Dynamic Seating in Manitoba with Macara McGregor, BMR-PT

One of my favorite things to do is speak with fellow clinicians about their experiences with Dynamic Seating. Today I had the pleasure of speaking with Macara McGregor, a physiotherapist in Manitoba, Canada who has been in practice for 13 years. Macara works at St. Amant, a center for adults and children with disabilities. Many residents live at the center, short or long term, and others attend day programs or the private school. The center also serves children and adults in the community.

Macara, how did you begin using Dynamic Seating?
Macara worked with a gentleman who had fetal alcohol syndrome and autism and had broken 3 manual wheelchairs within the span of 3 years. The funding source was not happy about paying for yet another wheelchair. Macara researched different dynamic options and ended up ordering him a Quickie 2 manual wheelchair with a Seating Dynamics Dynamic Rocker Back interface (DRBi). That was 3 years ago, and no more breakage! The elastomers have needed to be changed once due to wear, which is expected.

What are your primary goals in using Dynamic Seating with your clients?
Macara is using Dynamic Seating to prevent equipment breakage, decrease client extension, reduce skin breakdown from shear forces against static surfaces, maintain postural alignment within the seating system, and to decrease client movement overall. One unique benefit of Dynamic Seating for many clients is that by providing the opportunity to move, many clients ultimately move less. This allows the client to focus on more functional activities instead. Many of the clients Macara works with do seek out a rocking movement.

What other benefits of dynamic seating have you noted?
Macara anticipated ordering both the DRBi and Dynamic Footrests for many of the clients she works with. Oftentimes, only the DRBi has been required as so much extension has been diffused by this component. It is critical to evaluate the client to determine if the forces being generated are coming from the hips, knees, and/or neck to match those needs with the correct dynamic interventions. Macara also reports that her clients using Dynamic Seating are happier, more content, less agitated, and just have a better quality of life.

Can you share a specific client example?
Macara worked with an adult who has a rare neurogenic condition, Neuroacanthocytosis. He demonstrated significant extension and dystonic movements. He was breaking equipment, losing his position within the seating system, and developing skin breakdown on his coccyx and scapulae due to shear forces (moving across static seating surfaces). She recommended a DRBi and telescoping dynamic footrests. These components reduced breakage, maintained his posture within the seating system, and reduced shear forces – eliminating the skin breakdown. In general, Macara states that Dynamic Seating made a big change in his quality of life.

Macara has an evaluation manual tilt wheelchair with a DRBi to help justify funding for these components by actually trying it out with clients before making a final recommendation. She carefully determines the optimal pivot point at the pelvis in relation to the DRBi pivot point when selecting cushion height. She told me that she really appreciates Seating Dynamics’ good customer service and the fact that the components are retrofittable, allowing her to add them to a client’s existing wheelchair when needed.

“Great products! I work with kids and adults with developmental disabilities. I’ve had lots of success with their dynamic rocker back interface to address high extensor tone, as well as rocking behavior!”

Macara McGregor, BMR-PT
Manitoba, Canada