What postural management is

Postural management is the individualised assessment and management of posture, positioning and movement. It is used particularly for children and adults with neurological conditions, complex physical presentations or reduced mobility.

The aim is to support comfort, function and participation, and to reduce the risk of postural change over time. Because posture is affected by how someone is positioned throughout the whole day and night — not only during a therapy session — effective postural management looks at every part of the twenty-four hours.

What an assessment covers

Assessment of posture and positioning across different environments, including lying, sitting, standing and mobility.
Identification of factors contributing to postural changes, such as asymmetry, discomfort, reduced function or an increased risk of contractures.
Individualised positioning programmes and advice for families, carers and support staff.
Advice around standing and positioning equipment, including sleep systems, wheelchairs and standing frames.
Advice on night time positioning, including positioning strategies and appropriate equipment where required.
Consideration of 24 hour postural management, ensuring positioning is consistent across different environments and throughout the day and night.
Working alongside families, care teams, schools, case managers and other professionals so that recommendations are practical and consistently implemented.
Regular review and adjustment of postural management programmes as needs, posture, function or equipment change.

Why 24 hour postural management matters

Someone with reduced mobility may spend a large part of the day and night in a small number of positions. If those positions are asymmetrical or unsupported, the effect accumulates — which is why a programme that works well in a wheelchair during the day can be undone overnight.

Looking at lying, sitting, standing and moving as one continuous picture makes it possible to spot where the pressure is actually coming from, and to give families and carers a plan that fits around a real routine rather than an ideal one.

Lycra orthoses

Dynamic Lycra orthoses are close-fitting garments that apply gentle directional support to help align posture and improve control of movement. They can be used as part of a wider postural management programme for people with neurological conditions.

Claire Williamson is DM Orthotics certified, so assessment for and provision of Lycra orthoses can be arranged as part of a postural management plan in Derbyshire, Staffordshire and Nottinghamshire.

Working with case managers

Postural management usually involves several people around one person — family, carers, school or day service staff, wheelchair services and equipment suppliers. Recommendations only work when everyone is doing the same thing.

We provide detailed written assessments and reports, attend meetings in person or virtually, and review programmes as needs change. If you are a case manager arranging support for a client, you can contact Claire Williamson directly to discuss what is needed.

Read more about postural management in Derbyshire and Staffordshire or Nottinghamshire.

Frequently asked questions

What is 24 hour postural management?

It is an approach that considers a person's position across the whole day and night — lying, sitting, standing and moving — rather than treating posture only during therapy sessions. The aim is consistent, comfortable positioning across every environment the person spends time in.

Who is postural management for?

It is most often used with children and adults who have neurological conditions, complex physical presentations or reduced mobility. That includes people with cerebral palsy, acquired brain injury, progressive neurological conditions, and anyone at risk of contractures or postural change.

Can you advise on sleep systems and standing frames?

Yes. Assessment includes advice around standing and positioning equipment such as sleep systems, wheelchairs and standing frames, and on night time positioning strategies with appropriate equipment where it is needed.

Do you train families and carers?

Yes. Individualised positioning programmes come with advice for families, carers and support staff, because a programme is only effective if the people with the person day to day are confident carrying it out.