Michelle L. Lange, OTR/L, ABDA, ATP/SMS
Robert is a Dynamic Seating old-timer. This 27 year old man has been using Dynamic Seating for about 15 years now. I had the privilege of speaking with Robert’s parents, Jeffrey and Mary Elizabeth, on the phone recently.
How did Robert first begin using Dynamic Seating?
“At the time, a change in funding prompted the order for a new manual wheelchair and his therapists at California Children’s Services (CCS) along with Betsy McKone (then of Rehab Specialists and later Numotion) turned to Dynamic Seating options. Robert had a long history of breaking items on his wheelchair, particularly his footplates and back canes, due to very strong extensor tone.”
What did life look like before Dynamic Seating?
“Robert broke items on his wheelchair frequently. He was constantly extending in his seating system. He had a habit of breaking his wheelchair at 4:30pm on the Friday afternoon of a 3 day weekend! We couldn’t feed Robert unless he was in his wheelchair seat and he couldn’t sit in the wheelchair if it was broken. At these times, he sat in a Tumbleforms seat or Rifton chair, but we couldn’t go anywhere. If his wheelchair was broken, he couldn’t even go to school.” His Mom was so desperate that she took the wheelchair to a welding shop three times, as the standard repair process could be slow.
How had Dynamic Seating changed things?
“Since using a Seating Dynamics back and dynamic footrests, Robert does not fight the wheelchair as much. He looks like he uses less force and energy and is more comfortable. And of course, we have significantly less breakage.” The family locks the Dynamic Rocker Back during feeding. Overall, Jeffery has noticed that Robert is more stable which, in combination with reduced fighting against the seating system, helps him to be as functional as possible. The family also likes to take road trips in their accessible van. Dynamic Seating has increased Robert’s sitting tolerance during these rides and his parents don’t have to worry about something breaking while they are away from home.
Mary Elizabeth mentioned that Robert, although having very strong extensor tone, also has underlying low tone. This combination of muscle tone can be challenging to address in a wheelchair seating system. “Dynamic Seating has supported his fluctuating muscle tone very well.”
What would help Robert further?
Robert still breaks his back canes at times, though rarely. During our discussion, I talked to his parents about changing the elastomers in the Dynamic Rocker Back, as these are most likely worn. These often need replacement annually, particularly with clients who exert significant forces. We also discussed how to determine if they are using the correct resistance level in the back. Robert still exerts enough force against his head support that the supplier has added dual vertical rods to prevent breakage. Jeffrey and Mary Elizabeth were not aware of Dynamic Head Support hardware, as this is a more recent Seating Dynamics product offering. They are anxious to get this for Robert to diffuse his extension at the neck, as well.
Is there anything else you would like to share?
“The main take away for our family is that Robert has less breakdowns. This is huge. His breakdowns were frequent and unexpected.” Dynamic Seating has allowed Robert and his family to live life without life revolving around his wheelchair. And that’s what it’s all about, right?
More about Robert: Full Case Study