Postural management for children with severe cerebral palsy (GMCS IV and V) in low-resource settings

Target Audience: Clinicians, therapists, families, community-based rehabilitation workers; researchers

Background: Children with Cerebral Palsy in GMFCS Levels IV and V frequently develop complex asymmetrical  postures  that severely impact comfort, health, participation, and quality of life. In many low- and middle-income countries (LMICs), access to specialist equipment and services is limited, requiring clinicians and caregivers to rely on strong clinical reasoning, simple positioning strategies, and low-cost innovations.

Effective postural management is not about expensive equipment.  It is rather about understanding posture and postural patterns, anticipating secondary complications, and using appropriate, context-relevant solutions. This webinar focuses on practical assessment, problem-solving, principles of seating and lying, and the use of low-cost and Appropriate Paper-based Technology (APT) solutions that have been successfully used in resource-constrained settings.

Objectives

By the end of this webinar, participants will:

1.       Understand the core principles of 24 hours postural management (seating and lying) for children with GMFCS IV–V.

2.       Learn how to assess postural patterns and identify postural risks 

3.       Develop clinical reasoning skills for solving complex seating and lying problems.

4.      Explore low-cost and locally feasible postural management solutions.

5.       Understand the role, strengths, and limitations of Appropriate Paper-based Technology (APT).

Workshop Contents/Schedule

·       Session 1: Postural management in GMFCS Level 4 and 5 children with CP: the principles and problems and the potential solutions

·       Session 2: Appropriate Paper-based Technology (APT): what does it offer, what are its strengths and what are the limitations?

Learning Outcomes

After attending the webinar, participants will be able to:

·       Conduct a functional postural assessment for children with severe CP.

·       Identify early signs of postural asymmetry, contractures, and deformity risk.

·       Apply evidence-informed postural management principles using limited resources.

·       Use clinical reasoning to troubleshoot complex positioning problems.

·       Describe when and how APT can be used effectively.

·       Recognize pitfalls, contraindications, and safety considerations in low-cost devices.

·       Support caregivers in implementing safe 24-hour positioning routines.

Facilitators/Speakers

Dr. Gillian Saloojee, PT, Honorary Senior Lecturer, Physiotherapy Department, University of the Witwatersrand;  Co-lead for South African CP Register

Mr. Stewart Drew, PT, Clinical Specialist, Children’s Physiotherapist, based in Manchester, UK