title: Seating.
abstract: BACKGROUND
  Patients with neuromuscular disorders are not able to adapt their sitting posture continuously. Seating devices, like seating orthoses, braces, seating shells, and custom-made cushions for wheelchairs, however may improve their quality of life by stabilizing their pelvis and trunk. Sitting should be regarded as a dynamic process regulated by motor reactions of trunk and pelvic muscles due to endogenic and exogenic influences.
  
  
  METHODS
  Prerequisites for the indication of high-quality and cost effective seating devices are guidelines for planning and fitting which consider both pathomorphologic mechanisms and the patient's personality. In order to avoid functional problems and pain caused by an insufficient seating device it is necessary to pay attention to the exact indication, time, and combination of technical options. Planning within a seating clinic needs teamwork. Primarily the goal of treatment is defined; it depends on the functional deficit, on the daily living activities of the patient, and on the social environmental factors. Secondly, fitting of the devices follows defined treatment guidelines.
  
  
  CONCLUSIONS
  By examination of the sensor and musculoskeletal system, it is possible to classify the patient's sitting or seating ability for simplifying indication: three groups of ACTIVE sitters who are able to change position of trunk and pelvis actively are differentiated from three groups of PASSIVE sitters who have to be seated.
authors.affiliation: Clinic for Pediatric and Neuroorthopaedic Surgery, Orthopaedic Hospital Rummelsberg, Schwarzenbruck, 90592 Nuremberg, Bavaria Germany.
authors.forename: Walter Michael
authors.initials: WM
authors.lastname: Strobl
keywords: Neuromuscular spine deformities; Seating; Seating devices; Seating shells; Sitting; Technical aids for sitting and positioning; Wheelchairs