Posture is how we position our body when we sit, lie, stand and move. Posture affects a lot more than just your spine. We all need to look after our posture. Looking after our posture can help avoid acute and chronic pain. It also helps maintain good general health and well-being.
Postural care is vital to the health and wellbeing of children and young people who experience movement difficulties. Children and young people with movement difficulties (like Cerebral Palsy, Spina Bifida, Muscular Dystrophy), need to look after their posture throughout the day and night. This is to avoid joint and muscle changes (body shape changes).
Find out more about Postural Care from Postural Care Strategy for Scotland - Your Posture Matters.
What is Postural Care?
Postural care describes a 24-hour approach to protecting a person’s body shape. Postural care isn’t one thing, it isn’t something that is done to you, your child or young person. It is a toolbox to promote health and wellbeing.
This toolbox can include:
Activity
Therapeutic positioning and handling.
Use of equipment such as specialist seating, wheelchairs, standing frames, night-time positioning aids.
Training resources to promote postural care for all those who spend time with a child or young person.
The main goal is for everyone involved with your child or young person to have an understanding of the importance of postural care. In this PAMIS video, you can listen first-hand to families discussing the positive impact of postural care. Taking a multiagency team approach with your child or young person at the centre ensures the best approach to their care. Regular review is vital to meet any changes in your child or young person's needs.
Making people aware of good postural care improves quality of life and can in some extreme circumstances be lifesaving. It is never too late to start protecting and restoring body shape changes. Death by Indifference – Mencap 2007
Have a look at the YouTube video of “Tommy’s Story”. At 42 his carers started a 24-hour postural care approach to his care. The changes for Tommy are life-changing and almost definitely lifesaving.
How Body Shape Changes Occur
All children and young people who experience:
altered muscle tone
reduced muscle strength
reduced voluntary movement
an inability to adjust their own position,
are all at risk of body shape changes.
These changes occur when children or young people’s postures are unsupported due to three main factors:
Muscle Tone - Sometimes the brain cannot control the muscles of the body and the muscles can be floppy, this is low tone. More often the muscles can be tight, this is high tone or spasticity. If someone is in the same unsupported posture for a long time or is unable to move out of a damaging posture this can result in a change of body shape.
Gravity produces a downward pressure or “squashing effect” on the body. If your child or young person stays in one position for too long, the effects of gravity will become more obvious. These changes may become long-lasting and lead to permanent body shape changes.
Growth is a challenge for many children and young people. When bones grow, soft tissues structures have to stretch to catch up. Without opportunities to stretch and move, muscles can become tight and restricted.
Muscle tone, gravity and growth can cause children and young people to be stuck in unsupported postures. These unsupported/damaging postures (non-symmetrical) result in body shape changes. Body shape changes have a much more widespread impact than just physical concerns.
This video from PAMIS talks about the causes of body shape changes.
The best defence against body shape change is movement and regular changes of position. This allows the body to counter the effects of gravity and inactivity, therefore, protecting body shape.
Impact of Body Shape Changes
The impact of body shape changes is huge and should be never underestimated. The smallest change can have a big impact on your child or young person’s physical and mental wellbeing. It will impact their wider world, family, access to the community how they 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 physical and social impact for you and your child or young person.
Physical
Spine - 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 dressing and personal care difficult. Scoliosis can also make it hard to access education and leisure activities in the community. It is very important to maintain symmetry of the spine throughout a 24-hour period.
Heart and Lungs - Poor postural care can reduce the efficiency of the heart and lungs. Body shape changes can make it harder for vital organs to work. This can lead to the lungs and heart working harder. This can make your child or young person more tired and at risk of chest infections.
Digestion - Poor postural care can impact the ability to eat and digest food. Body shape changes can impact your child or young person's ability to swallow. They can also cause increased reflux and risk of choking. They can also increase pressure on internal organs causing difficulties with digestion and constipation which can lead to pain and malnutrition.
Pain - 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.
Joint Contractures - Poor postural care can cause muscle shortening. If joints are not supported they can be pulled into non-symmetrical positions. Muscles can shorten if held in the same position for a long period of time. This is called a contracture. Contractures prevent joints from being able to move through their full range of movement. It can make it harder to be comfortable or to move.
Hip Dislocation - Poor postural care can cause the hip to dislocate (move out of the joint). 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 child or young person's ability to find comfortable and restful positions. Treatment for hip dislocation can involve surgery and a lengthy recovery period.
Medication - Poor postural care can increase the need for medication. The 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.
Skin Health - Poor postural care can lead to pressure sores and skin breakdown. Altered body shape will impact the number of positions your child or young person can be comfortable in. This can lead to increased areas of pressure which may increase the likelihood of skin breakdown and pressure sores.
Premature Death - 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 that respiratory complications were the most common cause of premature death.
Psychological
Mental Health - 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. Body shape changes may lead to behaviours that challenge, a loss of choice and reduced concentration.
Fatigue and Sleep - 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 comfortable and therefore the quality of sleep and rest. This impacts the ability to function and learn the next day.
Social
Communication - Poor postural care can reduce the ability to communicate. Poor positioning may not allow your child or young person 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.
Lack of Free Time - 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 you, your child or young person.
Inaccessibility - 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 a barrier to participation.
Decreased Independence - Poor postural care can make a child or young person more reliant on others. Body shape changes increase your child or young person’s healthcare needs. This requires greater reliance on family and carers, reducing the child or young person's independence.
Isolation - Poor postural care can increase isolation. Increased healthcare needs can result in a 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.
Impact on Family Members - 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 well as the family dynamic.
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. 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 or young person’s body shape.
Remember it is never too late to start postural care. Think supported and symmetrical! NHSGGC Paediatric Physiotherapists
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. You can find out more about Craig's experiences on the Pamis website by looking at the publications section.
Watch the video below to hear first-hand how postural care helped families in Scotland. Talk to your child or young person's Physiotherapist for more information on postural care for you and your child or young person.
Positioning and Equipment
The best defence against body shape changes is movement or change of position. Every child or young person is different and requires individual advice, support and equipment. Your child or young person’s therapy team will be happy to support you with this. Some of the benefits/reasons for different positional equipment are discussed in the sections below.
The aim is for your child or young person to be symmetrical and supported throughout the day and night. This means they will be comfortable whatever piece of equipment they may be using.
A few questions to ask yourself:
How long has my child or young person been in one position?
Do they look symmetrical and supported?
Do I need to seek help to ensure appropriate support/equipment?
Can I improve their position during any part of my child or young person’s 24 hour day?
If you have questions about any of your child or young person's positioning equipment or need support with review, maintenance or repair have a look at the information below and the I'm Concerned about Aids, Equipment or Adaptations section.
Lying Equipment including side lying and night time positioning systems
Individuals with postural care needs can spend from 33% to 50% of their day in a lying position!
Sleeping is the longest time your child or young person will spend in one place during a 24 hour period. The average person will spend around 3340 hours in bed per year. Children or young people with neurological conditions can spend even more time in bed than that. It is, therefore, necessary to ensure your child or young person is supported in bed to prevent damaging body shape changes.
Anytime your child or young person is lying, the aim is for them to be symmetrically and supported. Altered tone, muscle strength and gravity can have an impact on your child or young person's body shape, even in lying. It is important to prevent them from being pulled into damaging postures.
Benefits of postural care in lying
Hip Development - Lying symmetrically and supported protects hips from dislocation. An imbalance of muscle pull can increase the risk of the hip coming out of the joint. This can cause discomfort and pain. Treatment for hip dislocation can involve surgery and a lengthy recovery period. Good positioning can reduce this risk and improve your child or young person’s comfort.
Skin Integrity - Lying symmetrically and supported improves skin integrity. When well supported and symmetrical, your child or young person’s weight is distributed evenly on the bed. This reduces the build-up of pressure points and protects the skin from breaking down.
Sleep - Lying symmetrically and supported can improve sleep. By supporting your child or young person’s lying position, pressure areas are reduced and joint positions are improved. This means your child or young person is more comfortable and will have better sleep and be more alert the next day.
Contractures - Lying symmetrically and supported protects a joint's range of movement. Keeping joints symmetrical and in ‘midline’ while lying is a better position to rest in. This prevents joints from being pulled into damaging positions for long periods of time. If the muscles shorten and contractures develop it is harder to position your child or young person more comfortably or allow them to move easily the next day.
Respiratory - Lying symmetrically and supported improves breathing. When your child or young person is positioned symmetrically, the lungs have room to breathe more easily and deeply. If the chest is pulled into a damaging posture, the shape of the rib cage can change. This changes the space that the lungs have to work in. This can make it more difficult for your child or young person to breathe easily.
Spine - Lying symmetrically and supported protects the shape of the spine. Keeping the spine symmetrical and in ‘midline’ while lying is a more comfortable position for your child or young person to rest in. This can prevent a spinal curve (scoliosis) which can have a negative impact on breathing. This may also affect your child or young person’s comfort, digestion, reflux, ease of positioning and general wellbeing.
Inclusion - Lying symmetrically and supported increases opportunities to participate socially. Being able to lie symmetrically protects your child or young person’s body shape and therefore makes it easier to position your child or young person during the day. This can help your child or young person to participate in social activities.
Comfort - Lying symmetrically and supported increases comfort. When your child or young person is lying in a symmetrical and supported position, the body is able to rest and relax. This prevents an imbalance of muscle pull into damaging positions.
Side Lying Equipment
Some schools have access to side-lying boards or Acheeva beds. These pieces of equipment allow a child or young person to spend time supported on their side for various classroom activities. It is important that your child or young person is supported and symmetrical. Talk to your child or young person’s Physiotherapist about side lying.
Night Time Positioning Systems
All night time positioning systems are designed with comfort in mind. Their aim is to provide a supportive position to protect your child or young person’s body shape. Night time positioning systems can be used while spending time in bed awake or asleep. They can support your child or young person to lie on their back or on their sides. They are adjustable to accommodate positional changes if required throughout the night.
Talk to your child or young person's Physiotherapist about whether a night time positioning system would be suitable for your child or young person.
Mobility Equipment including walking aids, buggies and wheelchairs
Walking Aids
For some, supported walking can have many benefits on their health and wellbeing.
It is not always possible for every child or young person to be supported to walk. There are different types of walking aids available. They can support many different needs. Below is the scale of walking aids based on the level of support given. These can be explored and discussed with your child or young person's Physiotherapist.
Benefits of Walking
Bone Density - Walking increases bone density and reduces the risk of fractures. Eating well and weight bearing (through standing or walking) helps the bones to develop. Doing regular activity also helps. Research shows that walking improves the bone density in the pelvis and legs of children and young people with Cerebral Palsy.
Circulation - Walking enhances circulation and blood pressure. Walking helps to keep the heart healthy and strong. It also helps to improve mood and overall feelings of wellbeing. Walking helps to reduce swelling in the legs and feet.
Contracture Prevention - Walking stretches muscles, preventing the onset of contractures. Walking provides ‘feedback’ to young developing muscles and joints. It stretches the muscles through active movement. Walking with the correct support will allow muscles to get stronger and help prevent shortening/contractures.
Exercise - Walking improves breathing and ability to participate in exercises. When walking a greater demand is placed on the body for oxygen as the muscles need oxygen to work. When walking it is necessary to take bigger breaths. This works the breathing muscles and over time they become stronger. Regular walking increases fitness and the heart becomes stronger too.
Interaction - Walking enables children and young people to interact and move around with their peers. Supported walking allows children and young people to keep up with their friends. They can choose where they wish to go without an adult moving them. Being at the same level as their peers or friends improves confidence and self-esteem. They can join in activities with their friends.
Wellbeing - Walking improves wellbeing, alertness and sleep patterns. Regular walking improves sleep, reduces tiredness and increases alertness. Walking is a form of physical activity. It promotes endorphin release. This improves mood and general feelings of wellbeing.
Digestion - Walking helps with digestion and going to the toilet. This is achieved through a combination of gravity and using the stomach muscles more efficiently.
Muscle Strengthening - Walking increases muscle strength and endurance. Walking involves the muscles actively contracting and relaxing to move the legs. The muscles become stronger as we repeat the pattern.
Buggies and Wheelchairs
Some children and young people use a wheelchair or buggy to get around. There are different types of wheelchairs/buggies depending on what your child or young person needs. Westmarc provide buggies and wheelchairs for children and young people with postural care needs. Talk to your child or young person's Physiotherapist about whether a buggy or wheelchair might be suitable for them. If your child or young person already has a buggy or wheelchair, you can contact Westmarc about maintenance and repairs.
Specialist Seating including buggies and wheelchairs
For many children and young people with physical disabilities, specialist seating is an important part of how they participate and engage in every day life. Supporting their posture in specialist seating can help them to play, eat, communicate and participate in school work.
Children and young people with postural care needs can spend from 33% to 50% of their day sitting. It is vital to make sure your child or young person is well supported in sitting to reduce the risk of body shape changes. Equally, spending too long in sitting even if it is a good position can also contribute to body shape changes. Seating should be just one part of a 24 hour postural management plan.
Your child or young person's Occupational Therapist will start by thinking about the purpose of the seating and what activities the seating is needed for. They will then assess postural needs including how much support they need, their muscle tone and the environment before deciding with you which specialist seating will best meet your child or young person's needs.
Talk to your child or young person’s Occupational Therapist for more information on specialist seating.
Buggies and Wheelchairs
Some children and young people use a wheelchair or buggy to get around. This is another option for supported sitting. There are different types of wheelchairs/buggies depending on what your child or young person needs. Westmarc provide buggies and wheelchairs for children and young people with postural care needs. Talk to your child or young person's Physiotherapist about whether a buggy or wheelchair might be suitable for them. If your child or young person already has a buggy or wheelchair, you can contact Westmarc about maintenance and repairs.
Standing Frames
For some, supportive standing can have many benefits on their health and wellbeing. It is not always appropriate for every child or young person to spend time in supported standing. There are various types of standing frames available.
For more information watch the videos below or discuss with your child or young person’s Physiotherapist.
Benefits of Standing
Interaction - Standing enables children or young people to be at the same level with their peers. This can improve confidence, self-esteem and self-image. Your child or young person may be able to engage in tasks in the same manner as other students or siblings. Supported standing reduces the fear of falling. This allows your child or young person to concentrate on their learning and interaction with their classmates and friends.
Circulation - Standing enhances circulation and blood pressure. This helps the heart muscle to stay strong and healthy. It also helps to reduce swelling in the legs and feet.
Respiratory - Standing improves breathing and voice control. When your child or young person stands, they can breathe in and out more deeply and efficiently as there is more room for the muscles to work. Standing helps your child or young person to speak louder and with more control.
Contracture Prevention - Standing stretches muscles, preventing contractures. Standing can improve the flexibility of the leg muscles. It can also increase the range of movement of joints and reduce muscle stiffness.
Bone Density - Standing increases bone density and reduces the risk of fractures. Normal bone development needs, good nutrition, weight-bearing (through standing or walking), and active use of muscles. Research shows that supported standing improves the bone density of children or young people who cannot stand or walk.
Wellbeing - Standing helps your child or young person to feel alert, sleep well and improves their wellbeing. Children or young people who feel well are happier and more able to engage with their family, friends and activities.
Digestion - Standing helps with digestion and toileting. This is achieved through a combination of gravity and using the stomach muscles more efficiently.
Hip Development - Standing helps the formation of the hip joint in early development. Children or young people who stand at the age of 12-16 months are more likely to develop the ball and socket joint. This can prevent hip dislocation. Standing from an early age also helps a child or young person with standing transfers in the future.
Skin Health - Standing improves skin health by relieving pressure areas caused by sitting. Standing allows more oxygenated blood to reach tissues that have been under pressure when seated. This results in fewer sore areas and improved skin health.
Using a Standing Frame
Your child or young person should be as symmetrical as possible and well supported in their standing frame. If your child or young person's standing frame needs adjustments there are key areas that are likely to show that alterations are required.
Upright or Prone Standers
Chest straps - The chest strap should be firmly fastened behind, ensuring that your child or young person's chest is supported on the front pad.
Knee cups - Knees should be as straight as possible in the knee cups. If these are at the right height they will help stop the knees from bending.
Foot straps – All straps should be comfortably fastened on top of shoes.
Supine Standers
Chest Strap - The chest strap should be in the middle of the chest and you should be able to slide your hand comfortably in and out. If the chest strap is too low the child or young person maybe leaning forward.
Pelvic Strap - The pelvic strap should be in line with your child or young person's hips.
Knee Straps - The knee straps should be directly over your child or young person's knees. If the knee straps are too low, your child or young person's knee may bend a little bit and won't be supporting your child or young person enough.
Foot Straps – All straps should be comfortably fastened on top of shoes.
Editorial Information
Author(s):
Physiotherapy and Occupational Therapy, Specialist Children's Services.
Reviewer name(s):
KIDS Content Group.
We are one of the leading paediatric care centres in the UK, and the largest in Scotland. We provide family centred care to newborns, infants, children and young people both in hospital and in the community.
Heart and Lungs - Poor postural care can reduce the efficiency of the heart and lungs. Body shape changes can make it harder for vital organs to work. This can lead to the lungs and heart working harder. This can make your child or young person more tired and at risk of chest infections.
Digestion - Poor postural care can impact the ability to eat and digest food. Body shape changes can impact your child or young person's ability to swallow. They can also cause increased reflux and risk of choking. They can also increase pressure on internal organs causing difficulties with digestion and constipation which can lead to pain and malnutrition.
Pain - 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.
Medication - Poor postural care can increase the need for medication. The 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.
Premature Death - 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 that respiratory complications were the most common cause of premature death.
Mental Health - 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. Body shape changes may lead to behaviours that challenge, a loss of choice and reduced concentration.
Communication - Poor postural care can reduce the ability to communicate. Poor positioning may not allow your child or young person 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.
Lack of Free Time - 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 you, your child or young person.
Inaccessibility - 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 a barrier to participation.
Decreased Independence - Poor postural care can make a child or young person more reliant on others. Body shape changes increase your child or young person’s healthcare needs. This requires greater reliance on family and carers, reducing the child or young person's independence.
Isolation - Poor postural care can increase isolation. Increased healthcare needs can result in a 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.
Impact on Family Members - 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 well as the family dynamic.
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. You can find out more about Craig's experiences on the 
Individuals with postural care needs can spend from 33% to 50% of their day in a lying position!
Hip Development - Lying symmetrically and supported protects hips from dislocation. An imbalance of muscle pull can increase the risk of the hip coming out of the joint. This can cause discomfort and pain. Treatment for hip dislocation can involve surgery and a lengthy recovery period. Good positioning can reduce this risk and improve your child or young person’s comfort.
Skin Integrity - Lying symmetrically and supported improves skin integrity. When well supported and symmetrical, your child or young person’s weight is distributed evenly on the bed. This reduces the build-up of pressure points and protects the skin from breaking down.
Sleep - Lying symmetrically and supported can improve sleep. By supporting your child or young person’s lying position, pressure areas are reduced and joint positions are improved. This means your child or young person is more comfortable and will have better sleep and be more alert the next day.
Contractures - Lying symmetrically and supported protects a joint's range of movement. Keeping joints symmetrical and in ‘midline’ while lying is a better position to rest in. This prevents joints from being pulled into damaging positions for long periods of time. If the muscles shorten and contractures develop it is harder to position your child or young person more comfortably or allow them to move easily the next day.
Respiratory - Lying symmetrically and supported improves breathing. When your child or young person is positioned symmetrically, the lungs have room to breathe more easily and deeply. If the chest is pulled into a damaging posture, the shape of the rib cage can change. This changes the space that the lungs have to work in. This can make it more difficult for your child or young person to breathe easily.
Spine - Lying symmetrically and supported protects the shape of the spine. Keeping the spine symmetrical and in ‘midline’ while lying is a more comfortable position for your child or young person to rest in. This can prevent a spinal curve (scoliosis) which can have a negative impact on breathing. This may also affect your child or young person’s comfort, digestion, reflux, ease of positioning and general wellbeing.
Inclusion - Lying symmetrically and supported increases opportunities to participate socially. Being able to lie symmetrically protects your child or young person’s body shape and therefore makes it easier to position your child or young person during the day. This can help your child or young person to participate in social activities.
Comfort - Lying symmetrically and supported increases comfort. When your child or young person is lying in a symmetrical and supported position, the body is able to rest and relax. This prevents an imbalance of muscle pull into damaging positions.
Bone Density - Walking increases bone density and reduces the risk of fractures. Eating well and weight bearing (through standing or walking) helps the bones to develop. Doing regular activity also helps. Research shows that walking improves the bone density in the pelvis and legs of children and young people with Cerebral Palsy.
Circulation - Walking enhances circulation and blood pressure. Walking helps to keep the heart healthy and strong. It also helps to improve mood and overall feelings of wellbeing. Walking helps to reduce swelling in the legs and feet.
Muscle Strengthening - Walking increases muscle strength and endurance. Walking involves the muscles actively contracting and relaxing to move the legs. The muscles become stronger as we repeat the pattern.
Some children and young people use a wheelchair or buggy to get around. There are different types of wheelchairs/buggies depending on what your child or young person needs. Westmarc provide buggies and wheelchairs for children and young people with postural care needs. Talk to your child or young person's 
For many children and young people with physical disabilities, specialist seating is an important part of how they participate and engage in every day life. Supporting their posture in specialist seating can help them to play, eat, communicate and participate in school work. 
For some, supportive standing can have many benefits on their health and wellbeing. It is not always appropriate for every child or young person to spend time in supported standing. There are various types of standing frames available.
