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Jonathan – Managing Extreme Extensor Tone

Jonathan is a 23 year old man with the diagnosis of cerebral palsy with significant extensor tone. Learn how Dynamic Seating, when used in combination throughout the body can eliminate equipment breakage, relax the body and improve function. 

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Why Movement Helps People With Brain Injuries

“Jackson” (named has been changed) was in a car accident when he was only 6 years old and sustained a significant brain injury. As a result, he was unable to move himself, communicate with others, or control anything in his environment. He has been using various mobility bases since that time.

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Dynamic Seating for People with Cerebral Palsy

Dynamic Seating is movement which occurs within the seat and/or wheelchair frame in response to force from the client.  Dynamic components absorb force which in turn assists the client back to a starting position. Dynamic Seating is frequently used to prevent equipment breakage, prevent client injury, diffuse extensor tone, and provide movement. For people with cerebral palsy who use a wheelchair, Dynamic Seating is a great option for many reasons.

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Determining if a Dynamic Back is Appropriate

In general, if a client has moderate to significant hip extension, is seeking movement, and/or has a history of equipment breakage, a Dynamic Back may be appropriate. However, trialing a Dynamic Back can be challenging, as the frame may have to be modified to trial this equipment. How do you determine if this intervention is appropriate without actually trying it?

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Seating Dynamics Dynamic Footrests Diffuse Tone and Respond Individually

Spencer has cerebral palsy and very strong extensor tone. His Dynamic Footrests move in response to his extension and diffuse his tone. Without Dynamic Footrests, Spencer ‘stands’ in his wheelchair! He also does not move the same on both sides of his body. The Seating Dynamics Dynamic Footrests move in response to each leg, regardless of the degree of force or movement.

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Seating Dynamics Dynamic Telescoping Footrest for Wheelchair Movement

Some clients may benefit from a telescoping feature in their wheelchair footrest. This client may have very tight hamstrings which limit active knee extension. The telescoping feature can absorb and diffuse force. Knee extension, in combination with the telescoping feature, follows the natural arc of movement which occurs when the knee is straightened.

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Determining if Dynamic Footrests are Appropriate

In general, if a client has moderate to significant extension and/or has a history of equipment breakage, Dynamic Footrests may be appropriate. You may note that the client is extending at the knees, exerting significant force on the footplates, or actually leveraging off of the footplates and elevating the pelvis clear off of the seating…

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