What is postural care? We all need to look after our posture. Whether it’s sitting up straight so we are eye level with our computer, getting our seating right when driving or not straining our neck hunched over our mobile phone or other devices, we realise as we get older that we will have aches and pains if we don’t look after our posture. Living a lifestyle where we don’t move much can also affect our posture and our general health. Postural care is any intervention which protects a person’s body shape. There are many ways to look after your posture. Some of these involve being more active such as taking part in sport, regular walking and exercise. Some people may need therapeutic positioning and the use of equipment such as appropriate seating, wheelchairs and night-time positioning equipment. These methods should be regularly reviewed to make sure they continue to suit the individual and their current situation. For some people, poor postural care can be a silent killer. For people of all ages who struggle to move their own bodies, including people who are physically disabled, people who have a profound and multiple learning disability and people who have had a stroke, poor posture can over time lead to a range of health difficulties including changes in body shape called ‘body shape distortion’; health complications such as hip dislocation; scoliosis; difficulty breathing, eating and drinking; difficulties with digestion and increased respiratory infections. The Confidential Inquiry into Premature Deaths of people with learning disabilities in 2013 highlighted that people with learning disabilities are a high-risk group for deaths from respiratory problems and recommended that Clinical Commissioning Groups should ensure they commission expert, preventative services including proactive postural care support. (Heslop P, Blair P, Fleming P, Hoghton M, Marriott A and Russ L. (2013) Confidential Inquiry into premature deaths of people with learning disabilities (CIPOLD) Bristol: Norah Fry Research Centre, University of Bristol) Fred's Story The vast majority of people are born with a symmetrical body shape. Fred had a diagnosis of quadriplegic cerebral palsy and was able to move himself around on the floor. However, he did not receive good care, and developed a severe twist in his spine which ultimately caused his death at the age of 23. Fred was limited in the amount he could move, and so he was forced to stay in one position for much of the day. Gravity pulled his muscles and bones down which caused his chest to rotate and squashed his lungs and stomach. This was not a quick process. You can see from his X-rays that Fred’s posture gradually deteriorated as he got older. As Fred’s body shape worsened, it caused chest infections, swallowing problems and pain. Fred died of health complications which were the direct result of the dramatic changes to his body shape. These extreme distortions to a person’s body are not inevitable. Fred, like many others, may not have died if he had received good postural care, such as a sleep system, a specially designed wheelchair or regular exercise in childhood. Making people aware of good postural care improves quality of life and can, in some extreme circumstances, be lifesaving. Postural care support can include a wheelchair designed for the person’s needs, individually designed seating, a standing frame, night-time supports such as special cushions to help them sleep straight, regular exercise or active therapy programmes devised by physiotherapists or occupational therapists. Read the Postural Care Leaflet here.