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In the rapidly evolving field of Complex Rehab Technology, innovation is no longer a future promise — it’s happening now. From assistive devices that boost independence to seating systems that rethink posture and function, emerging technologies are transforming how clinicians support mobility, comfort and quality of life. At the heart of this transformation are clinician-innovators — individuals who combine frontline experience with creative problem-solving to birth new solutions.

One such innovator who embodies this intersection of clinical practice and inventive design is Bart Van der Heyden, PT, owner of Superseating. Bart is a physical therapist whose deep understanding of movement, human function and unmet clinical needs informs his work. His recent inventions — now on the market through leading manufacturers — illustrate how clinician-led innovation accelerates advancement in CRT.

The need for innovation in CRT

CRT serves individuals with significant mobility limitations due to neurological, congenital or traumatic conditions. CRT isn’t just equipment; it’s a lifeline. Devices must optimize function, promote independence and support health over the lifespan.

Yet the complexity of the human body, the diversity of clinical presentations and everyday life demands challenge designers and clinicians alike. Traditional products often address singular needs — stability or mobility, posture or comfort — leaving gaps in function or user experience.

Emerging technologies — materials science, self-adjusting support systems and user-centered design — are bridging these gaps. When clinicians lead product conceptualization, the results can be transformative.

The quadruple helix model, an innovation framework involving collaboration among academia, industry, government and civil society, has increasingly highlighted the critical role of clinicians in the development of products for wheelchair seating and mobility. Clinicians through their direct interaction with client challenges can offer indispensable insights into user needs, ergonomics and functionality, which are essential for creating effective and user-friendly seating and mobility solutions.^1,2 

Innovation #1: A dynamic arm support

Van der Heyden’s journey toward innovation began with a recurring clinical observation: Many wheelchair users with weak or uncoordinated upper extremities suffer from glenohumeral subluxation, leading to damage of the non-elastic shoulder capsule, range of motion deficits and shoulder pain. Prevalence rates of GHS with clients post stroke range from 17 % to 81% but are also high with other client populations.

A second observation is the high prevalence rate of wrist and finger contractures.  Up to 84% of clients with traumatic brain injury develop contractures.  Conventional wheelchair arm supports often fail; pillows don’t stay in place or do not provide enough support to prevent contractions and GHS.

This triggered Van der Heyden to dive into the pathomechanics of GHS and hand contractures and develop a prototype based on three key principles: 1) a contoured elbow support to stabilize the GH joint; 2) when deep wrist and finger flexor muscles (flexor digitorum profundus, superficialis, flexor carpi radialis and ulnaris) are short they influence the elbow, wrist and fingers. In order to manage the effect of tone in these muscle groups the elbow, distal forearm and hand needs to be supported with the hand supported minimizing adversely sensory input and neutral joint positions of the articulation of the hand. When tone occurs of the deep flexors, metacarpal and phalangeal flexion is possible while interphalangeal joints remain extended. 

Van der Heyden developed a proof of concept and a prototype and collaborated with engineers to translate clinical insight into mechanical design. The final product, called Dynamic Arm Support, licensed to Bodypoint, is now available on the market. The Dynamic Arm Support³ is a mobile support for the elbow, forearm and hand that attaches to a manual or power wheelchair. It provides upper extremity support, functional dynamic range of motion at the shoulder and an innovative, flexible hand support that promotes hand function and helps to minimize flexor tone and contractures. This product includes modular components that can be adjusted for a customized orthotic fit. A pivot mechanism allows users to exercise the shoulder in a functional, dynamic range of motion. The flexible hand support helps to position the wrist, hand and fingers in neutral alignment and minimize flexor tone and contractures. This product is designed to be mounted on a variety of wheelchair models with height adjustable armrests and can be easily removed for transfers by utilizing the quick-release function. 

More info:  https://app.bodypoint.com/product/dynamic-arm-support-kits

Innovation #2: Postural variation seating concept/EPiC seating.

Van der Heyden’s second major innovation addressed the limitations of current positioning approaches and technology in the field. He made the following observations:

1. Static seating solutions often fail because of postural fatigue setting in. The wheelchair user often sits in the same position for extended periods of time leading to fatigue of postural muscles, kyphotic seating, sliding and a flexed head position.
2. Lumbar support has limitations: Clients seated in a passive position (posterior pelvic tilt) tend to have a flat and posteriorly oriented lumbar spine. In addition, lumbar segments tend to be stiff, so the force created when pushing the lumbar spine toward lordosis and extension generates a sliding force resulting in a slouched position and sliding forwards position.
3. Recline systems have an axis of movement different than the movement of the wheelchair user, so recline backward changes the position of postural supports upward in relation to the user’s spine (laterals, pelvic, lumbar supports and head support position changes in relation to the spine). The opposite movement is occurring when reclining forward so variation in recline during the day has a consequence on the client’s posture.

His observations have led to an ergonomic study whereas a new postural concept was developed, tested and validated: 

1. A seat with an adjustable PSIS support was developed to accommodate to hip range of motion deficits of wheelchair users.
2. The lower thoracic area can move in sync with the client’s back so laterals, pelvic, lumbar supports and head support position remain aligned regardless of adjustments made.
3. Bringing the lower thoracic area backward with the PSIS supported increases lumbar lordosis without direct force on the lumbar spine. Instead, the lumber spine moves actively towards to the position of the thoracic spine.
4. Postural variation is introduced whereas the caregiver can change the position during the day for function or comfort without postural consequences.
5. For clients with tone, the system can self-adjust to postural changes and tone. The system’s range of movement and resistance level can be adjusted individually according to each client’s needs.

Clinical trials have showed that most wheelchair users benefit from this approach, from users with degenerative conditions such as multiple sclerosis, muscular dystrophy, motor neuron disease, ALS and Parkinson’s disease to users with postural deficits and clients with tone.

Together with the engineers at Stealth Products a postural system called EPiC (Effortless Postural Control) seating was developed.⁴ The EPiC system is added to the existing mobility base using adaptor tubes and provides an adjustable PSIS support and anatomically segmented postural support, which can be operated without tools. Releasing the handles maintains an alignment and locking the same handles will absorb tone and allow postural variation or movements of the client. Range of motion and resistance of client movement can be individually adjusted.

More info :  https://epic-seating.stealthproducts.com

Van der Heyden’s design process highlights key principles: observe clinical needs, iterate through prototypes, collaborate with manufacturers and license strategically. His work demonstrates how clinician-driven innovation can shape the future of CRT.

As emerging technologies continue to evolve, innovators like Van der Heyden ensure that CRT solutions remain grounded in real human needs — improving independence, function and quality of life.

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References:

1. Etzkowitz, H., & Leydesdorff, L. (2000). The dynamics of innovation: From National Systems and “Mode 2” to a Triple Helix of university–industry–government relations. Research Policy, 29(2), 109-123. https://doi.org/10.1016/S0048-7333(99)00055-4
2. Carayannis, E. G., & Campbell, D. F. J. (2009). ‘Mode 3’ and ‘Quadruple Helix’: Toward a 21st century fractal innovation ecosystem. International Journal of Technology Management, 46(3-4), 201-234. https://doi.org/10.1504/IJTM.2009.023374
3. Bodypoint, Inc. (n.d.). Dynamic Arm Support. Retrieved from https://www.bodypoint.com/dynamic-arm-support
4. Stealth Products, LLC. (n.d.). Epic Seating System. Retrieved from https://www.stealthproducts.com/epic-seating-system

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Bart may be reached at info@superseating.com.

Bart Van der Heyden, RPT, is a skilled and well‑known clinician with more than 29 years of experience in wheelchair seating and wound care. He is also the owner of a physical therapy clinic in Ghent, Belgium. He founded SuperSeating, a seating competence center that develops and delivers clinical courses for health care professionals on seating and wound care challenges. Through SuperSeating, he has presented courses around the world and created methods and techniques that enhance seating assessments, interventions and clinical decision‑making. Van der Heyden has collaborated with innovative manufacturers globally, supporting them with training materials, clinical expertise and research and development initiatives. He has also served on the scientific committees of POSITI’F, the French National Wheelchair Seating Conference, the European Seating Symposium and the International Posture and Mobility Conference in the U.K. Since founding SuperSeating in 2009, he has inspired clinicians worldwide with his structured approach to solving complex seating needs, including a five‑step program and unique clinical assessment techniques for evaluating supra‑ and infra‑pelvic scoliosis, kyphosis, dystonia and lower‑extremity range‑of‑motion deficits. In addition to supporting seating-, mobility- and support‑surface manufacturers with product development and clinical education, his ergonomic expertise is sought after even outside the medical equipment industry by prominent manufacturers looking to optimize user comfort and performance.

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