The impact of body shape changes is huge and should be never underestimated. The smallest change can have a profound impact on your child’s physical and mental wellbeing. It will impact their wider world, their family, their access to their community and their ability to join in.
Some body shape changes are unfortunately unavoidable. By being aware of how changes occur and promoting postural care, you can minimise the risk of physical changes. This can reduce the physiological and social impact for you and your child. The tabs below discuss these impacts in more detail. They also include some family stories about body shape changes; Craig’s story and Fred’s story.
Poor postural care can lead to curvature of the spine, Scoliosis - Altered muscle tone and strength in the chest and spine can lead to scoliosis. This can put pressure on vital organs and affect breathing and digestion. It can cause pain and make it difficult for dressing and personal care. Scoliosis may also impact the ability to access social activities. It is very important to maintain symmetry of the spine throughout a 24-hour period.
Poor postural care can reduce the efficiency of the heart and lungs - Body shape changes can reduce the ability of vital organs to work. This can lead to the lungs and heart working harder and making your child become more tired and vulnerable to chest infections.
Poor postural care can impact the ability to eat and digest food - Body shape changes can impact your child's ability to swallow, increased reflux and the risk of choking. It can also increase pressure on internal organs causing difficulties with digestion and constipation which can lead to pain and malnutrition.
Poor posture can result in increased pain - Pain can be caused by joints being in a poor position for a long time. Muscle spasms, reflux, constipation or areas of pressure can also cause pain. Pain can impact mental wellbeing, ability to concentrate and ability to take part in activities.
Poor postural care can cause muscle shortening - If joints are not supported midline they can be pulled into non-symmetrical positions. Muscles can shorten if held in the same position for a prolonged time. This is a contracture. Contractures prevent joints from being able to move through their full range. It can make it harder to be comfy or move.
Poor postural care can cause the hip to move out of the joint, dislocate - An imbalance of muscles pulling around the hip joint can cause the legs to rest in a non-symmetrical position. This increases the risk of hip dislocation. Hip dislocation causes pain, difficulty with dressing and personal hygiene. It can also restrict the different positions an individual is comfy and rest in. Treatment for hip dislocation can involve surgery and a lengthy recovery period.
Poor postural care can increase the need for medication - TThe impact of body shape changes on vital organs and pain management can result in an increased need for medication. It may become difficult to manage the interactions of these medicines and their side effects.
Poor postural care can lead to pressure sores and skin breakdown - Altered body shape will impact the number of positions your child can be comfortable in. This can lead to increased areas of pressure on vulnerable skin which may increase the likelihood of skin breakdown and pressure sores.
Poor postural care can impact mental health and wellbeing - Poor posture can lead to significant discomfort and difficulty in accessing social activities. This can lead to feelings of isolation, low mood, low self-esteem, self-harm and mood swings. Other reactions may be challenging behaviour, lack of confidence. Even the feeling of loss of choice and decreased concentration.
Poor postural care can impact health and lead to premature death - The Confidential Inquiry into Premature Death of People with Learning Difficulties (2013) highlighted:
"A high incidence of premature death of those with profound and multiple learning difficulties due to secondary complications from body shape changes". The inquiry found respiratory complications is the most common cause of premature death.
Poor postural care can impact alertness, fatigue and ability to sleep - Body shape changes and poor positioning result in the body having to work harder. This can cause an increase in tiredness. Body shape affects the ability to get comfy and therefore the quality of sleep and rest. This impacts the ability to function and learn the next day.
Social Impacts
Poor postural care can reduce the ability to communicate - Poor positioning may not allow your child to rest in a position where they can see the world around them. This means they may not be able to interact easily all of the time. Pain may be too distracting to allow them to focus and concentrate. Low self-esteem and mood may cause them to feel lonely and quiet.
Poor postural care can lead to a reduction in free time to engage in social activities - Body shape changes and other complications can lead to an increase in appointments, visits from health professionals and possibly hospital admissions. The means less free time to access social activities for your child and yourself.
Poor postural care can make it challenging to access the wider community - Body shape changes make it more difficult to access appropriate transport and suitable changing facilities. Even simple access to buildings can be barriers to participation.
Poor postural care can make an individual more reliant on others - Body shape changes increases your child’s healthcare needs. This requires greater reliance on family and carers, reducing their independence.
Poor postural care can increase isolation - Increased healthcare needs can result in lack of free time to be able to access your community. In-ability to access activities can lead to further isolation and deterioration in mental health and wellbeing.
Poor postural care impacts the whole family - Body shape changes and their consequences can cause significant pressure on the wider family. There may be difficulties finding space within the home for the storage of equipment and medications. Family finances are often significantly affected causing high levels of stress. Families may often feel a loss of privacy within the home with visits from carers and healthcare professionals. The family may begin to feel isolated with difficulty in finding time to attend their own social activities. This can impact the mental wellbeing of individual family members as the family dynamic.
Remember it is never too late to start postural care. Think supported and symmetrical!
Fred was born with quadriplegic cerebral palsy. He had increased tone throughout his body and was unable to move around on the floor. Unfortunately, Fred did not receive good postural care and adopted unsupported postures. Over time, the effects of gravity, growth and increased tone resulted in many body shape changes. The most significant being in his spine. Below you can see the change in the curve of his spine over the years. This resulted in his chest rotating and squashing his lungs and stomach. As his body shape worsened, he began to have swallowing difficulties, chest infections and pain. Fred died of health complications which were a direct result of the dramatic changes to his body shape
These extreme distortions are not inevitable! It is never too late to start protecting your child’ body shape.
Watch the video below to hear first-hand how postural care helped families in Scotland. Talk to your child's physiotherapist for more information on postural care for you and your child.
Jenny has taken the time to think about the impact of having no postural care, She reflects on her personal experience caring for her child Craig with complex needs and movement difficulties. Please click here to hear her reflections on life without postural care.
Below is a Pamis video from families in Scotland who have implemented postural care into their children’s care. If you would like to discuss postural care further do not hesitate to contact a member of your child’s physiotherapy or specialist children’s service team.
