title: Effects of the standing program with hip abduction on hip acetabular development in children with spastic diplegia cerebral palsy.
abstract: OBJECTIVE
  Early identification and intervention with conservative measures is important to help manage hip dysplasia in children with a high adductor and iliopsoas tone and delay in weight bearing. The effect of a daily standing program with hip abduction on hip acetabular development in ambulatory children with cerebral palsy was studied.
  
  
  METHODS
  The participants were 26 children with spastic diplegia cerebral palsy (CP), classified at Level III according to the Gross Motor Function Classification System (GMFCS). Thirteen children stood with hip abduction at least 1 h daily from 12 to 14 months of age to 5 years with an individually fabricated standing frame with hip abduction.
  
  
  RESULTS
  At the age of 5 years, radiologic results of the study group were compared with a comparison group of 13 children with spastic diplegia CP who had not taken part in a standing program. The migration percentage in all children who stood with abduction remained within stable limits (13-23%) at 5 years of age, in comparison to children who did not stand in abduction (12-47%) (p < 0.01).
  
  
  CONCLUSIONS
  The results indicate that a daily standing program with hip abduction in the first 5 years may enhance acetabular development in ambulatory children with spastic diplegia CP.
  
  
  CONCLUSIONS
  Abnormal acetabular development is a problem related to mobility problems and spasticity muscles around the hip. The literature suggests that postural management and standing programs could reduce levels of hip subluxation and increase function in children with cerebral palsy. A standing program with hip abduction can be a beneficial to develop more stable hips in children with spastic diplegic GMFCS level III.
authors.affiliation: a Early Intervention Public Service of Catalunya, Universitat Internacional De Catalunya , Barcelona , Spain.
authors.forename: Lourdes
authors.initials: L
authors.lastname: Macias-Merlo
authors.affiliation: b Physical Therapy Department , Universitat Internacional De Catalunya , Barcelona , Spain.
authors.forename: Caridad
authors.initials: C
authors.lastname: Bagur-Calafat
authors.affiliation: c Physical Therapy Department (Biostatistics Unit) , Universitat Internacional De Catalunya , Barcelona , Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Girabent-Farrés
authors.affiliation: d Physical Therapy & Motion Analysis Lab , Munroe-Meyer Institute for Genetics and Rehabilitation , Omaha , NE , USA.
authors.forename: Wayne
authors.initials: W
authors.lastname: A Stuberg
mesh_terms: D002547:Cerebral Palsy / Q000150:complications / Q000175:diagnosis / Q000534:rehabilitation; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D061345:Early Medical Intervention; D026241:Exercise Movement Techniques / Q000379:methods*; D005260:Female; D006617:Hip Dislocation / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D006621:Hip Joint / Q000254:growth & development / Q000503:physiopathology; D006801:Humans; D007223:Infant; D007593:Joint Instability / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D011187:Posture; D012189:Retrospective Studies; D013030:Spain; D016896:Treatment Outcome
keywords: Cerebral palsy; hip dislocation/prevention; postural management; standing program