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

A while back, someone asked me if a heavy-duty wheelchair frame was required when using Dynamic Seating components. Good question! Quick answer – No!

A long time ago, heavy-duty wheelchair frames (think steel) were often recommended for clients who had a history of strong extensor forces, strong and forceful movements, injury, and/or equipment breakage. The justification was that the wheelchair frame was less likely to be damaged.

The challenge with this approach is that, instead of diffusing forces, the equipment is made more durable. The client forces have not changed. These unrelieved forces can lead to further increases in extension, shear (as the client moves out of alignment with the support surfaces), loss of position, pain, and agitation. The forces tend to go wherever movement is – often the client’s joints, particularly the knees, hips, ankles, and neck.

Friend and colleague Sharon Sutherland recounts a story told to her by an evaluating team. Apparently, a client was extending their neck with enough force to break the head support mounting hardware. The solution – make the hardware more durable. While the client no longer broke the mounting hardware, these unrelieved forces led to a fracture in their cervical vertebrae! Force diffusion is a better option than making super heavy-duty equipment. Heavy-duty equipment may solve the breakage part of the equation but does not address the root cause, client exerted force. This evaluating team ordered Dynamic Head Support hardware.

Dynamic Seating options work well on aluminum lightweight wheelchair frames. As the Dynamic Seating components diffuse force, the strain on the wheelchair frame, seating system, and mounting hardware is actually reduced. Recommending an aluminum frame opens up a much wider selection of frame options to best meet an individual’s needs and the frame will be significantly lighter for self-propulsion and lifting in and out of a vehicle.

Dynamic Seating cannot be used on titanium or carbon fiber wheelchair frames, at this time. Titanium and Carbon Fibert are primarily used to significantly reduce the weight of the wheelchair frame for clients who self-propel. Adding Dynamic Seating components to the frame would add to the weight of the wheelchair, negating this advantage. Also, most clients using a titanium or carbon fiber wheelchair are unlikely to require Dynamic Seating.

Next time you are working with a client who would benefit from Dynamic Seating, don’t shy away from the wide variety of aluminum wheelchair options available to best meet an individual’s need.