumstances, babies begin life unable to independently achieve a balanced and straight posture. Th
If these children are routinely placed in or adopt positions that do not keep their spine in line or that they are unable to move out of, they become uncomfortable and stiff and the body eventually becomes fixed in that position or other destructive postures. This is likely to cause pain, lead to damaged skin, reduce function and limit access to “normal” activities.
Postural Care is carried out on a day to day basis by all people involved in the child’s care. Postural management should start as soon as a movement problem has been identified.
Who should be involved in postural management?
Postural Management should involve everyone who has contact with the child including:
• Parents/carers/grandparents/siblings/friends etc
• Teachers & Support staff
• Allied Health Professionals (e.g. Physiotherapists, OT’s)
• Orthotists
• Doctors (Paediatricians MUST be onboard)
• Other hospital staff (esp. during inpatient episodes)
• Wheelchair services
• Equipment companies and their representatives.
The Postural Management Plans
A postural Management Plan will include assessment, the setting of postural management goals and a package of interventions (including the provision of often highly specialised equipment).
We are currently creating A5 laminated Posture Management plans for our clients with movement disorders. These are made in conjunction with Parents, Liverpool Children's Occupational therapists, Liverpool Wheelchair Service and Liverpool Manual Handling Team. If you would like to know more about this project then please contact your Physiotherapist.
What are we aiming for?
We are aiming to:
- Give comfortable, symmetrical support for children who are unable to move well
- Protect a child’s body shape during the day and night, encouraging them to grow as straight as possible
- Give advice and training in positioning your child, including the use of specialist equipment.
Disabled children and young people with postural needs are usually provided with specialist equipment to help them sit and stand. With help from Aiming High for Disabled Children there has been additional equipment in Liverpool to support their posture around the clock.
Looking after posture is not just about getting a good sitting position in a wheelchair or a school chair. Out of nearly 9000 hours in a year around 4000 are spent in bed! Night time positioning equipment can have a therapeutic benefit even whilst a child is asleep. Sleep pattern, position and posture can all be improved as well as reduced pain and better mood. Stress levels may also improve because the less a child needs their position changed in the night and the longer and better they sleep, so do their parents.
In consultation with children and parents we are in the process of developing a Night-time Positioning Pathway and 24 Hour Postural Care Plans for all children with a postural need. These care plans can go wherever the child goes so their requirements are met in a consistent way by everyone involved with their support. In addition to equipment for home, night-time positioning equipment is also available in short breaks settings including Claire House,
If you have any concerns or questions please contact your therapist.
