Adaptive seating for children with cerebral palsy classified as Gross Motor Function Classification System (GMFCS) levels IV and V at General Justice Gizenga Mpanza Regional Hospital in KwaZulu-Natal, South Africa: a mixed methods study.

BACKGROUND: Children with cerebral palsy (CP) classified as Gross Motor Function Classification System (GMFCS) levels IV and V experience severe functional limitations and are unable to sit independently. Access to appropriate adaptive seating devices in low- and middle-income countries (LMICs) remains limited due to financial and resource constraints. AIM: To evaluate the effect of commercially available car seats as adaptive seating device on sitting posture in children with CP (GMFCS IV-V), and to explore caregiver experiences regarding its impact on function and caregiving. SETTING: General Justice Gizenga Mpanza Regional Hospital, KwaZulu-Natal, South Africa. METHODS: An explanatory sequential mixed-methods design was employed. Sitting posture was assessed before and after intervention using the Posture and Posture Ability Scale and semi structured interviews were conducted with caregivers. RESULTS: Baseline PPAS scores indicated poor posture (mean 15.00%). Post-intervention scores improved significantly (mean 80.83%; p < 0.001). Caregivers reported improvements in posture, feeding, comfort, participation, and reduced physical strain, alongside increased independence in caregiving. CONCLUSION: The use of a commercially available car seats as adaptive seating device significantly improved sitting posture and was perceived to enhance functional abilities and caregiving experiences. CONTRIBUTION: This study provides evidence supporting the use of commercially available car seats as a feasible alternative to specialised adaptive seating devices in LMICs.