title: Can we prevent hip dislocation in children with cerebral palsy? Effects of postural management.
abstract: BACKGROUND
  Hip dislocation is common in children with cerebral palsy (CP). At birth they do not have musculoskeletal deformities but they develop over time due to the combined effects of the movement disorder and impaired gross motor function. Early detection and treatment of a hip at risk is needed to modify the natural of hip development in CP.
  
  
  OBJECTIVE
  The aim of this study was to determine the effect of postural management treatment on hip displacement's progression in children CP.
  
  
  METHODS
  Prospective comparative non-randomized study.
  
  
  METHODS
  Rehabilitative outpatient unit.
  
  
  METHODS
  Fifty-one children with CP were studied; the treated group (N.=30) was compared to a control group (N.=21).
  
  
  METHODS
  The treated group followed a two year's long combined treatment program consisting a neurodevelopment treatment (NDT) two times a week and a 5 hours daily siège moulé postural program. The control group underwent only NDT twice a week for two years. Hip radiographs were measured with the migration percentage (MP) method at baseline, at 1 and 2 years of follow-up.
  
  
  RESULTS
  A significant difference has been observed in the MP (%) trend (P<0.001) between treatment and control groups. At 2 years, there was a marked worsening (MP from 23.0 to 37.7) in the control group, compared to the stability (from 28.8 to 26.8) in the treatment group.
  
  
  CONCLUSIONS
  This study supports the evidence that conservative postural management of hip deformity is useful to prevent the natural progression of hip dislocation.
  
  
  CONCLUSIONS
  Hip radiographic follow up program together with NDT and postural management program is useful to modify the natural progression of hip dislocation in children with CP.
authors.affiliation: Pediatric Rehabilitation Unit, NICU, Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy - odoardo.picciolini@mangiagalli.it.
authors.forename: Odoardo
authors.initials: O
authors.lastname: Picciolini
authors.forename: Michel
authors.initials: M
authors.lastname: LE Métayer
authors.forename: Dario
authors.initials: D
authors.lastname: Consonni
authors.forename: Massimo
authors.initials: M
authors.lastname: Cozzaglio
authors.forename: Matteo
authors.initials: M
authors.lastname: Porro
authors.forename: Verusca
authors.initials: V
authors.lastname: Gasparroni
authors.forename: Artemisia
authors.initials: A
authors.lastname: Panou
authors.forename: Fabio
authors.initials: F
authors.lastname: Mosca
authors.forename: Nicola M
authors.initials: NM
authors.lastname: Portinaro
mesh_terms: D000367:Age Factors; D000553:Ambulatory Care; D016022:Case-Control Studies; D002547:Cerebral Palsy / Q000150:complications* / Q000175:diagnosis / Q000534:rehabilitation; D002648:Child; D002675:Child, Preschool; D005260:Female; D006617:Hip Dislocation / Q000209:etiology / Q000517:prevention & control* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D026741:Physical Therapy Modalities; D011187:Posture / Q000502:physiology*; D011379:Prognosis; D011446:Prospective Studies; D012016:Reference Values; D018570:Risk Assessment; D012737:Sex Factors; D018709:Statistics, Nonparametric; D016896:Treatment Outcome