Michelle L. Lange, OTR/L, ABDA, ATP/SMS
When I say, “Dynamic Seating”, you may immediately think of clients who have a lot of tone and are breaking equipment. Dynamic Seating is often used to prevent equipment damage, but has other applications, as well. As a matter of fact, Dynamic Seating is being used more and more with people who have a spinal cord injury.
Many people hear “spinal cord injury” and immediately think “paralysis”. Paralysis certainly implies lack of movement and so Dynamic Seating may not seem like an appropriate option. However, most people who have a spinal cord injury have an incomplete injury (NSCISC, 2018). Increased spasticity is common in people with incomplete injuries and cervical injuries. The muscles receive too many signals from the motor nerves as a result of damage to the spinal cord. Spasticity can be triggered by certain stimuli, including pain, bladder infections, reclining in the wheelchair, bumps and jolts from wheelchair movement, and more. Spasticity varies from muscle stiffness to uncontrollable leg movements. Clonus, a series of involuntary, rhythmic, muscular contractions sometimes seen at the ankles, is also common in this population.
Where does Dynamic Seating fit in?
If spasticity or spasms are occurring at the hips and knees, a Dynamic Back and Dynamic Footrests can move in response, absorbing and diffusing these forces. Movement often reduces overall spasticity, as opposed to forces exerted against an unyielding surface which typically increases spasticity. Dynamic Seating can reduce the intensity and duration of muscle spasms and clonus, reduce forces which would otherwise be translated to the joints of the lower extremities, and, as a result, improve function.
Dynamic head support hardware might enhance the functional goal of neck extension for individuals with spinal cord injury, as movement is allowed into extension beyond neutral while maintaining postural support.
Don’t count out Dynamic Seating for people with spinal cord injuries. This intervention may reduce overall spasticity, accommodate spasms and clonus, increase head control, and increase overall functioning.
Are you currently using Dynamic Seating with people who have spinal cord injuries? If so, please leave a comment below, I would love to speak with you!
National Spinal Cord Injury Statistical Center, Facts and Figures at a Glance. Birmingham, AL. University of Alabama at Birmingham, 2018. https://www.nscisc.uab.edu/Public/Facts%20and%20Figures%20-%202018.pdf.