ATP Series

Defining Dynamic

In Complex Rehab, One Word Is Full of Possibilities

Defining Dynamic

ACTIVE PEOPLE: SOLARSEVEN/ISTOCK.COM

It’s ironic that an industry called seating and wheeled mobility has at times been static when designing systems for clients with complex needs. In the past, the strategy was often to position them in their wheelchairs and then make sure they stayed in exactly the same place all the time.

That scenario required wheelchair users to do something ablebodied people were not expected to do: Stay still. Yes, there were weight shifts — intermittent tilting and reclining, or push-ups to relieve pressure. But in between, wheelchair users were set into prescribed, largely static positions that were expected to suffice for hours every day.

The human body and mind aren’t meant to remain placid, and complex rehab’s buzziest term right now might be dynamic, meant to describe seating or mobility that moves or changes much more frequently, quickly and functionally than in the past.

But within that single word are several different interpretations, because fittingly, there is more than one way to move.

Different Dynamics

Currently, the word dynamic is applied to complex rehab in a few distinct ways:

  • Dynamic seating: Seating systems and components often described as moving with the client, typically when the client experiences spasticity or high muscle tone and pushes against seating components. A client might lean or push against positioning components, such as a harness, intentionally, such as when leaning forward to reach something on a table. Can also include seating systems that can be very easily, quickly and repeatedly adjusted to fit clients’ needs.
  • Dynamic feedback: Systems designed to provide movement in response to the client’s movement, which can aid with proprioception and balance, and can help to reassure clients with sensory issues.
  • Dynamic wheeled mobility: Wheelchairs that can change aspects of their configuration very quickly and repeatedly in response to changes in environment or a client’s functional needs.

The different interpretations have a couple of things in common. Wheelchairs or seating systems with dynamic features must still optimally carry out their primary positioning and mobility functions; those goals can’t be sacrificed for the sake of the dynamic components. And ideally, dynamic features will work in concert with the rest of the system to provide a whole experience greater than the sum of its components.

As Steve Mitchell, OTR/L, ATP, says of the different types of dynamic technology now available, “What they [all] have in common are improving function.”

Check out these “dynamic dynamos,” complex rehab components and systems that feature different dynamic functions, all in the name of better accommodating clients with complex needs.


AEL’s Omnilink Swing-Away Lateral Bracket

AEL Omnilink Swing-Away Lateral BracketWhat makes it dynamic: Includes a unique telescoping feature that allows the pad to be locked at varying depths without requiring the use of additional links.

How the wheelchair client benefits: The telescoping feature provides additional lateral pad pressure prevention. A complication frequently seen with non-adjustable lateral pads is the increased pressure that develops between the user’s trunk and the lateral pad. For clients who pose a significant risk for skin breakdown, especially as a result of an aggressive seating posture (e.g., hypertonicity, repetitive or writhing motions), the telescoping function will allow slight pad adjustments to be made on a routine basis. Adjustments can be made while the client is seated in the wheelchair, bringing the pad toward the posterior aspect of the client’s trunk, repositioning in neutral and/or advancing the pad to the anterior trunk — all by adjusting the depth of the telescoping base. This adjustment allows for a shift in pressure application and the prevention of pressure injuries or skin breakdowns under the laterals.

(866) 656-1486
aelseating.com


Matrix Seating USA’s Easy Fit

Matrix Seating USA Easy FitWhat makes it dynamic: Adjustable micro-modular custom-molded wheelchair seating is infinitely adjustable and flexes to accommodate the client while maintaining the client’s position. Matrix Seating also flexes with the wheelchair movement resulting in shock absorption and reducing sheer and pressure.

How the wheelchair client benefits: The adjustable micro-modular custom mold can be added to or reduced, as the user’s size requires. For example, Matrix Seating can be easily grown to accommodate weight gain and body shape changes. Matrix Seating adjustability can enable incremental changes to positioning in order to provide orthotic spinal correction.

(800) 986-9319
matrixseatingusa.com


Symmetric Designs’ Axion Rotary Interface

Symmetric Designs Axion Rotary InterfaceWhat makes it dynamic: Enables headrest pads and head positioning devices to rotate with the user’s head, transforming headrests into dynamic positioning devices.

How the wheelchair client benefits: When the Axion is implemented with the user’s head support, it allows the head support device to rotate, resulting in reduced shear forces, increased peripheral vision and users can now have their head supported while still having freedom to move their head horizontally.

(800) 537-1724
symmetric-designs.com


EasyStand’s Glider

EasyStand GliderWhat makes it dynamic: Features Active Standing Technology that enables a user or caregiver to facilitate motion with the arms that is reciprocated in the legs.

How the wheelchair client benefits: Simulates the motion of cross-country skiing, which provides increased range of motion at the ankles and hips while also weight bearing. Adjustable resistance cylinders can also be engaged to provide additional possibilities for cardiovascular conditioning. Users complete a self or assisted transfer in a seated position and use the hydraulic or optional electric lift to stand. Sit-tostand provides a gradual transition to standing and allows those with tightness the ability to progress toward full extension.

(800) 342-8968
easystand.com


Bodypoint’s PivotFit Shoulder Harness

Bodypoint PivotFit Shoulder HarnessWhat makes it dynamic: Bodypoint dynamic posture supports include proprietary materials to control the amount of stretch and provide comfortable movement. The manufacturer tests to ANSI/RESNA WC-3: S3 2013 Standard for Postural Support Devices to ensure product safety and performance. The dynamic PivotFit provides a body-contouring shape with curve-hugging Laminar Pads. This support is used for shoulder retraction and/or trunk rotation. The carefully engineered swivel buckle equalizes tension to allow for precise pad placement for an individualized fit.

How the wheelchair client benefits: Jordan (pictured) gained stability and head control using the dynamic PivotFit. Now he operates a head array mouse system for computer use in school and for fun.

(800) 547-5716
bodypoint.com

This article originally appeared in the November 2016 issue of Mobility Management.

About the Author

Laurie Watanabe is the editor of Mobility Management. She can be reached at lwatanabe@1105media.com.

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