The purpose of this study was to establish the a)feasibility, b) reproducibility of spinal Quantec scans (a non-intrusive surface topography system) and c) the validity of the Quantec Q-angle against Cobb angles from spinal radiographs, in non-ambulant children with cerebral palsy (CP). Eighteen non-ambulant children (aged 5–11 years) with CP had successful clinical, radiological and Quantec assessment of their spine while seated in a supportive seating system. Scoliosis incidence was 72%, Cobb angles ranged from 1–73° (mean 18.2°). Quantec scanning was feasible with appropriate postural support. Mean interobserver differences were 0.5 ± 5.8° (median 1.3°, 5 / 95th percentiles lying at −7.3 / 8.5° respectively). Mean differences between Cobb and Q-angle were 0.02 ± 6.2° (median 1.0°, with 5 / 95th percentiles lying at −8.2 / 7.7° respectively). Surface topography may be used to safely monitor the spine for non-ambulant CP children. Results show similar or improved trends to previous comparisons with idiopathic scoliosis. Ovadia (2007) showed an interobserver mean difference of 6.3 ± 4.9° using an Ortelius800TM system. Thometz (2000) showed mean differences between Cobb and Q-angle ranging from 1.1–12.6 ± 4.9–10.2°. Further research is needed for the user group described in this study with larger spinal curves.
The purpose was to develop an objective measurement system to assist in the prescription of supportive seating for non-ambulant cerebral palsy children with scoliosis. Currently the prescription of patient’s bespoke seating setup relies on clinical skills and knowledge of trained seating staff (physiotherapists and engineers). Therefore to develop an objective measurement system to supplement this clinical approach, a user centred design approach was used. Standard design processes presented in Pahl’s ‘Engineering Design’ (2007) were adopted, allowing in depth user involvement. Stakeholders (clinical, seating, and technical staff) were interviewed to develop requirements lists for each group. Following each development stage; task clarification; concepts; embodiment; detailed design; manufacture; and commissioning, these requirements were reviewed with stakeholders. Requirements lists were collated to form the device specification, involving all stakeholders allowed the discussion of contradicting requirements. The final design incorporated critical aspects of seating while measuring important outcomes such as force distribution and spinal deformities. A user centred design approach allowed for informative decision making from stakeholders, highlighting the fundamental requirements and facilitated effective solutions to meet these requirements. The manufactured device complies with the collaborated specification, utilising stakeholder defined spinal and seating parameters. This was commissioned for use in a pilot study involving twenty non-ambulant cerebral palsy children aged 5–11 years, with high risk of scoliosis.
