Bread and Butter: Dynamic Backs and Pelvic Positioning Belts

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

Just like Bread and Butter, Dynamic Backs and Pelvic Positioning Belts go together. Dynamic Backs are designed to allow movement at the pelvis and torso in response to client force and then return the client to a neutral starting position. A key component is the pelvic positioning belt, which is designed to maintain the pelvis in as neutral a position as possible in relation to the seating system. When that seating system moves, the pelvic belt is even more critical in maintaining pelvic position.

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Dynamic Stories: Time to Rock and Not Roll

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

Phillip is a mover and a shaker – literally! This adult with developmental disabilities likes to move. He lives at a residential facility in Delaware. Years of rocking in his manual wheelchairs have left a trail of destruction. He has broken seating systems, mounting hardware, and wheelchair frames as a result of repeated and often strong movements. Phillip is currently using a tilt in space manual wheelchair with a linear back and an off-the-shelf cushion. When he rocks, he tends to move the entire chair across the room, so the staff lock the wheels. The result? He rocks with such force that the solid tires have repeatedly broken where they contact the wheel locks!

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Dynamic Stories: An interview with Daniel’s Mom

Daniel is a 17 year old young man with the diagnosis of cerebral palsy. He has been successfully using dynamic seating for over 5 years now. He started with a KidRock dynamic manual wheelchair. He currently uses a tilt in space manual wheelchair with a dynamic rocker back and dynamic footrests. I sat down with his Mom, Mary, to ask her some questions.

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Will my client break the Dynamic Seating?

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

Dynamic Seating is often used to prevent equipment breakage, specifically the wheelchair frame and seating system. The Dynamic components absorb strong, repeated, sudden, and/or sustained forces, hence protecting vulnerable areas of the seating and mobility base. This was addressed in two prior Blogs (Dynamic Seating to Prevent Equipment Breakage, part 1 and part 2). But what about the Dynamic Components themselves? Just how durable are these?

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Can I get this paid for? Part 4: Dynamic Headrest

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

Our last blog provided suggested wording to be used in documentation to obtain successful funding for Dynamic Footrests. In the last of this series, we will look at specific wording for various applications of Dynamic Headrests.

These examples do not replace competent evaluation. Choose the wording that matches an individual’s specific needs and modify accordingly to reflect a specific client’s needs. I find it helpful to begin with a brief definition, as reviewers are often unfamiliar with this technology. For example:

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Can I get this paid for? Part 3: Dynamic Footrests

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

Our last blog provided suggested wording to be used in documentation to obtain successful funding for the Dynamic Rocker Back. In this blog, we will look at specific wording for various applications of the Dynamic Footrests.

These examples do not replace competent evaluation. Choose the wording that matches an individual’s specific needs and modify accordingly to reflect a specific client’s needs. I find it helpful to begin with a brief definition, as reviewers are often unfamiliar with this technology. For example:

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Can I get this paid for? Part 2: the DRBi

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

Our last blog provided suggested general wording to be used in documentation to obtain successful funding for Dynamic Seating components. In this blog, we will look at more specific wording for various applications of the Dynamic Rocker Back Interface. The justifications we provide in a Letter of Medical Necessity will vary with the specific dynamic component as well as the individual reasons the client would benefit from this technology.

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Can I get this paid for? Part 1: general documentation guidelines

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

I personally recommend Dynamic Seating components for the clients I work with, as well as provide education in this area of practice. One question that is often posed to me is, “Can I get this paid for?” My answer – “Yes!” Of course, funding varies by payer, coding, and the direction the wind is blowing. I find that clinicians are often unsure of how to justify the need for this equipment in their documentation. Documentation is key to getting funding approval and so I have compiled some suggested wording for you here. If you require further assistance with documentation, please contact Seating Dynamics or myself for help.

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Modular Dynamic Seating Components Vs. Integrated Dynamic Seating Systems

Our last two blogs have addressed Integrated and Modular Dynamic Seating. Integrated systems are a dedicated mobility base incorporating several areas of movement. Modular components can be retrofitted to a mobility base and used individually or in combination with one another.

Let’s take a look at Spencer’s transition from an Integrated system to Modular components.

Spencer’s Dynamic Wheelchair Story

Spencer is a young man who has used an Integrated Dynamic System for a number of years. He has increased muscle tone and frequently extends with significant force. Before receiving the Integrated Dynamic System, he had broken numerous components on his seating system and manual wheelchair.

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