Michelle L. Lange, OTR/L, ABDA, ATP/SMS
Doug Cobbs, ATP, CRTS is Vice President of Healthcare Equipment, Inc. in Durham, North Carolina. Doug has been working closely with Seating Dynamics to address the needs of a client he works with, Carl. Doug graciously shared some of his time with me recently.
How long have you worked in this industry and how did you get started?
Doug has worked with wheelchair seating and mobility since 1998. He actually started in engineering, machining, and manufacturing. His brother-in-law owned Healthcare Equipment and asked Doug if he would be willing to come over and work with them. Doug said yes 23 years ago.
How did you start using Dynamic Seating with your clients?
Early on, Doug was told by seating and mobility educators to strap down a client with spasticity or dystonia at 90/90/90 to ‘break up tone’ (placing the hips, knees, and ankles each at 90 degrees of flexion). He tried this, but it wasn’t working in the real world. Let’s admit it, if you have been in this field for a while, we’ve all tried this! Caregivers were reporting having to reposition clients 15-20 times a day. Doug needed another solution.
Doug often used the Mulholland Growth Guidance System (that takes you back, doesn’t it?). Although not designed to move, the frame did move a bit in response to client forces. He noticed that the children he was working with would extend and then relax in response to this frame movement.
When the Kids Rock came out (this is now discontinued), Doug tried this dynamic wheelchair with some of his clients, but had issues with durability and the available seating. Other Dynamic Backs placed the pivot point too low and the client would lose positioning of the pelvis upon return to upright. Some dynamic components didn’t lock out and some dynamic head support hardware didn’t capture client movement when rotation was involved.
Finally, the Invacare Solara offered a Dynamic Back solution – the DeGage which was the predecessor to the Seating Dynamics Dynamic Rocker Back interface. Doug gave this a try with some of his clients and it worked! He now uses the Seating Dynamics Dynamic Rocker Back interface, Dynamic Footrests, and Dynamic Head Support hardware.
What were your goals in using Dynamic Seating?
Doug was striving to reduce equipment breakage and client injury. While caregivers were not reporting client injury, Doug assumed that the forces required to cause damage to the equipment were certainly resulting in extreme forces throughout the client’s body which could potentially leading to injury.
He also knew that the clients he worked with who had high tone needed to move. Instead of standing up in their wheelchairs all day, the clients using Dynamic Seating were maintaining alignment with their seating systems.
Doug sums it up very well.
“We need a paradigm shift – conventional wisdom about seating and mobility changes and needs to change. The equipment must accommodate the individual, not the other way around.”
We couldn’t agree more, Doug!
Keep an eye out for our next blog focusing on Carl, a client Doug is working with and how Dynamic Seating has made a difference in his life.