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

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 REHABILITATIONDynamic 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.

RESNA position on the application of power mobility devices for pediatric users.

This paper serves as an update to the previous RESNA Position on the Application of Power Wheelchairs for Pediatric Users with more current and additional scientific literature. This document contains typical clinical applications and best evidence from the literature supporting the application of power mobility (PM) for young children and to assist practitioners in decision-making and justification. It is RESNA' s position that age, limited vision or cognition, behavioral issues, and the ability to walk or propel a manual wheelchair short distances should not, in and of themselves, be used as discriminatory factors against providing PM for children. RESNA recommends early utilization of PM for children with mobility limitations as medically necessary, to promote integration and psycho-social development, reduce passive dependency, and to enhance participation, function, and independence.

RESNA position on the application of dynamic seating.

Dynamic Seating is an intervention used as a part of a manual or power wheelchair to provide movement against resistance in response to client force. This technology can be used for various clinical applications including preventing client injury and equipment breakage; dissipating extensor forces; providing movement for sensory input, calming, and increased alertness; increasing muscle strength, trunk and head control; and other medical benefits. The purpose of this RESNA Position Paper is to provide a definition for this technology in relation to other seating and wheeled mobility technologies as well as present clinical indicators for this seating intervention including literature to substantiate these claims. Although more recent and stronger evidence is needed, existing research does support the application of dynamic seating in numerous clinical scenarios.

RESNA position on the application of seat-elevating devices for wheelchair users.

This document, approved by the Rehabilitation Engineering & Assistive Technology Society of North America (RESNA) Board of Directors in September 2005, shares typical clinical applications and provides evidence from the literature supporting the use of seat-elevating devices for wheelchair

RESNA position on the application of power wheelchairs for pediatric users.

This document, approved by the Rehabilitation Engineering & Assistive Technology Society of North America (RESNA) Board of Directors in March 2007, shares typical clinical applications and provides evidence from the literature supporting the use of power wheelchairs for children.