Use of S.W.A.S.H. Brace to facilitate sitting balance, function and ambulation in presence of adductor spasticity
NUZHAT PEWEKAR*, SINI JOSEPH**
PHYSIOTHERAPISTS CP UNIT CHILDREN'S ORTHOPAEDIC HOSPITAL, MUMBAI*, PHYSIOTHERAPISTS CP UNIT CHILDREN'S ORTHOPAEDIC HOSPITAL, MUMBAI**
Abstract
Purpose of the study:
  • Use of S.W.A.S.H brace to facilitate sitting balance, function and ambulation in presence of adductor spasticity.
  • A single case study of Physiologic Cost Index (PCI) with Hip Abduction Orthoses and S.W.A.S.H brace and without both braces.

Methodology: 3 severe spastic quadriplegics were studied.
  • A video camera was used to study the sitting balance of 2 subjects.
  • A comparative study of the PCI with Hip Abduction Orthoses (HAO) and S.W.A.S.H brace and without brace was performed in the third subject with bilateral hip dislocation. The child ambulated with posterior walker on a 6.1 meter (20 feet) track.

Discussion: Improved range of abduction at hips increases the base of support in sitting thereby improving trunk posture and balance. This in turn facilitates weight-bearing, upper extremity function, manipulation and head control to some extent. A fair amount of abduction in cases of adductor spasticity or scissoring gait can improve step and stride length.

Conclusion: Use of S.W.A.S.H brace in two of the cases gave a visible benefit of improvement in sitting balance, standing posture and stability. Use of this brace in the third child showed improvement in gait and low energy expenditure as compared to ambulating with Hip Abduction Orthoses and without any brace (as measured by PCI).
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