Page 11 - Mobility Management, September/October 2022

components absorb force which, in turn, assists the client back to a starting position.”
Preventing Potential Injury & Equipment Breakage
Dynamic seating components can be helpful to different wheelchair clients for different reasons.
Pedersen cited the RESNA Position on the Application of Dynamic Seating, a paper available at resna.org. She and Lange were among the paper’s authors.
“To paraphrase: Two big things that we look at is we want to protect that indi- vidual so that they don’t hurt themselves,” Pedersen said about the position paper. “If they’re having hyper-extension in their trunk or in their legs, they’ll come back [into position]. And they won’t get hurt.
“And the equipment won’t get broken. So it’s a two-way situation. You’re trying
not to have this continued breakage, because you have somebody with such powerful force that they break the footrest or they crack the backrest. You can have that dynamic component that will afford them that resistance and then save the equipment.”
Lange said it’s important that this force exerted by clients be given a safe outlet, a harmless way to be expended. Otherwise, the force is turned back onto the client.
“It’s going into the joints,” Lange said. “What happens is clients move out of position — like standing up in their seating system during extension — and then they don’t land back in an appro- priate position, often winding up in
a posterior pelvic tilt. And also, that unrelieved force goes somewhere, and it’s usually their joints.”
She recalled a report she read: “There was an interesting article about adults
with cerebral palsy who developed arthritis in their joints far earlier than the average population. I think a lot of it is because you have these massive forces, and if you can’t move to relieve those forces, they’re going to end up where there’s any movement — and that’s in
the joints. There’s a little movement in the joints, and you’ve got this huge force. Can you imagine what your knees would feel like if you were exerting enough force for your legs to stand up in your chair,
to move your footrest out of position and sometimes to even break the footrest hanger?”
“You don’t want that femur jamming into the acetabular joint,” Pedersen affirmed. “You don’t want something happening with the ankles or the knees. And so you’ve got to look at those three joints and see where you want that dynamic to come into play.”
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