The Importance of Dynamic Backs

Clinician Interview: Mark R. Schmeler, PhD, OTR/L, ATP
Michelle L. Lange, OTR/L, ATP/SMS

Mark Schmeler is well known in our industry and is currently an Associate Professor / Vice-Chair for Clinical Services & Policy in the Department of Rehabilitation Science & Technology at the University of Pittsburgh. He also leads a team in running the International Seating Symposium in the United States.

Mark was kind enough to share his thoughts on the importance of Dynamic Backs.

“Dynamic backs are essential to accommodate people with severe tone and spasticity. They are also essential to accommodate people with severe cognitive and behavioral issues who tend to rock / thrash themselves against their backrest. In my 34 year experience providing Complex Rehabilitation Technology to people with severe disabilities, the lack of an appropriate dynamic back with proper construction and integrity to withstand the above-mentioned conditions leaves clients at risk for injury associated with repeated forces applied to their equipment. My experience has also indicated the lack of force diffusion results in both ongoing equipment damage and premature repair and injury risk to the client. This is more concerning due to repair delays and the lack of covered preventative maintenance benefits for complex rehab technology (CRT).”

“The population that benefits from dynamic backs typically have the most severe disabilities, both physical and cognitive. Historically this population has been institutionalized but many of these clients now live in the community and need to be supported. This can only be accomplished through the provision of properly provided CRT and options such as dynamic backs.”

“This is a small, unique, vulnerable, protected, high risk, and underrepresented/studied population. It is not likely and perhaps not feasible to conduct rigorous research on the benefits of dynamic backs at this time. Therefore, from a policy and payment perspective, we have to apply clinical common sense here where high durability and force diffusion is reasonable to address the need.”

Thanks so much for sharing your expertise and passion for these issues and for all that you have contributed to the field of seating and wheeled mobility, Mark!