positioning in peds

Question 1

Positioning

Answer 1

child cannot be excepted to particapate in school unless they are positioned appropriately

Question 2

Balance and Equilibrium

Answer 2

 Emerge later in infancy and remain
throughout life
 Automatic responses:
1. Straightens & abducts arm and leg on
uphill side
2. Straightens arm/leg on downhill side,
extending limb towards ground
3. Rights head so it is straight up & down in relation to the ground

Question 3

Spinal Abnormalities

Answer 3

 Kyphosis
 Lordosis
 Scoliosis

Question 4

Footstool

Answer 4

for children whose feet do not
reach the floor when they are seated
- Can prevent heel cord contractures

Question 5

Wedge Seat

Answer 5

kids who have trouble sitting up straight in seat—low muscle tone or posterior pelvic tilt
 Facilitates anterior pelvic tilt

Question 6

Therapy Ball

Answer 6

 Used with kids who squirm or bounce in their seats

Question 7

T Stool

Answer 7

 Works on refining balance
 May be used instead of a chair for a
child who has difficulty keeping their
feet on the floor

Question 8

Inflatable or Pellet-Filled Seat
Cover

Answer 8

May help maintain stability and attention while seated

Question 9

Crescent-Shaped Pillow

Answer 9

 Can support infant in sitting, supine
or side lying
 Provides support at hips for sitting
 Close adult supervision required

Question 10

Beanbag Chair

Answer 10

 Can be used with children who
have restricted movement to give
them a break from restricting
positioning devices
 Can promote relaxation
 Make sure the bean bag is not
promoting further deformities

Question 11

Chairs that are a “better fit”

Answer 11

 Can be used with children who have
mild physical disabilities or children with
ADHD
 Cube chairs
 Rifton chairs
 Trip Trap chairs

Question 12

Floor Sitter

Answer 12

 Enables children with physical
disabilities to sit independently in
preschool tasks such as circle time
and floor playing
 Can add additional supports as
needed

Question 13

Corner Chairs

Answer 13

used with children who have fair
head control but have difficulty with trunk and upper extremity control
 Corner back inhibits shoulder retraction
 Promotes activity at midline

Question 14

The pelvis

Answer 14

 Position of the pelvis affects the spine,
head, and extremities
 Attempt to get pelvis in neutral position
 Practice:
Neutral
Anterior tilt
Posterior tilt

Question 15

Lower Extremities

Answer 15

 90-90-90
 Supported feet
 Tight hamstrings may need more
knee flexion

Question 16

Trunk

Answer 16

 Straight up and down
 Proper alignment
 May need lateral supports for poor
postural control
 May need contoured seat

Question 17

Head

Answer 17

 Head needs to stay up and righted
 Stabilized to avoid involuntary,
unwanted movements

Question 18

Upper Extremities

Answer 18

 Support at shoulders if child tends
to retract shoulders
 Tray table—be aware of restraint
laws/guidelines

Question 19

Skin Integrity

Answer 19

 Fit needs to be proper, and change
with the child’s needs to protect skin
integrity
 Tilting chair
 Carefully chosen cushion
 Good skin hygiene and monitoring

Question 20

Pommel

Answer 20

 Prevents adduction of hips
 Maintains hips in neutral or slight
abduction
 Place at distal part of knee
 Do NOT place in the groin to
prevent sliding

Question 21

Lateral Thigh Supports

Answer 21

 Prevents excessive abduction of
hips
 Can be counterpoint to control hip
external rotation

Question 22

Lateral Pelvic Supports

Answer 22

 Keeps hip and pelvis in center of
seat
 Helps keep pelvis in vertical
position
 Minimize asymmetry of trunk

Question 23

Pelvic Belt

Answer 23

 Has to cross the hip joint and
inferior and anterior superior iliac
spines
 Controls hip extension
 Can be placed at

Question 24

Posterior Lumbar Support

Answer 24

 Supports lumbar spine
 Placed slightly below the posterior
iliac crests

Question 25

Lateral Supports

Answer 25

 Provide lateral support to the
thoracic spine
 Placed higher on the trunk

Question 26

Chest Strap

Answer 26

 Anterior upper trunk control
 Again…know restraint
laws/guidelines

Question 27

Headrest

Answer 27

 Posterior head support
 Position head in neutral position

Question 28

Armrest

Answer 28

 Support surface for forearm
 Make sure armrests aren’t too high,
or they will cause scapular elevation
and shoulder and neck problems

Question 29

Anterior Knee Support

Answer 29

 Stabilizes hips and thighs in neutral
alignment
 May be used to prevent sliding out
of chair

Question 30

Bolster

Answer 30

 Can be used with children who
have athetoid or spastic CP with LE
stiffness
 Feet need to be supported on floor
 90-90-90
 Straddle bolster

Question 31

Bolster Chair

Answer 31

 Increased spasticity in LE can lead to
adduction and extension of legs
 Promotes hip flexion, abduction,
external rotation, knee and ankle flexion
 Breaks extensor pattern

Question 32

Stander

Answer 32

Used with children who cannot
safely maintain an unsupported
standing position
 PT typically orders/measures for
this device
 Passively stretches tight
muscles/joints
 Sensory feedback; weight

Question 33

Dynamic Trunk Splints

Answer 33

 Thoracic lumbar spinal orthosis
(TLSO)
 Prescribed by a physician, and
implemented by PT and/or OT
 Wearing schedule
 Improve trunk control, posture and
UE function
 Monitor respiratory function

Question 34

Tables & Trays

Answer 34

 Raised tables
 Table cut outs—horseshoe
desks/table
 Wheelchair tray