In wheelchair evaluation for a child with cerebral palsy, the therapist should FIRST examine which anatomical region?

In wheelchair evaluation for a child with cerebral palsy, the therapist should FIRST examine which anatomical region?

• A. Pelvis
• B. Legs
• C. Head
• D. Spine

Answer: (A)

Starting with the pelvis is essential because it forms the base of support in a seated position. In cerebral palsy, pelvic alignment—whether there is tilt, obliquity, or rotation—drives how the rest of the body positions itself in a wheelchair. If the pelvis isn’t stable and well-aligned, the trunk, hips, and knees will compensate, making proper seating, pressure distribution, and stability impossible to achieve. By first assessing pelvic posture and control, you guide where to place supports or how to contour the seating to level the pelvis, which then allows accurate evaluation of spine, head position, and limb alignment. The legs and spine are addressed after establishing a stable pelvis, since their positioning depends on the pelvis being properly aligned.

Starting with the pelvis is essential because it forms the base of support in a seated position. In cerebral palsy, pelvic alignment—whether there is tilt, obliquity, or rotation—drives how the rest of the body positions itself in a wheelchair. If the pelvis isn’t stable and well-aligned, the trunk, hips, and knees will compensate, making proper seating, pressure distribution, and stability impossible to achieve. By first assessing pelvic posture and control, you guide where to place supports or how to contour the seating to level the pelvis, which then allows accurate evaluation of spine, head position, and limb alignment. The legs and spine are addressed after establishing a stable pelvis, since their positioning depends on the pelvis being properly aligned.