Serial changes in independent sitting in adults with severe cerebral palsy

We investigated the natural course of independent sitting in 28 institutionalized patients with severe cerebral palsy (CP) and evaluated the factors associated with presence or absence of independent sitting during adulthood. Seventeen subjects (61%) who could not sit at the age of 10 years were never able to reach the milestone of independent sitting. Five (45%) of 11 subjects subsequently lost the ability to sit independently during the early stage of adult life. In adulthood, many of the dependent sitters had poor activities of daily living (ADL) scores and required medical care for respiration and eating/swallowing. Hip dislocation was not directly associated with the presence or absence of independent sitting. We conclude that it is important to prevent further deterioration of swallowing and respiratory functions, as well as the development of deformities or contractures from childhood and to maintain previously acquired motor function and ADL in adults with severe CP.