When a full equipment trial is impractical, clinicians can use simulation during the seating or mat assessment. By manually allowing controlled movement at the back, lower extremities, or head, the clinician can observe whether force, extension, or tone decreases and whether the client can return toward an upright position. These findings can help determine whether a dynamic seating component may be clinically appropriate.

A clinician can sit behind the client on a mat table and move slightly backward when the client extends at the hips. If allowing this movement reduces active extension or muscle tone and the client can then be guided back toward upright, a Dynamic Rocker Back may be indicated. Active rocking or movement seeking may also support consideration of a dynamic back.

One strategy is to swing the existing footrests away and observe how the client’s legs move without leverage against the footplates. If overall extension decreases or the client demonstrates significant knee extension, Dynamic Footrests may be appropriate. A clinician can also assess how much force the client generates against a static footplate during extension.

A clinician can move the existing head support rearward and place foam between the client and the head pad to observe how strongly the foam is compressed during extension. Another strategy is to carefully place a hand behind the client’s head and feel for repeated forceful extension. Significant repeated force may indicate that Dynamic Head Support Hardware should be considered.

The clinician should document the simulation method, the client’s response, the forces observed, and how movement affected extension, tone, or positioning. These findings can be included in the Letter of Medical Necessity to support the recommendation. It is also important to describe the potential consequences of not providing the intervention, such as continued force against the joints, cervical area, seating system, or wheelchair hardware.