[Free Full Text] Lying to sitting to standing up in achondroplasia

Children with achondroplasia usually have strategies to pass by different phases of gross motor skills acquisition.

In the article "Development in children with achondroplasia: a prospective clinical cohort study"  Ireland, P. J., Donaghey, S., McGill, J., Zankl, A., Ware, R. S., Pacey, V., Ault, J., Savarirayan, R., Sillence, D., Thompson, E., Townshend, S. and Johnston, L. M., 2012, Developmental Medicine & Child Neurology, 54:  532–537. doi:  10.1111/j.1469-8749.2012.04234, the authors studied a population of 48 children under 15 months old with achondroplasia, for specific developmental information across gross motor, fine motor, feeding, and communication skills.

The following excerpts were taken from the article: "When transitioning between lying to sitting, the most frequently reported strategy demonstrated by 30 children was to lie prone (when one lies flat with the chest down and back up), fully abduct the lower limbs (legs wide open) and push up through the arms on the floor or on their legs, until able to extend backwards into a fully upright position."

This is the typical movement children adopt for sitting up.

"When moving from a sitting to standing position, the cohort demonstrated two different strategies: 21 children came up through a kneeling or squatting position or lay in prone position (n=19) or sat with full lower limb abduction before using their arms to pull up into a standing position.

Table  III.   Transitional movement strategies used by children with achondroplasia

Transition	Movement strategya	Number of children (n=48)
aParents may have identified movement strategy but not reported on age of acquisition for skill.
Into sitting from lying	Roll onto one side	9
	Push up from stomach	29
	Other	3
From standing up into sitting	Dropping backwards	13
	Squatting down	21
	Spreading legs	8
	Other	3
Pull into standing from sitting down	Kneeling up on both knees	21
	Lying on stomach	19
	Other	6

The goal is to teach children strategies for standing up unsupported that will prevent damage in their lower spine while transitioning from the sitting to the stand up position.