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Tuesday 26 March 2019
Derbyshire Healthcare NHS Foundation Trust
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24 Hour Postural Care

What is postural care and how can this help your child?

Postural care is important for all children who have a physical disability. It is a term that is used to describe an approach to looking after your child’s body shape and preventing deformity and discomfort. Postural care is very gentle; it is not about doing exercises and stretching to change your child’s shape but instead using equipment to protect the shape they have from birth.

Babies are usually born with a symmetrical body shape (ie no curvature of the spine) 24 hour postural management aims to maintain this shape throughout their lives.

Unfortunately children who are born with, or acquire, a disability are more prone to their bodies altering and deformities occurring. You may hear terms such as Kyphosis, lordosis and scoliosis; these are all terms to describe different ways in which the spine may alter. Postural care may also protect your child’s hips from dislocation and from muscle shortening.

In some cases these deformities will require surgery as the child grows.

The good news is we can do something about slowing this process down and in some cases even stop it occurring.

How can we use postural care?

Postural care is a programme of controlled posture which manages a child’s shape using different pieces of equipment ( it can also be achieved using rolled up towels, soft toys and pillows). It needs to occur throughout the day and night, wherever your child is. It enables your child to be comfortable in sitting, lying standing or when moving position.

If your child is more comfortable then they will be more able to participate in class and more able to learn.

The equipment which helps us achieve postural care over a 24 hour period includes:

  • Standing frames
  • Wheelchairs
  • Special seating
  • Sleep systems
  • Wedges and other ways of positioning for play
  • Classroom positioning systems


Postural management is a central part of a child’s life at home, school and short break service. It works best if it is carried out by everyone who is involved with your child. It can be very effective and we all need to make best use of the available hours in a child’s life to protect their body shape. There are 8,760 hours in a year and on average a child will spend approximately 1,140 hours at school and 7,620 hours at home, of which 3,600 of those hours are spent in bed. Night time positioning can be an extremely effective way of protecting body shape.

It is important that your child is not left in a position which could cause deformity or in the same position all day. By changing positions from sitting to lying and from the front to their back it will stop your child from becoming fixed in one position. Staying in one position all the time is not comfortable.

Your Occupational Therapist or Physiotherapist can measure changes in your child’s body symmetry and monitor their body shape.

NB. Deterioration in body shape is not inevitable.


  • 24 hour Postural management Active Design LTD (2005)
  • Fulford, G.E. Brown,J. K. (1976) “Position as a cause of Deformity in Children with Cerebral Palsy” Developmental Medicine and Child Neurology 18. 305-314
  • The Chailey Approach to Postural Management. Journal of the Association of Paediatric Chartered Physiotherapists 90:15-27 Pountney TE, Green E, Machachy C, Nelham R (1999)
  • Postural Care Skills Programme (PCSP UK Ltd)
  • Goldsmith, S. (2000) “The Mansfield Project: Postural care at night within a community setting” Physiotherapy 86, 10, 528-534


Other professional groups we may work with

  • Acute Hospital Physiotherapy and Occupational Therapy Services

  • Education Staff

  • Short Breaks Services

  • Social Care Occupational Therapists advise on housing adaptations

  • Social Care staff including social workers and familly support workers

  • Specialist Health Visitors

  • Speech Therapists

  • Orthopaedic Surgeons

  • Paediatrician's and GP's

  • Voluntary sector staff working with your child

  • Wheelchair Services