- Cerebral palsy
- Traumatic brain injury
- Spinal cord injury (when spasms are present)
- Huntington’s Chorea
- Other diagnoses where increased tone is present
- Cerebral palsy
- Developmental disabilities
- Sensory processing disorder (when a wheelchair is also required)
- Other diagnoses where the client seeks out movement
- To protect the client from injury
- To protect wheelchair and seating hardware from breakage
- 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
It is also important to ensure the client return to an appropriate posture. For example, a client may return to upright after extending at the hips, but assume a posterior pelvic tilt. Individual manufacturer’s dynamic components work differently and may vary in ability to return the client to an optimal posture.
Some clients may experience increased extensor tone and/or postural insecurity and anxiety in response to dynamic movement. Decreasing the amount of movement may help.
Check out our blog entry for more information.
Installation and Adjustment:
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 an upright position. The least amount of resistance is the Yellow (soft) elastomer. The strength of the elastomer initially installed in a new DRBi is Clear (Medium). If the client is able to completely compress the clear (Medium) elastomer, then the Blue (Firm) should be evaluated. The next step is to evaluate the green (Extra Firm) elastomer.https://www.seatingdynamics.com/2018/02/06/much-much-choosing-resistance/ https://www.seatingdynamics.com/2021/03/01/quick-class-dynamic-seating-resistance-drbi-back/
Latch (lock out):
The DRBi should be unlatched all the time, except when the wheelchair is being transported with the client in the chair. Remember to unlatch the back as soon as the wheelchair and client leave the vehicle.
Occasionally you may want to latch the DRBi when pushing a manual wheelchair over rough terrain to prevent excessive movement, but remember to unlatch as soon as possible to prevent breakage of the DRBi and to allow the client to benefit from the dynamic feature.
Education about the equipment and how and why it works is essential. A DRBi which is latched when not in transportation is not allowing the client to benefit from the dynamic feature.
The DRBi needs to be “un-weighted” in order to be latched / unlatched. 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 adjust the bolt going through the elastomers.
If the DRBi is more than 2 years old, the elastomers may need to be replaced. We have a re-build kit for this, which may be obtained through the supplier. The re-build kit includes upper and lower elastomers as well as plastic caps for the top of the elastomers.
- All dynamic footrests have dynamic 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. All 3 resistance springs are included in the purchase. Using telescoping movement without knee extension is appropriate for clients who would need dynamic movement, but who may lose hip position when the knee extends. This can be an issue particularly with clients who have very tight hamstrings. This model is not available in the high pivot design.
- Dynamic knee movement which allows the wheelchair user to extend or semi elevate their knee up to 30 degrees. This allows 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 up to approximately 17 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.
- Extension at the knee which creates a pull between the seat frame and the footrest hanger. This could result in seat frame and/or footrest hanger damage.
- Downward pushing or banging of the foot on the footplate. This could lead to bending or breaking at the footplate, footplate attachment, the footrest hangers and/or the seat frame. This may be first noted as reduced clearance between the footrest / footplate and the front caster.
Installation and Adjustment:
Elastomers and Springs:
Check out our blog post for more information.