A Seating System Based on a Completely New Idea
Reducing the “Pains” “Stress” and “Risks”
It has been believed that sitting in the same way as standing and keeping the pelvis upright was a “good posture”. Through observation of the posture in daily life, however, it became obvious that forcefully straightening the pelvis to vertical was causing pains, stress and a lot of risks, The CASPER Approach is a completely new seating concept to minimize those pains and stress based on many years of trial and error. The CASPER approach has demonstrated that minimizing the pains and stress and stabilizing the body against gravity can produce many changes that have never occurred before.
Conventional Seating System for Children with Cerebral Palsy
Historically, the 90-90-90 posture, or 90 degrees of flexion at the hips, knees and ankles was the basic seating solution for children with cerebral palsy. This posture was seen ergonomically ideal and many papers were written in the 80’s to support this idea. In the 90’s, however, researches pointed out that this posture was difficult to maintain over time and might hinder function as some muscles were forced to maintain high tension. （Engstrom,2002/Howe & Oldham, 2001）
Evidence of Seating Systems Developed in the U.S. and European Countries
As an alternative to the 90-90-90 posture, the Functional Sitting Position (FSP) was introduced in Northern Europe. In FSP, it is recommended to keep the pelvis upright in a lean-forward posture. In the 00’s, some research literatures identified that FSP improved the upper extremity function, drawing attention of the world as the most evident seating technique. Those researches, however, are targeted for children and young people with mild to moderate physical disabilities who are able to perform task assignments, and those with moderate to severe disabilities with contractures and deformities who require the special seating most are not included in the research.
developed in Japan in 90’s to 00’s based on a completely new idea and has been applied to children and adults with severe physical disabilities. Instead of focusing on body alignment as in 90-90-90 posture or FSP, the CASPER APPROACH identifies the body as the object consisting of various parts such as head, chest, and pelvis, and focuses on putting each parts in dynamically stable position. Specifically, head stability is considered most important, and an adjustment is made to prevent head from falling to the side, backward or forward. It is believed that by eliminating unstable elements which make head and trunk control against gravity difficult, synergist muscle patterns are neutralized and the natural body functions of those with severe physical disabilities can be brought out to the fullest.
Prospects and Challenges of the CASPER
We have received positive comments in many cases such as “abnormal muscle tone was mitigated and facial expression is much better”, “the child appears easier to breathe”, and “the scoliosis was improved”. The numerical evaluation on application of the CASPER has not been performed, however, and that’s why it has not become the mainstream of the seating systems in the world. In Japan, objective evaluations on its application have been started and the CASPER is becoming a significant step forward in the meaning and potential of seating systems for children and adults with severe physical disabilities. The CASPER APPROACH is a technique developed in Japan to enrich the lives of children and adults with severe physical disabilities who require special seating care.