Fourteen studies (176 participants, range two to 23) were included in the review. Most studies were single group designs acting as their own control groups; two studies were experimental with separate control groups. The quality of four studies was classified as strong, seven studies as moderate and three studies as weak.
Saddle position (three studies): There was mixed evidence to support use of saddle seats. Single studies reported improved sitting postural control, no to slight improvements or a significant increase in sitting posture and postural control.
Seat position angles (four studies): Two studies supported use of an anterior tilt seat with improvements in trunk extensor muscle activity (one study) and improved trunk extension (one study) in children with cerebral palsy. One study reported increased lower limb stability with a posterior tilt and one study found evidence to support the use of zero degree tilt for optimal trunk extensor activity.
Modular seating system (four studies): Modular seating may improve postural control and duration of head control (three studies), decrease the number of pathological movements (three studies) and increase trunk extension (one study) in children with cerebral palsy.
Due to the small number of participants the authors reported that they were unable to draw conclusions on seat inserts (two studies; seven participants). One study reported on three-point supports.
Functional ability: Mixed effects on upper limb function as a result of adaptive seating were reported in four studies. One study reported an overall increase in mobility as a result of using a saddle seat. Parent perceived improvements in their child’s social interaction and in parental ease of performing caregiving tasks were noted in two studies.