What is 24 hour postural care?

A symmetrical body and stable posture are foundations for health and will support success in traditional therapies and meaningful activities. The vast majority of people are born with symmetrical bodies and are able to assume a variety of different positions throughout the day and night. It is easy to take this for granted – but for people with motor impairments that limit their movement repertoire it is different.

When such a person spends many hours without moving easily and often into different positions, soft tissues shorten, ligaments stretch and gravity affects the person’s body so that slowly and gradually it becomes distorted. Eventually the body changes shape and no longer bounces back to where it started. Two Scottish doctors identified this dynamic in 1976*, and any person with movement impairment is at risk.

Children and adults using wheelchairs or other mobility devices are especially vulnerable to the force of gravity because their variety of positions is typically limited. Children are at special risk during growth spurts; crooked sleep positions at night when much growth takes place can lead to long-term problems like scoliosis and joint dislocations.

24 hour postural care is a gentle, non-invasive, inexpensive way to promote health and quality of life for people with motor impairments. It can protect the shape of a person’s body, help balance muscle tone, reduce pain, ease physical care, improve sitting posture and tolerance, and help people sleep better. As developed and described by Hill and Goldsmith, a 24 hour postural care approach can be used both to prevent body distortions and treat them *.


* Fulford, G.E. and Brown, J.K. (1976) “Position as a cause of deformity in cerebral palsy”. Developmental Medicine and Child Neurology, Vol. 18, pages 305-14.

** Hill [Clayton] S., Goldsmith J. (2010) “Biomechanics and Prevention of Body Shape Distortion”. Tizard Learning Disability Review, Vol. 15, No. 2, pages 15-29