Clinical changes as a result of dynamic seating in a young adult with cerebral palsy

Abstract

Purpose

This case study follows a single participant with cerebral palsy through 15 years of wheelchair seating interventions. Positioning challenges within the wheelchair seating system included significantly increased muscle tone, extension patterns, extraneous movement, loss of body position in relation to the seating system, loss of alignment with other assistive technologies, high energy expenditure, client injury and pain, and equipment damage. The purpose of this article is to present clinical changes seen in this participant during a progression of dynamic seating interventions.

Case Description

includes four separate seating and wheeled mobility evaluations over an eight-year time frame and subsequent equipment recommendations. A key intervention was the application of dynamic seating. No standardized assessments for wheeled seating and mobility evaluation are available, at this time.

Outcomes

the recommended interventions resulted in reduced extension patterns, extraneous movement, loss of position and alignment with other assistive technologies, energy expenditure, client injury and pain, and equipment damage. Further, functional gains and increased seating tolerance were noted.

Conclusion

dynamic seating may address numerous positioning challenges in clients with increased muscle tone in conjunction with an appropriate seating system and mobility base.

IMPLICATIONS FOR REHABILITATION

• Dynamic seating may:

• •Dissipate client forces to reduce active extension.

• •Protect a client from injury by reducing intermittent and sustained forces.

• •Protect wheelchair seating, mounting hardware, and the frame from loss of alignment and damage.

• •Provide movement to decrease agitation and increase alertness.

Keywords:

• Assistive technology
• wheelchair seating
• dynamic seating
• cerebral palsy
• muscle tone
• client injury
• equipment breakage
• case report

Acknowledgements

The author would like to acknowledge Brady and his family, his equipment supplier TD Schenck of Numotion, Aspen Seating, and Seating Dynamics.

Disclosure statement

I provide consultation and education for Seating Dynamics and Stealth Products who both manufacture dynamic seating components. In accordance with Taylor & Francis policy and my ethical obligation as a researcher, I am reporting that I am a consultant to a company that may be affected by the research reported in the enclosed paper. I have disclosed those interests fully to Taylor & Francis, and I have in place an approved plan for managing any potential conflicts arising from that involvement.