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Hi Mary,
Yes, you are correct when a pattern is in balance the side seams are perpendicular to the floor and hems are meant to be parallel to the floor. When a person is unable to stand-up straight custom pattern making is the only way to achieve this balance.
For those who have irregularities of the spine due to such issues as scoliosis, although they may be able to stand erect, the unexpected angels of the shoulders, hips and so on are tricky to fit but not impossible. Recently I saw a testimonial of a woman who has scoliosis and is using the DittoForm to create stylish cloths the fit so well you don't notice the differences in her shape. To see her results and comments click Here.
When a person has a rounded back caused by poor posture, curvature of the spine, or aging patterns only need a minor adjustment. You can find the tutorial video here: Rounded Back Adjustments.
Lastly, if a person is really stooped over, often using a cane or walker it is best to continue to fit the clothing to the body as if standing erect.
Happy Sewing!!
Janet
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