Continuous postural management and the prevention of deformity in children with cerebral palsy: an appraisal

Continuous postural management programmes are commonly used for children with cerebral palsy (CP) in Gross Motor Function Classification System levels IV and V, with the aim of preventing musculoskeletal deformity. There is a lack of evidence to support their use in this capacity and a possibility that children with CP who are most likely to develop deformity may be least able to comply with a continuous postural management programme. The implications for the child and family of such a programme in terms of increased demands and potential discomfort are discussed within the framework of the International Classification of Functioning, Disability and Health. A shift in focus in the use of postural management from an emphasis on body structure towards the environment and participation of the child with CP is suggested.