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Clinical Indicators: Maintaining Posture by Providing Movement

Clinical Indicators: Maintaining Posture by Providing Movement

Michelle L. Lange, OTR/L, ATP/SMS

Dynamic Seating has many clinical indicators, including reducing active client extension, preventing client pain and injury, preventing equipment breakage, providing movement, and improving postural control, stability, and function. These benefits have been addressed in many of our past blogs which can be found here. Clinical indicators are also addressed in our popular Quick Class on this subject here.

Another clinical indicator for Dynamic Seating, particularly for the Dynamic Rocker Back interface (DRBi), is preventing loss of position. When a client extends at the hips in a static seating system, this force is not diffused and so results in movement of the client in relation to the support surfaces. Simply said, the client extends their hips, lifts the pelvis off of the seat surface and, once active extension ceases, the pelvis falls back to the seat in a posterior pelvic tilt. In a similar situation, the client extends their hips, pushes their trunk against the back of the seating system, and their pelvis pushes forward into a posterior pelvic tilt. There is nowhere else for the pelvis to go. Most likely, the client is unable to correct the position of their pelvis independently and will need repositioning. All day long.

In this first video, this client is extending his hips against the static back of his seating system and lifting (elevating) his pelvis off of the seat cushion. When he stops actively extending, he lands on the cushion in a significant posterior pelvic  , far forward on the cushion.

In the second video, a dynamic back is being used successfully in combination with Dynamic Footrests to prevent this loss of position in another client, Amber. Amber extends and rotates her pelvis, yet when she stops actively extending, she returns to a neutral pelvic position.

The Dynamic Back moves posteriorly in response to hip extension, diffusing force, keeping the pelvis on the cushion and in alignment while allowing hip extension. When hip extension ceases, the Dynamic Back returns the client to an upright posture without loss of position in relation to the seat and back.

A Dynamic Back has many clinical benefits. A very important one is keeping the pelvis in position in relation to the seating support surfaces. If you are working with a client who is pushing themselves out of alignment with the seating system, consider whether Dynamic Seating can help!

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