Review of the Efficacy and Effectiveness of Adaptive Seating for Children with Cerebral Palsy

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Abstract
The purpose of this article is to review the published research evidence for the efficacy and effectiveness of adaptive seating in the management of children with cerebral palsy. This review is undertaken to determine whether adaptive seating outcomes proposed in the clinical literature have been substantiated. The literature search was confined to English-language publications between 1982 and 1994. Thirty-seven research studies were identified through: 1) on-line search of Index Medicus, Cumulative Index to Nursing and Allied Health Literature, and Psychological Abstracts; 2) scanning conference proceedings and article reference lists; and, 3) tracking of author citations through the Science Citations Index. Eight studies met the selection criteria of using subjects who were children with cerebral palsy, including adaptive seating as an independent variable, and including an unsupported sitting comparison condition. Study quality was evaluated using an adaptation of Sackett's validity criteria. Sackett's classification system was utilized to identify levels of evidence and to grade recommendations. Grade A, B, and C recommendations were generated from Level I to Level V evidence for some of the clinically proposed seating outcomes. Additional seating research is required to strengthen the recommendations and investigate unexplored outcomes. Limitations of the review are potential reviewer and publication bias.