As a supplier or clinician, how do I determine which dynamic movements are appropriate for an individual?

Dynamic seating is a relatively new area of wheelchair seating and many providers are needing further information. It is important to identify if the issue is caused by muscular or behavioral conditions. This will assist in determining what needs to be addressed.   We have a number of resources on our website and are also happy to speak with you by phone.

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, lengthening and knee extension provides more movement and active range at the knee. If the client has active ankle dorsi and 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.

As a parent/caretaker, how do I know which dynamic movements the client needs?

Please contact your local supplier and clinician for evaluation of specific needs. A good starting point is to try to identify the problem. If you are experiencing breakage of the wheelchair components, try to isolate the specific area and see which type of movement caused it. There are two primary movements which tend to cause breakage:

  • 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.

In which directions do the dynamic footrests move?

Seating Dynamics footrests can move in up to three different axes:

  • 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.

https://www.seatingdynamics.com/2017/01/17/dynamic-footrest-hangers-design/