Dynamic Stories – Clinician Interview: Missy Ball, PT, MT, ATP
Michelle L. Lange, OTR/L, ABDA, ATP/SMS
Missy Ball is a retired physical therapist in Metairie, LA who has many years of experience in wheelchair seating and mobility, including Dynamic Seating (DS). In a recent advocacy effort with the Centers for Medicare & Medicaid Services (CMS), Missy shared her valuable insights on the importance of DS, which we have shared here.
The Need for Dynamic Seating
“In my over 36 years of seating & mobility experience, there has always been a need for dynamic components. Before our team discovered dynamic seating, the clients we worked with who had severe dystonia, cerebral palsy, or traumatic brain injuries (TBI) were frequently breaking the stainless-steel back canes on their wheelchairs. We also were seriously concerned about potential cervical spine injury as a result of clients colliding into their head supports with strong force. Front rigging (footrest hangers and footplates) often broke off completely with the client’s lower legs and feet in harm’s way, as a result. What an absolute blessing and effective solution dynamic products provided.”
Benefits of Dynamic Seating
“Dynamic seating also allows movement of the client in their wheelchair which is so essential for increased sitting comfort and tolerance, as well as pressure reduction of key areas of the body. Dynamic seating returns the client back to a position that is biomechanically advantageous for the skeletal system, as well as internal organ function. Lastly, these dynamic components have provided independent power wheelchair control for some of the clients I work with, as well.”
“I developed a 2-day seminar (in conjunction with Jill Sparacio) called Eat, Breathe and Move, discussing in detail the benefits of tilt and dynamic components to:
- aid the gastrointestinal system as food could now move more readily from the stomach to the small intestines, reducing constipation.
- assist the respiratory system by allowing expansion of the client’s chest cavity for inspiration/ expiration.
- assist the integumentary system, specifically skin integrity and reduction of skin pressure.
- improve comfort.”
Implications for Clients without access to Dynamic Seating
“Without dynamic seating, these clients’ needs could not be served well. The effect would be a return to 40 years ago:
- clients injured as a result of equipment breakage, such as broken back canes.
- skin pressure issues, as a result of lack of movement within the wheelchair.
- feet injured from dragging along the ground, as a result of broken footrest hangers and/or footplates.
- head injuries from intermittent or sustained extreme forces against an immoveable headrest.
- loss of best posture, biomechanically, impacting systemic organ function.”
“All of us in this industry need to solidly stand against this huge regression and educate all involved in the decision making at CMS. We have taken 20 steps back with reduced or lack of adequate funding for dynamic seating components.”
Missy, we couldn’t agree more and appreciate your passion for the clients we serve, well into retirement!
CMS announced a final payment determination for Dynamic Backs that went into effect 4/1/2024. Unfortunately, the reimbursement for this code is far below manufacturing costs. Seating Dynamics continues to address this issue so that the Dynamic Rocker Back interface can continue to be provided to those needing this technology.
