Dynamic Seating Back to top ⤴
General
Dynamic seating is movement which occurs within the seat and/or wheelchair frame in response to client movement and force. Dynamic components absorb force which, in turn, assists the client back to a starting position without loss of posture. Basically, when the client moves, the dynamic seating moves at the back, footrests, and/or head support and returns the client back to upright sitting. More information.
Movement can occur at the back (dynamic back), legs (dynamic footrests), and/or the head (dynamic head support hardware).
Yes, Dynamic Backs, Dynamic Footrests, and Dynamic Head Support Hardware can be used in combination with each other. Assessment will determine where an individual will best benefit from dynamic seating and if more than one area of the body needs to be addressed.
The amount of resistance to client movement can be changed on several of our dynamic seating components, including the Dynamic Rocker Back interface and Dynamic Footrests (telescoping downward and footplate rotation). In general, the client should be able to move or activate the component and readily return to a starting position. If the client cannot readily move the component, the resistance should be reduced. If the client does not readily return to a starting position, the resistance should be increased. More information.
Seating Dynamics Dynamic Seating components can be used on many different manual and power wheelchair frames, either retrofitted or at initial delivery. Please see our Product Compatibility Matrix.
No. While a heavy duty wheelchair frame is often recommended to reduce equipment damage due to client force and movement, Dynamic Seating diffuses client forces so that these forces are not translated to the frame itself. Dynamic Seating can be used on a wide variety of frames and protects equipment from damage without limiting frame choice to heavier options.
Who Should Use Dynamic Seating?
A client may benefit from Dynamic Seating if you are seeing any of the following:
- The client is moving seating components out of alignment.
- The client has broken seating, hardware, or the wheelchair frame.
- The client actively seeks out movement, such as rocking.
- The client is more alert or less agitated with movement.
- The client has sustained injuries from colliding with portions of the seating system or wheelchair frame with sudden or sustained force.
- The client is ‘standing up’ in the seating system.
- The client is extending within the seating system and moving out of alignment with the support surfaces.
If you are seeing any of these concerns, contact your local seating and wheeled mobility evaluation team and ask whether Dynamic Seating may be appropriate. More information.
Clinical goals include:
- To protect the client from injury
- To protect wheelchair and seating hardware from breakage
- To maintain client posture within the seating system.
- To increase sitting tolerance and compliance
- To provide vestibular input
- To provide active range of motion
- To increase alertness
- To decrease agitation
- To increase function
- To increase strength and postural control
- To reduce active extension
- To reduce energy exertion
Ordering Considerations
Complex Rehab Technology Equipment Suppliers can register to use our Request for Quote (RFQ) App at https://www.seatingdynamics.com/newregistrant/. After successfully registering, simply log on and enter your RFQ here https://www.seatingdynamics.com/registrantrfqs/.
Call us at 303-848-3838 and we can give you contact information for complex rehab technology equipment suppliers in your area.
Dynamic Seating Funding Back to top ⤴
This, of course, depends on the funding source. However, with proper justification, this equipment is often approved. Please refer to our Funding webpage for more information and sample justification wording.
Dynamic Rocker Back interface (DRBi) Back to top ⤴
General
In Dynamic Back design, two features reduce shear forces. First is the placement of the pivot point. The pivot point must be raised, ideally to a level just above the cushion surface. Second is the degree of movement. The Dynamic Rocker Back interface only opens the seat to back angle approximately 10-15 degrees. This amount of movement leads to a minimal amount of shear, allowing the client to remain in alignment with the contours of the back. By providing movement in response to force, alignment may actually be improved, and these shear forces are decreased. When a client extends within a static seating system, loss of alignment with the support surfaces, friction, and loss of position occur. When a Dynamic Back is used, the client maintains contact without loss of posture.
Compatibility
Currently there are over 50 different manual and power wheelchair models, the majority of all commonly used CRT wheelchairs, on which we can install a DRBi. For a full list of compatible wheelchairs, please click here . If you don’t see a brand and model listed, please contact us, we may have a solution.
Yes, a DRBi is very often installed on wheelchairs which are not new. For a full list of compatible wheelchairs please click here.
Yes. DRBis are used very often on tilt-in-space wheelchairs and is our most common installation. For a full list of compatible wheelchairs, please click here.
The DRBi is incompatible with a reclining back.
No, the installation of a DRBi will remove any folding back functionality.
The back of the seating system must move separately from the seat in order to activate the DRBi.
A molded back can generally be used with a Dynamic Rocker Back Interface for two reasons. First, the seat to back angle only opens approximately 10-15 degrees. This amount of movement leads to a minimal amount of shear, allowing the client to remain in alignment with the contours of the back. Second, the Dynamic Rocker Back is mounted with a pivot point that further reduces shear, again, allowing the client to remain in alignment with the contours of the back.
Installation and Adjustment
The DRBi should be installed by a trained technician or ATP at the complex rehab supplier offices. The PN 6100 Back Cane Saw and Drill Jig makes installation quick and easy.
We have warranty information for OEM manufacturers and non-OEM manufacturers.
Yes. The seat to back angle is adjustable through the wheelchair manufacturer brackets, if this is a standard or added feature. If Seating Dynamic brackets are used, the seat to back angle can be adjusted 80 – 120 degrees, depending on the base.
No, a DRBi is flush with the front of the back post.
This is dependent, of course, on the specific wheelchair frame and armrest options. With back cane attached armrest options, the armrests may be mounted too high. If this is the case, a seat mounted armrest may be more appropriate. This is more likely with a client of small stature.
Call or visit your supplier.
Elastomers (Resistance and Maintenance)
The DRBi includes a range of elastomers to change the resistance without having to order more equipment. The elastomers should allow the client to move the back and then assist the client back to a starting position. The default elastomer is clear (Medium). The least amount of resistance is the Yellow (soft) elastomer. Also available is Blue (Firm) and Green (Extra Firm). If the client cannot readily move the DRBi, less resistance is required. If the client does not readily return to a starting position, more resistance may be indicated.
The DRBi will respond with movement even if the client exerts more force on one side of their body. The DRBi is not designed to rotate and so we recommend that the same level of resistance by used on each backcane.
An extra firm elastomer may not provide enough shock absorption and movement. The elastomer with the least level of resistance that still allows posterior movement and return to a starting position is optimal.
Carrying any heavy object on the back or looped around the back canes will adversely affect the DRBi function and is not recommended. If a backpack is used, a firmer elastomer may be required to prevent movement of the DRBi soley from the backpack and instead provide movement in response to client forces. If you are still having difficulty, the DRBi may need adjustment. The supplier may need to make adjustments and/or replace worn elastomers.
The elastomers should be checked for wear every 6 months, depending on the frequency and forces applied. We have an elastomer replacement kit available for order through your supplier.
We have an easy to follow instruction guide on how to change the DRBi elastomers. To access this guide, click here. Changing the elastomers should take less than 30 minutes.
Call or visit your complex rehab supplier.
Latch (Lock Out)
The DRBi should be latched when the client is being transported in the wheelchair. Caregivers may also use latch when pushing a manual wheelchair over rough terrain to prevent excessive movement or during feeding. Unlatch the DRBi as soon as possible to allow the client to benefit from the dynamic feature.
The DRBi needs to be “un-weighted” in order to be latched or unlatched (i.e. push the back forward). If there is weight or pressure put on the DRBi, the elastomers are compressed, and the back cannot be latched smoothly. If you are still having difficulty, the DRBi may need adjustment. The supplier may need to make adjustments and/or replace worn elastomers.
Other
Yes. The pelvic positioning belt helps to maintain a neutral pelvic position during movement.
A positioning device, such as a pelvic positioning belt, is designed to maintain alignment with the support surfaces (i.e. the seat and back), provide stability and postural support and to promote function. A restraint is intended to limit movement to protect the client and/or others. For specific restraint regulations and documentation requirements to allow provision of necessary postural supports, please click here.
Yes, Dynamic Backs, Dynamic Footrests, and Dynamic Head Support Hardware can be used in combination with each other. For more information, please read our blog on this topic.
Dynamic Footrests Back to top ⤴
General
A client may benefit from Dynamic Footrests if you are seeing any of the following:
- The footplates are no longer in the correct position. These may be drooping or rotated outward.
- The footrest hangers are bent or broken.
- The footrest mounting hardware is broken.
- The client is injuring their lower legs against the footrest hangers (i.e. banging, bruising).
- The client is injuring themselves by pushing with force through the legs. This could lead to swollen and painful knees or ankles, patellar dislocation, tendon tearing, or even bone fracture.
- The client seeks out movement, such as knee extension or a kicking motion.
- The client is ‘standing’ on the footplates, getting leverage to ‘stand up’ in the wheelchair.
If you are seeing any of these concerns, contact your local seating and wheeled mobility evaluation team and ask whether Dynamic Footrests may be appropriate. The Dynamic Footrests may be combined with a Dynamic Back and/or Dynamic Head Support Hardware, as appropriate.
Seating Dynamics Dynamic Footrests can move in up to four directions:
- All dynamic footrests have telescopic movement. In other words, the footrests extend or get longer in response to force, up to 1.5”. When the force lessens, the dynamic footrest will return to its original length. The amount of the resistance can be changed by using different springs. Three springs of differing resistance are included. Using telescoping movement without knee extension is appropriate for clients who have very tight hamstrings and may slide into a posterior pelvic tilt with active knee extension.
- Dynamic knee movement allows the client to extend or semi elevate their knee up to 30 degrees. The footrests to be set at a starting point of 90, 80, 70, 60, or 50 degrees of knee flexion. Each footrest can be adjusted separately to meet an individual client’s needs.
- Another option is dynamic plantar and dorsi flexion at the ankle. This option allows approximately 10 degrees of movement in either direction. This should not be used when the client has an AFO (ankle foot orthosis), as this will not allow the ankle to move. The footplate to footrest hanger starting angle is adjustable.
Footplate rotation: When the lower extremity is extended, external rotation may be present, leading to the feet turning outward. The footplates rotate outward in response to client forces and then return to a set starting position.
In general, use of dynamic footrests that lengthen only is appropriate for clients who may lose the position of the pelvis if the knee also extends, such as clients with very tight hamstrings. If the position of the pelvis can be maintained, combining lengthening and knee extension provides more movement and active range at the knee. If the client has active ankle dorsi and/or plantar flexion, providing this option allows movement and active range at the ankle, as well. If the client wears AFOs, this movement will not be possible and so this option is not recommended. Finally, if the client tends to rotate their foot outward during extension (external rotation), then the rotating footplate will rotate in response to client forces and return the foot to a set starting position. For more information, click here.
Yes, the client’s feet need to be secured using ankle and/or toe straps, “ankle huggers” or shoeholders with straps to maintain contact with the footplate and activate the dynamic footrests. Otherwise, the feet may simply move off of the footplate during movement.
A positioning device, such as an ankle strap, is designed to maintain alignment with the support surfaces (i.e. a footplate), provide stability and postural support and to promote function. A restraint is intended to limit movement to protect the client and/or others. For specific restraint regulations and documentation requirements to allow provision of necessary postural supports, click here.
Yes. Lateral Knee Pads are available for any Dynamic Footrest with knee elevation. These pads are indicated for a client who would otherwise contact the metal surfaces of the Dynamic Footrest with the lateral knee and/or lower leg.
Compatibility
Currently we offer dynamic footrests for approximately 35 different models of wheelchairs. For a full list of compatible wheelchairs, please click here.
Dynamic footrests are not available at this time for center mount applications. We are able to supply a dynamic footrest for most “side mount” style footrest hangers.
Manual or power elevating and / or articulating legrests (ELRs) are not compatible as both interventions open the knee angle. Clients with increased tone and force are able to readily move a manual ELR in extension and cannot return to a starting position. Clients with increased tone and force may not tolerate a power ELR as external force is pulling against a tight muscle. Dynamic Footrests move in response to client force and only as far as the client has active range.
The different wheelchair must have Seating Dynamics receivers. We suggest you contact us to confirm compatibility between the two wheelchairs. We are happy to speak with you to verify if current dynamic footrests can be reused or if a new receiver and/or other components are required.
Installation and Adjustment
We provide a “receiver” for the footrest. This receiver mounts to the wheelchair, typically to the seat frame. Each receiver is designed for a specific model wheelchair.
Yes, the Seating Dynamics footrests will swing away (in or out) or lift out from the wheelchair by simply sliding the release button located on the outside of the receiver to the rear. Swinging inward allows the footrest to move out of the way for a transfer when there is not room to the side of the wheelchair for the traditional swing-out style of footrest hanger.
Yes, the dynamic footrests have 2.5 inches of length adjustment.
A one-piece footboard can be added to the dynamic footrests unless the footplate rotation option has been selected. In this case, separate footplates are required.
If the footplates are rotating, and you are not using our rotating footplate option, please contact us so that we can determine the cause and instruct you on the appropriate solution.
Elastomers and Springs (Resistance and Maintenance)
The telescoping feature can be adjusted by changing a spring. Knee extension resistance and plantar/dorsi flexion resistance has been standardized to a single resistance level. The footplate rotation resistance can be increased by adding or removing a second spring. Please read our blog on this topic by clicking here.
The elastomers and springs can be changed when worn to maintain optimal functioning. As the elastomer or spring repeatedly absorbs strong forces, wear occurs to this replaceable component, protecting the client from injury and the equipment from damage. The springs (used for telescoping and footplate rotation movements) generally do not require replacement. We recommend checking the elastomers for wear every 6-12 months. In general, if a client is moving the Dynamic Footrests in a certain direction too readily or not returning to a starting position, the elastomers most likely need to be replaced.
Yes, each Dynamic Footrest can be individually adjusted to meet an individual’s needs. Client forces may be stronger on one side of the body than the other. Forces can also fluctuate throughout the day and so the resistance level may need to accommodate these variations.
Other
Yes, Dynamic Backs, Dynamic Footrests, and Dynamic Head Support Hardware can be used in combination with each other. For more information, please read our blog on this topic.
Static Adjustable Footrests Back to top ⤴
General
Our static footrests are very durable and will maintain position even under great force. If you are working with a client who is moving their footplates out of position or damaging the footrest hanger, you should first consider absorbing and diffusing these forces through our Dynamic Footrests.
- Our Adjustable Windswept upper footrest hardware is designed to accommodate increased hip adduction on one side and increased hip abduction on the other side.
- Our Adjustable Super Contracture upper footrest hardware is designed to accommodate significant knee flexion contractures. Seating Dynamics also provides adjustable plantar and dorsi flexion extensions.
- Plantar Dorsi lower extension footrest hardware is designed to accommodate significant ankle range limitations and maintain footplate position.
Yes, our Adjustable Knee upper footrest hardware provides a wider range of knee angles using hardware that is very durable and will not lose position.
Yes, our Adjustable Windswept upper footrest hardware is designed to accommodate increased hip adduction on one side and increased hip abduction on the other side. This hardware can also accommodate bilateral hip adduction or abduction.
Yes, our Adjustable Super Contracture upper footrest hardware is designed to accommodate significant knee flexion.
One-Piece Footboard
Yes, we do offer a one piece footboard that also flips-up for transfers. A one piece footboard provides a wider space to accommodate the feet where needed and also will not “sag” medially as many footplates tend to do over time and under force. This also prevents the feet from falling into the space between the footplates.
Dynamic Head Support Hardware Back to top ⤴
General
A client may benefit from Dynamic Head Support Hardware if you are seeing any of the following:
- The head support pads are moving out of alignment.
- The head support pads, or hardware are broken.
- The client is able to move into neck hyperextension.
- The client repeatedly contacts the posterior head pad with force (banging).
- The client pushes with sustained force against the posterior head pad.
- The client is rotating their head, losing contact with the posterior pad, and falling forward.
If you are seeing any of these concerns, contact your local seating and wheeled mobility evaluation team and ask whether Dynamic Head Support Hardware may be appropriate. The Dynamic Head Support Hardware may be combined with a Dynamic Back and/or Dynamic Footrests, as appropriate.
Yes, the Dynamic Head Support Hardware will move posteriorly in response to client posterior and/or rotational movement. Approximately 10 degrees of movement is available posteriorly. The resistance can be changed using different elastomers.
Compatibility
For a full list of compatible head pads, please click here.
Installation and Adjustment
Yes, the sub-occipital pad adaptor is available to support a sub-occipital pad. The sub-occipital pads are available separately from the manufacturer.
Yes, our Lateral Component Hardware supports the Stealth Products lateral swing away assemblies. These assemblies are available separately from Stealth Products and can be used to mount a lateral pad or a switch.
Seating Dynamics offers two options: First, our dynamic head support hardware will attach to any surface with a universal mounting pattern (2” x 2” or 1” x 2”). Second, a spreader bar mount is available if the universal mounting bracket will not work, dependent on the type of back used. This is width and depth adjustable. A quick release mount is available to easily remove the head support.
A pad adaptor is installed to the head pad and then to the dynamic head support hardware. Instructions can be found here.
We do not offer a flip-down mount, as these tend to become loose and are not as durable. We do offer optional Removable Mounting Hardware.
Yes, you can use the Stealth Products i2i head support, as long as you order our removable mounting hardware. The angle of our hardware, depending on how the links are adjusted, allows the i2i to slip upward off of the client without the need to move the client forward or back.
Elastomers (Resistance and Maintenance)
Dynamic head support hardware resistance has been standardized to a single resistance level.
The elastomers should be replaced if worn and should be checked every 6 months. If the head support does not readily return to a starting position, the elastomers may need to be replaced.
Lockout Feature
Yes, the Dynamic Head Support Hardware can be locked out, preventing movement, by pulling the red knob on the right side of the base. To restore movement, simply push in the knob.
The Dynamic Head Support Hardware should be locked during transportation. It may also be helpful to lock the hardware when moving over rough terrain to prevent excessive movement. Finally, it may be helpful to lock the hardware during feeding to increase stability for the client.