Section 1 - Important; Section 2 - Assessment Notes - Active Design Dynamic Footrest Operating Instructions Manual

SECTION 1 - IMPORTANT

Caution, Dynamic Seating components must be used with care, and
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consideration given to all factors, in particular ensuring that inappropriate
movement patterns are not promoted.
Dynamic Footplates should not normally be used with a kneeblock. A
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'P-shaped' adjustable or fixed pommel should be used. Where the travel
of the footrest assembly is less than 25mm (such as on the Double Plate
Type), a kneeblock may be used subject to it being checked. In this case,
you must ensure that on full extension, the front surface of the knee is still
in contact with the full surface of the kneecup, and not the bottom edge.
By fitting and using this Dynamic Footrest Assembly, you confirm that you
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have fully read these instructions, in particular Section 2 – Assessment
Notes and has been taken into account during your clinical
decision-making. You also agree that you will provide feedback on the
use of the footplates to further improve their clinical application.
This Dynamic Footrest must only be fitted by a competent person.
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SECTION 2 – ASSESSMENT NOTES
Dynamic footplates could considered after assessment and configuration of
standard seating, and found that a person demonstrated a need to move within
the seated position using an extension pattern which uses the footplates and
backrest or headrest for leverage.
Research suggests (Nwoabi et al, 1983, 1987) that orientation of the trunk behind
the base of support will often produce increased extensor tone in people with
spastic CP, which reduces their pelvic stability, and therefore their ability to
function effectively.
Rather than accommodate active extension as a total pattern, a better solution
may be to accommodate the need to extend by provision of a footrest assembly
which moves with their legs into extension, rather than utilising total body
extension.
It should be possible to maintain pelvic stability with the usual configuration of
sacral support, pelvic lateral pads, a seat cushion with a flat ischial area and
reduced ramped cushion.
The need to manage any asymmetry at their pelvis should be achieved via a one-
piece pommel or medial pads only, and not through the application of standard
kneeblocks, as the movement of the knees downwards may cause them to get
caught under the lower edge of the kneeblock cup as they relax.
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