Page 67 - Handbook of Electronic Assistive Technology

54 HANDBOOK OF ELECTRONIC ASSISTIVE TECHNOLOGY

neurological disabilities frequently display significant problems with their ability to con-
trol their posture and movements. For example, they may have difficulties maintaining a
stable, sitting position without someone to hold them or the need to use their upper limbs
for support. This means that in the sitting position, they are unable to use their hands for
functional activities. However, provision of suitable equipment can assist in promoting a
more comfortable, stable body position from which to achieve optimum functional ability
(Pountney et al., 2004; Pope, 2007).
Promoting posture for function can be viewed within the conceptual framework of the
International Classification of Functioning, Disability and Health (ICF) (WHO, 2001, 2007).
A person’s health condition may mean that they have body structures or functions such
as contractures or deformities, abnormal muscle tone or gastrointestinal reflux, which
affect their ability to maintain and control their posture. When considering how best to
meet the needs of the child or adult, this framework helps us to consider the many factors
impacting on the outcomes of any postural intervention. It will be important to consider
what aspects of the person’s body structure or function are impacting on a functional
posture, what activities the person is aiming to achieve through any change in posture
and their goals for participation (Fig. 3-1). Personal factors such as choice of aesthetics
may be important to the person (Goodwin et al., 2018), and factors such as family life-
style may influence whether the equipment will be useful. Environmental factors need to
be considered to ensure that the equipment can be used within the chosen environment
(Huang et al., 2009); for example, there may not be sufficient space for a large powered
chair within a home environment. With children, there may be additional factors such as
parental choices, differing environments such as school or nursery and training of school
staff, which may affect postural solutions. Without these considerations, the person may
be provided with postural equipment that may be sufficiently comfortable or supportive,

Health condition, e.g.,
cerebral palsy

Body Structure and
Function, Activity, Participation,
e.g., spasticity
limiting motor e.g., driving a e.g., Playing
control of left upper powered wheelchair wheelchair football
limb, scoliosis

Environmental Factors,
Personal Factors,
e.g., child’s behaviour e.g., used in school only,
home too small
FIGURE 3-1 Diagram adapted from International Classification of Functioning, Disability and Health (WHO, 2001)�