Functional impact of a rigid pelvic stabilizer on children with cerebral palsy who use wheelchairs: users' and caregivers' perceptions

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Abstract
A within-subject ABA design was used to assess the functional impact of a novel wheelchair mounted rigid pelvic stabilizer (RPS) compared with a traditional wheelchair lap belt in a group of six children with cerebral palsy (mean age 10.4 years). The lap belt was worn during the two baseline phases which were each 3 weeks in duration. During a 5 week treatment phase the lap belt was replaced with the RPS device. Using the Canadian Occupational Performance Measure (COPM) each subject's self-evaluated performance ability and satisfaction with performance for five key tasks was measured at the end of each study phase. In addition, a structured weekly interview was conducted with the primary caregivers to assess perceived changes in their child's functional performance with each task. Results of repeated measures ANOVAs were statistically significant, indicating that the RPS as compared to the lap belt is a more effective device. The RPS allowed significantly better occupational performance and satisfaction with performance as measured by the COPM. Single-subject data analyses showed clinically significant changes in task performance and satisfaction with performance when the RPS was worn as compared to the lap belt for all subjects. Caregivers' perception of functional change ratings closely corresponded to subjects' self-rated performance on specific tasks. Visual inspection of subject data also showed that, overall, the increased performance ratings for different tasks during the treatment phase decreased in the second baseline phase, when the RPS was removed, however, performance did not return to initial baseline levels. This suggests that the RPS has a facilitating effect for increasing physical functioning. These results are further discussed in terms of implications for practice, and future research.