Seating and positioning to manage spasticity after brain injury

Regaining function and independence after sustaining a brain injury is ofte n complicated by abnormal muscle tone, particularly spasticity. A conservat ive, non-invasive, and relatively inexpensive treatment is therapeutic seat ing and positioning. To inhibit spasticity seating will need to address spe cific issues including: individualized optimum posture, neurophysiological techniques, primitive postural reflexes, abnormal movement patterns, proxim al stability, pelvic stabilization, lower extremity position, upper trunk a nd head position, upper extremity position, orientation in space, dynamic e quipment, sensory and visual disturbances, emotional and cognitive stress, physical work demand, discomfort and pain, and skin irritation. Despite the rehabilitation team's efforts to inhibit spasticity, it will persist in ma ny clients with head injury. Therapeutic seating and positioning also offer s several techniques for accommodating unavoidable spasticity and for deali ng with the long-term sequelae. In particular, seating will reduce the risk of deformities, accommodate existing fixed deformities, provide safety mod ifications, use durable heavy-duty equipment, and provide additional traini ng to caregivers.