National Physical Therapy Examination (NPTE) Practice Exam

What wheelchair modification is best for a child with cerebral palsy exhibiting severe extensor posturing of the lower extremities?

1. Hip adductor weakness included in the seat

2. Seat positioned in the anterior tilt direction

3. Seat position to create flexion less than 90 degrees at the hip and knees

4. Seat position to create flexion greater than 90 degrees at the hip and knees

The correct answer is: Seat position to create flexion greater than 90 degrees at the hip and knees

For a child with cerebral palsy who is experiencing severe extensor posturing of the lower extremities, positioning the seat to create flexion greater than 90 degrees at the hips and knees is vital. This type of modification encourages proper alignment and stability by promoting the flexion of the lower extremities, which can help counteract extensor spasticity. When the hips and knees are flexed beyond 90 degrees, it aids in bringing the legs closer to a more relaxed position, reducing the tendency for the legs to extend and creating a more comfortable seating arrangement. This adjustment helps facilitate better function and control during mobility tasks and can minimize discomfort associated with extensor tone. Additionally, by maintaining a position that promotes flexion, it becomes easier for the caregiver or therapist to assist the child in transferring in and out of the wheelchair or engaging in other therapeutic activities. Ultimately, this modification aligns with the goals of improving postural control and overall mobility for children with cerebral palsy.