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.