Innovative Technologies for People with Cerebral Palsy: A Study of Dynamic Wheelchair Seating and User Perceptions - Many people with cerebral palsy(CP) require a manual or power wheelchair for mobility. Some of those people also demonstrate increased muscle tone that contributes to large and forceful extraneous body movements, whole body extensor spasms, and/or repetitive rocking while seated. As these individuals extend and/or move their bodies against static seating surfaces (i.e., seat and back), they can sustain injuries to their bodies, pain, loss of postural alignment, and damage to their equipment. Dynamic seating (DS) is an under-utilized and under-funded technology designed to assist individuals who have excessive force and movement while in a wheelchair seating system. This technology integrates with the seating frame of the wheelchair, and as the user extends and moves, the seating system moves with their body to accommodate and absorb the force they generate. When the individual relaxes or stops moving, the energy stored in the DS components helps them return to their previous sitting position. DS is often recommended to minimize the user’s risks for injury, postural instability, pain, and equipment damage. People with cerebral palsy who use DS are a small and underrepresented group in research who often require extensive support from their caregivers. Early evidence suggests that DS can have a meaningful impact on health and quality of life. However, research in this area is limited. Most studies to date consist of small sample experimental designs, case studies, and technical evaluations. No known study examines the characteristics of people using this technology, their patterns of use, or their perceptions about its impact on their lives. Experts argue, however, that it is vitally important to consider user perspectives when determining the technology effectiveness. To better understand the characteristics, patterns-of-use, and perceptions of people who use DS, I am requesting grant funds to support a mixed-methods study. This study will include the development and dissemination of a cross-sectional survey to individuals who use DS and their caregivers, followed by semi-structured interviews with a subset of participants. Survey data will be collected and used to investigate the characteristics of users, their patterns-of-use, and their perceptions about the impact of DS on their health, functional abilities, social engagement, and satisfaction with their equipment. Data from semi-structured interviews will be used to understand user perceptions in greater depth, and to explore the impact of these technologies on their lives, participation, and experiences of disability. This study aligns well with NIDILRR’s overarching aim to evaluate the experiences and outcomes of people with disabilities by seeking input from users and their caregivers directly. Unfortunately, DS is a poorly understood technology. Early research suggests that it can have many positive impacts on those who use it, yet it remains under-utilized and poorly funded. By using both quantitative and qualitative methodologies, and by applying a critical lens to understanding how DS impacts the lives of those who use it, the data from this study will guide clinicians, researchers, and policy makers as they make decisions about the potential medical, functional, and social benefits of this technology. As the impacts of these technologies are discovered, this information may ultimately improve the participation and community living of some of society’s most vulnerable individuals.
