Dynamic Head Support Hardware: Choosing Tilt and Recline Resistance

Michelle L. Lange, OTR/L, ABDA, ATP/SMS

The Dynamic Head Support Hardware absorbs client forces and then returns the client to an upright and neutral head position. The purpose of this dynamic component is to protect the client from harm, prevent the mounting hardware from breaking, and to reduce overall extension tone. This hardware can be used with nearly any head pad to best meet an individual’s needs.

Seating-Dynamics-Blog-56-Dynamic-Head-Support-ElastomersSeating Dynamics offers a Single Axis and Multi Axis version of this Dynamic Head Support Hardware. The level of resistance can be changed by switching elastomers. The hardware comes standard with Blue (medium) elastomers. A firmer set of elastomers (Green) are included, if needed. A previous blog reviewed how to choose the most appropriate level of resistance.

An important factor to consider is whether the client is using a tilt and/or recline system. Many clients using a Dynamic Head Support are using a tilt in space manual wheelchair. As the client tilts or reclines posteriorly, gravity will increase the force the head exerts against the head pad. As a result, the elastomers may engage, particularly if the client also extends. If this is the case, you may consider changing to the firmer green elastomers. The firmer elastomers may prevent the head support from ‘sagging’ during tilt or recline which could lead to neck hyperextension. When the client is upright, ensure that the dynamic component can still be engaged by the client, even with this firmer level of resistance.

Some caregivers may attempt to hang a backpack or other items off the head support hardware. This may also engage the elastomers. These items should instead be hung on the push handles or another area of the wheelchair frame.

With any wheelchair, it is critical to analyze the specific component set-up for an individual – such as how components may work differently during tilt or recline. This takes time and problem solving but improves overall outcomes for the client.

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