Netti Dynamic User Manual

My-Netti.com

DYNAMIC SYSTEM

COMFORT

Netti Dynamic System

Seat-, back- and head-support

USER MANUAL AND

MOUNTING DESCRIPTION

2

Model: Netti Dynamic System

Language: English Version: 2016-03

CONTENTS

1. INTRODUCTION.................................................. 3

The Netti Dynamic System Concept

What is Netti Dynamic Seating?.................. 3

Short explanation of relevant diagnosis
and a matrix for which Netti Dynamic

solutions are suitable ...................................... 4

Intended use and important benefits........ 5

Netti Dynamic models and components...6

How to use this manual................................... 6

Netti Dynamic System:

Maximal extension………................................…. 7

Exploded view of Netti Dynamic

System……………..................................................... 8

2. ADJUSTING THE WHEELCHAIR

TO THE USER ...................................................... 9

Seat adjustments - balancing the chair .... 9

Seat depth .......................................................... 10

Seat angle ........................................................... 11

Seat plate ............................................................ 11

Seat plate lock .................................................. 11

Assessment and choice of Netti Dynamic

back support gas cylinder………..................... 12

Option 1: Variolock............................................ 12

Option 2: Full Free gas cylinder ................. 12

Overview of available recline cylinders.... 14

Technical specification and options of
Netti Dynamic back support gas

cylinders .............................................................. 14

Chair back height ............................................. 16

Netti Dynamic head support ....................... 16

Arm support position ..................................... 17

Harnesses and belts: Mounting,

positioning and adjustments ...................... 17

How to adjust the pelvic stabilizer ....……. 17

Ankle huggers and shoe shells .................. 18

Foot support height and angle .................. 18

3. EVERYDAY USE OF THE NETTI

DYNAMIC SYSTEM ................................ 19

Transfer to / from the wheelchair ... 19

Attendant use ......................................... 20

Push bows and push handles............ 20

Anti tips .................................................... 20

Brakes ........................................................ 20

Arm supports ........................................... 21

Foot support ............................................ 21

Foot board lock ...................................... 21

The foot support angle ………………..... 22

Harnesses ................................................. 22

Key words: tilt and recline of static
comfort wheelchairs, and common

features of dynamic wheelchairs...... 22

Tilt and recline of dynamic comfort
wheelchairs with «OK-C» movement23
Operating tilt handle: Tilting the

seating unit................................................ 24

Operating recline handle: Reclining

the chair back ......................................... 25

Safety guidelines when leaving a

user in the wheelchair........................... 26

Wheelchair used as seat in a car .... 26

Lifting the wheelchair .......................... 26

Driving a wheelchair with

Netti Dynamic System ......................... 26

4. MOUNTING DESCRIPTION

Changing the back gas cylinder ...... 27

5. NETTI DYNAMIC COMPONENTS

AND ACCESSORIES ............................. 30

6. TRANSPORT ............................................ 33

7. MAINTENANCE ...................................... 33

8. TROUBLESHOOTING ........................... 33

9. WARRANTY ............................................. 34

10. APPENDIX Medical terms and

diagnosis with reference to Netti

Dynamic System..................................... 34

3

Dynamic System

COMFORT

Model: Netti Dynamic System
Language: English Version: 2016-03

1. INTRODUCTION

The Netti Dynamic System
Concept:
What is Netti Dynamic Seating?

Netti Dynamic System is a tilt and
recline wheelchair which allows
controlled Open Kinetic Chain
(OK-C) movements of the user.
Static comfort wheelchairs can
be accommodated to support the
user’s distal segments. The con­trolled OK-C movement has an
extra impact: The distal segments
can move, with a moderate resist­ance. OK-C helps to gain control of
the proximal segments, especially
when the user cannot inhibit
muscle movements due to their
medical condition.

Netti Dynamic System is a modu­lar system that can be customized
and adjusted according to the
user’s need.

Typically Netti Dynamic System or
its components may be used for
wheelchair users with involuntary
movements.

Examples of involuntary
movements are:

- Dystonia (involuntary, sustained
or intermittent muscle contractions
that can cause twisting and repeti­ tive movements, abnormal posture
or both. Muscle tone varies from
normal or hypotonia to hypertonia.

- Athetosis (slow, involuntary writh­ ing movement)

- Chorea (brief, irregular jerking
movements)

- Tremor (This is a rhythmic move­ ment of part of the body)

- Hemiballism(These are wild fling­ ing/throwing movements of one
arm or leg, usually occurring as a
result of a cerebrovascular event)

- Clonus (rapid muscle jerks that are
frequently repetitive)

Before using Netti Dynamic System
(NDS) or any of its components, a
seating assessment should be carried
out by a trained professional.

Below you can see a matrix based on
dierent diagnosis and suggestions of
Netti Dynamic System parts that could
be used. We emphasize that this is an
overview of possible applications and
possible product options / suggestions
of Netti Dynamic System or compo­nents. The final solutions should be
based on the findings of an individual
seating assessment, conducted by a
trained professional.

4

CP ALS CVA Intel Park. MS TBI SCI Hunting­ Disorder ton
Dystonia 1,2,3 or 4 3 3 or 4 3 4 4 4
Athetosis 1,2,3 or 4 3 or 4 4 4
Chorea 1,2,3 or 4 3 or 4 4
Tremor 1,2,3 or 4 3 or 4 3 4 4 3 4
Hemiballism 3 or 4 4
Clonus 1,2,3 or 4 3 or 4 4 3 4
Stereotypic
Movement
Disorder 1,2,3 or 4 1,2,3 or 4 4

1,2,3 el.4
1,2,3 el.4

1,2,3 el.4
1,2,3 el.4

1,2,3 el.4

Model: Netti Dynamic System

Language: English Version: 2016-03

Short explanation of relevant diagnosis and a matrix for which Dynamic System
solutions are suitable

Netti Dynamic System (NDS) Components:

1 = Netti Dynamic headsupport
2 = Netti Dynamic recline (Free range
gas spring or 15 degrees gas spring)
in combination with a dynamic seat
plate (front pivoting and rear lifting
part seat base)
3 = Netti Dynamic leg and foot support
4 = Netti Dynamic System (complete
system)

Definitions of the above-mentioned move­ment patterns are listed on page 3.

Definitions of the above mentioned diag­nosis are listed in 10. Appendix page 33.

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Model: Netti Dynamic System
Language: English Version: 2016-03

INTENDED USE

Netti Dynamic System is an advanced
mobility aid for users aected by dysto­nia. It is for users with extensive move­ment patterns resulting in strong spasms
and contractions of the user’s muscu­loskeletal apparatus causing joint dislo­cations, involuntary movements, sliding,
loss of function and also challenging the
strength of the wheelchair.

The patented Netti Dynamic System ac­commodates the user’s extension move­ments letting the wheelchair work in syn­ergy with the user’s movements. When
accommodating the spastic extensions
pattern, muscle tone and frequency of
spasms could be reduced. The wheel­chair is dynamic and will follow the user’s
movements of both upper and lower
body.

NETTI DYNAMIC SYSTEM

allows for Open Kinetic Chain move­ments (OK-C)::

n Leg movements
n Hip movements
n Back movements
n Head movements
n Foot movements

IMPORTANT BENEFITS

n The wheelchair adapts to the movements

of the user.

n The user will have less discomfort during

spasm as the wheelchair supports
the movement.

n After a spasm the user returns to the

original sitting position securing a good
position and pressure distribution.

n It prevents unintentional change of

position.

n It prevents the user from sliding forward

in the chair and thereby getting a bad
sitting position and inadequate distri-
bution of pressure.

n Extends the lifetime of the wheelchair.

6

Model: Netti Dynamic System

Language: English Version: 2016-03

NETTI DYNAMIC SYSTEM

is a modular system that can be cus­tomized and adjusted according to the
user’s need. The Netti Dynamic System
seat and back unit can be ordered with
these chair models:

n Netti Dynamic III HD
n Netti Dynamic 4U CED (S)

(2 models)

n Netti Dynamic Mobile
n Netti Dynamic 4U BASE

USER REQUIREMENTS

* If you choose a Netti III model, we
recommend the reinforced frames Netti
III HD due to hard use and uncontrol­lable muscle movements of the user.
In order to get the right model, width,
heights etc. a seating evaluation should
be performed by a trained clinician.

Netti Dynamic Components:

The Netti Dynamic head support and
foot supports can be mounted on
a wide range of our static comfort
wheelchairs: Netti III models, Netti 4U
CED (S) and Base models, and Netti
Mobile.

HOW TO USE THIS MANUAL

This manual focuses on the adjust­ments and use of the Netti Dynamic
System seat-, back- and headsupport.
It is to be used together with the user
manual of the wheelchair, for general
information.

The user manual for relevant Netti
comfort static wheelchairs models
contains all necessary information
about mounting, adjustments and use
of the static wheelchair parts of the
Netti Dynamic System, and is delivered
as a part of the complete product.

Netti Dynamic III HD with
Dynamic System with a pelvic
stabilizer and ankle huggers.

Netti Dynamic CED

7

Model: Netti Dynamic System
Language: English Version: 2016-03

NETTI DYNAMIC SYSTEM

Maximal extension - applied to a
Netti III wheelchair.

The dynamic elements moved into
max extension:

Headrest pushed backwards

Back in max recline

Seat lifted

Frame extender

Foot supports lifted
and extended

Tilted foot plate

8

Model: Netti Dynamic System

Language: English Version: 2016-03

EXPLODED VIEW OF NETTI DYNAMIC SYSTEM

Netti Dynamic System Foot support

Netti Dynamic seat
plate

Netti Dynamic head
support

Long anti tippers

Netti Dynamic back
gas spring

Frame extender

Armrest with finger
protection

9

F

Model: Netti Dynamic System
Language: English Version: 2016-03

2. ADJUSTING THE WHEEL­CHAIR TO THE USER

Initial adjustments

Start with normal relaxed seating position.

SEAT ADJUSTMENTS - BALANCING THE
CHAIR

It is vital to adjust the seat correct.
Adjustments to the seat change the centre
of gravity which eects the balance of the
wheelchair.

Proper adjusted seat provide stability
and the ability to manoeuvre the wheel­chair, even during a max extension of the
dynamic parts of the wheelchair.

• Correctseatdepthdependsonthe

user’s thigh length and is measured while
seating - see the red horizontal arrow on
the illustration.

• Seatdepthcanbeadjustedonthe

back of the chair by moving the back
brackets followed by adjusting the back
cylinder head.

• Seatdepthcanbeadjustedinthe

front by adjusting the extension pieces
where the foot supports are mounted.

• Therelationshipbetweenseatangle

and backrest angle should be constant
when the tilt function is used to create
variation for the user.

• Seatheightistobeseentogetherwith

the foot supports.

• Footsupportsneedtobeadjustedto

accommodate the seat height.

Please note: the Netti Dynamic System
foot support adjustments are described in
detail in a separate mounting description.
Please, see the drawings on next page
regarding seat depth adjustments.

10

Model: Netti Dynamic System

Language: English Version: 2016-03

SEAT DEPTH ADJUSTMENTS IN
THE BACK:

When the chair is equipped with a
main wheel larger than 12” or 16”
remove the main wheels first. Then
remove the screws on each side
which are holding the back hinge.
Pull the bracket on each side back
or push it forward to desired posi­tion before the screws are fixed
again.

Adjusting on Netti 4U: Remove the
bolt holding the recline cylinder
head and reposition it in the corre­sponding number hole as the previ­ously adjusted chair back bracket.
This will also have influence on
the chair back angle.

By choosing another hole you
can change the angle of the
back support which means that
the back angle or hip angle will
be more open or more closed.
See separate table in the chap-
ter: “Technical specification and
options of Netti Dynamic back
support gas cylinders”

SEAT DEPTH ADJUSTMENTS IN
THE FRONT:

The extension pieces are adjusted
by removing the screws holding
them and then pulling the exten­sion pieces out to desired position.

The aim is to have the centre of
the users knee joint aligned with
the center of the foot support
rotation centre - while the user at
the same time is having good back
support of his lower back - also
when the foot support angle is
changed.

11

Model: Netti Dynamic System
Language: English Version: 2016-03

SEAT ANGLE ADJUSTMENT:

Can be adjusted at any time by the
use of the tilt handles.

SEAT PLATE ADJUSTMENT:

The Netti Dynamic System seat plate
is pivoted in the front of the seat.
This allows the seat to rise in the
rear when doing a hip extension. The
pelvic stabilizer which is fixed to the
seat plate, is necessary to make this
happen. The pelvis stabilizer must be
used together with the dynamic seat
plate.
Remember! The pelvic stabilizer must
be firmly tightened to minimize the
risk of sliding.

To prevent the seat plate to pivot
too high, there are seat plate limiters

- belts - between the seat plate and
the chair frame. The seat plate limit­ers can be adjusted to allow for max
seat pivoting. Adjustment of the seat
plate limiter is done by loosening the
screw holding the seat plate limiter
belt under the seat and sliding it back
or forward to find the desired move­ment of the seat plate.

SEAT PLATE LOCK

In some cases it may be necessary
for safety reasons to lock the move­ment of the seat. This is when the
wheelchair is used as a seat in a car
or when driving the chair on rough
surface where a sudden spastic ex­tension may cause the chair and user
to become unstable.

The seat plate lock is easy to use;
remove the QR-Axcle by pressing the
head to release it and move it from
its upper position and push it into the
lower position.

NB: Remember to unlock the seat
plate when you are back in smooth
areas, allowing the Netti Dynamic
System to work.

12

Model: Netti Dynamic System

Language: English Version: 2016-03

ASSESSMENT AND CHOICE
OF NETTI DYNAMIC BACK
SUPPORT GAS CYLINDER

The chair back position is defined by
the chair back cylinder. There are two
dierent type of cylinder available for
the Netti Dynamic System:

Option 1: VARIOLOCK

The Variolock cylinder is never fixed
but allows for a 15 degree flex at any
position where the chair back has been
reclined to. Variolock cylinder is suit­able for users with open kinetic chain
(OKC) movements with max extension
less than 15°. If 15 ° closes the kinetic
chain movement, more forces will have
impact on the foot support.

Warning: the foot support might break
if it is not correct adjusted so that the
user foot extension reaches the end
of the foot support dynamic area, or if
the user has slid forward.

Variolock cylinders are available in 80,
120 and 160N force.
The recline function is controlled by
the recline handle on the bar behind
the back support.

Warning: Netti Dynamic System
wheelchair with Variolock gas cylinder
is not approved for being used as a
seat in a vehicle.

Option 2 FULL FREE CYLINDER

The full free cylinder allows the back
support to move backwards to full
recline, giving full support during
extension movement. When the user
starts to relax the cylinder move the
back support to its original position.

The strength of the full free cylinder
has to be fitted individually according
to body weight. A cylinder that is too
strong will not allow the back support
to move. A cylinder that is too weak
will not be strong enough to lift the
back support to its original position.
Standard cylinder forces are: 600,
800, 1000 and 1200N.

FULL FREE CYLINDER LOCKING
The full free cylinder is locked in any
reclined angle - when the recline han­dle on the back is in neutral position.
This may be necessary / required,
when the chair is used as seat in a car
or driven on rough ground where a
sudden spastic extension may make
the chair unstable. Or when the user
needs to lay back for a rest.

If you recline the chair back on a
wheelchair with free cylinder, locking
it in reclined position, it is only the
Netti Dynamic Foot supports, seat
plate and head support that will re­spond to spastic movements.
If you lock the full free cylinder, it
is important that the user is correct
positioned and not sliding forward to
prevent damage on the foot support.

13

Model: Netti Dynamic System
Language: English Version: 2016-03

FULL FREE GAS CYLINDER
ACTIVATED

The dynamic back solution of Netti
Dynamic System is activated by pull­ing the recline handle. The dynamic
back solution is done with the lock
handle on the same recline handle.
See page 21 for detailed illustrations.

The back support cylinder can be
considered replaced by another
cylinder (more/less Newton) if
needed; either because of new
or changed user needs, or if the
weight of the user has changed.

Please contact your local dealer
for advice on which new cylin­der to choose. At the end of this
manual the change of gas cylinder
is described.

ASSESSMENT OF DYNAMIC
BACK SUPPORT RECLINE GAS
CYLINDER FORCES SUITING
USER STRENGTH AND MOVE­MENT PATTERNS

An assessment of the user is
needed to find the right power of
the cylinder.
Correct solution: The back cylinder
gives full support on a full, open
kinetic chain movement during the
user’s extension pattern. When the
user starts to relax, the cylinder
move the back support to its origi­nal position.

How to assess and choose the right
power of the dynamic back support
cylinder?

Main factors to be considered by a
trained professional:

• Theuser’sweight,widthand 

height

• Thecharacterandstrengthofthe

body part extensions and move-
ment patterns

• Goalsandimprovementregard 

ing the user’s “Activity daily life”
and health condition.

The user’s movement pattern and
muscle tone may also change over
time. It is relevant to assess and
monitor the fitting of the wheel­chair and the power of gas cylinders
according to the development of the
user’s movement pattern and muscle
tone over time. If the gas spring is too
strong, the user will not be able to
make an extension. It will be a “closed
kinetic chain”, or a static position for
the user.

If the gas spring is too weak, the user
will not be able to be lifted back to
his/hers original seating position after
an extension of the upper body part.

14

Newton (N)

Minimum

kg

250

mm

300

mm

350

mm

380

mm

400

mm

430

mm

450

mm

500

mm

200 N

45000

20 kg

X X

300 N

45001

30 kg

X X

400 N

45002

40 kg

X X

500 N

45003

50 kg

X X

600 N

45004

60 kg

X X X X

700 N

45006

70 kg

X X X X X

800 N

45007

80 kg

X X X X

X

900 N

45008

90 kg

X X X

X

1000 N

45009

100 kg

X X

X

1100 N

45010

110 kg

X X

X

1200 N

45011

120 kg

X

1300 N

45012

130 kg

X

80N Variolock

82330

120N Variolock

82331

160N Variolock

82332

45005

Model: Netti Dynamic System

Language: English Version: 2016-03

OVERVIEW OF AVAILABLE DYNAMIC RECLINE CYLINDERS AND
SEAT WIDTHS

The user’s width is an indicator to assess regarding the choice of minimum gas
spring force.

The user’s weight is an indicator to assess regarding the choice of minimum gas
spring force:

Seat widts

User

weight

Full free
cylinder

article

numbers

Kit with handle
and wire

Full free
cylinder

models

TECHNICAL SPECIFICATION AND OPTIONS OF NETTI DYNAMIC
BACK SUPPORT GAS CYLINDERS

FULL FREE BACK SUPPORT CYLINDER:

Combination of seat depths, front bracket hole and cylinder head - short and long.

The recline angle range is approximately 40° and valid for all wheelchair-models
with full free cylinder locking.
Netti Dynamic Dynamic Mobile recline solutions have a starting angle of app. 90°

15

400

B X

91

425

A X

92

450

C X

95

475

A X

87

500

A X

98

92

104

N/A

N/A

83

92

104

N/A

N/A

83

92

104

N/A

N/A

83

92

92

104

N/A

N/A

83

92

104

N/A

N/A

83

92

104

N/A

N/A

83

92

….

500

A X

98

475

A X

87

475

B X

97

450

B X

85

450

C X

95

425

A X

92

425

B X

101

425

C X

85

400

B X

91

Model: Netti Dynamic System
Language: English Version: 2016-03

Recommended combinations for Netti III models

Seat depth

Front bracket
hole (A-B-C)
A is upper hole

Cylinder
head short
38 mm

Cylinder
head long
96 mm

Starting
angle in
degrees °

* Green color is the standard adjustment for the chosen seat depth.
* Yellow color could be an option. Other combinations of seat depths, front bracket holes
and cylinder head sizes are not recommended.

Recommended combinations for Netti III HD models

Seat depth
in mm

Front bracket
hole (A-B-C)
A is upper hole

Cylinder
head short
38 mm

Cylinder
head long
96 mm

Starting
angle in
degrees °

Seat depth

(SD)

375 mm

Seat depth

(SD)

400 mm

Seat depth

(SD)

425 mm

Seat depth

(SD)

450 mm

Starting recline angle for Netti Dynamic CEDS

Starting recline angle for Netti Dynamic CED / BASE

Seat depth

(SD)

425 mm

Seat depth

(SD)

450 mm

Seat depth

(SD)

475 mm

Seat depth

(SD)

500 mm

Front cylinder bracket hole (A-B-C).
A is upper hole. B is the possible
option. A and C will NOT work.

Front cylinder bracket hole (A-B-C).
A is upper hole. B is the possible
option.

B: with first hole on cylinder hinge

B: with second hole on cylinder hinge

B: with third hole on cylinder hinge

B: with fourth hole on cylinder hinge

B: with fourth hole on cylinder hinge

B: with third hole on cylinder hinge

B: with second hole on cylinder hinge

B: with first hole on cylinder hinge

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Model: Netti Dynamic System

Language: English Version: 2016-03

CHAIR BACK HEIGHT

It can be extended by mounting a
back extension.

NETTI DYNAMIC HEAD SUPPORT

The Netti Dynamic System is
equipped with a dynamic head
support. The head support follows
the extension movement of the
neck.

The depth of the head support
should be adjusted to barely touch
the back of the user’s head when
sitting relaxed.

For head support depth adjust­ment simply:

• Unlockthe2twolevers,one

on each side of the head sup­ port holder.

• Movetheheadsupportfor-

wards or backwards to desired
position.

• Fixrmlythetwolevers.

The height of the head support
needs to be adjusted to fit directly
behind the head:

• Openthescrewonthebracket

holding the vertical pole of the
head support.

• Pulltheheadsupportto

desired height and fix the
screw firmly.

17

B

A

Model: Netti Dynamic System
Language: English Version: 2016-03

ARM SUPPORT POSITION

Depending on the product model of
Netti Dynamic System, the arm sup­port may vary.
The arm supports are static and
adjustable (no “Open Kinetic Chain
movement concept”). The adjust­ments of arm support are described
in the user manual of each type of
static comfort wheelchair: Netti III
(Netti Dynamic III), Netti 4U CED
(Netti Dynamic CED), Netti Mobile
(Netti Dynamic Mobile), Netti BASE
(Netti Dynamic BASE) etc.
Arrow A points to depth adjustment
knob on the arm support on a wheel­chair with swing away arm support
(Netti Dynamic CED). Height adjust­ment is done once loosening the
screw B and fixing it in correct height

MOUNTING, POSITIONING AND AD­JUSTMENTS OF PELVIC SUPPORTS
AND SUPPORTIVE HARNESSES

Netti Dynamic System can be
equipped with several dierent types
of pelvic stabilizer and supportive har­nesses each type developed to give
the user the best stabilization support
depending on the conditions:

• Pelvicstabilizer-(includedinNetti

Dynamic System)

• Upperbodyharnesses

• Anklehuggers

• Shoeshells

• Pelvicstabilizer,mountedtothe

seat plate, helps the user to keep his
position on the seat even under full
spastic extension.
See separate Mounting Description for
upper body harnesses.

HOW TO ADJUST THE PELVIC
STABILIZER

The pelvic stabilizer is mounted on the
guide-rail under the seating plate as
shown on the illustration.

• Slidethepelvicstabilizertoaposi­tion where it crosses the upper thighs,
Angle: 70- 90 degrees.

• Adjusttheharnessmountingpoint

so that the harness can be tightened.

• Remembertoshortenthestabilizer

beneath the last used hole to avoid any
conflict with chair frame.

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Model: Netti Dynamic System

Language: English Version: 2016-03

ANKLE HUGGERS AND SHOE SHELLS

helps to keep the feet on the foot sup­port not letting them slide of during an
extension spasm.

The ankle huggers are mounted by
threading them through the slots in
the foot board on the foot support and
fixing the belt on the underside of the
foot plate, threading shown in the illus­tration - follow the numbers.

FOOT SUPPORT HEIGHT AND ANGLE

Please see separate user manual for
Netti Dynamic System Foot support

TABLE

Please do a user assessment to
determine if a table is suitably. By
special or extensive movement
patterns a table may brake or
cause danger to the user or 3rd
parties because the table is stati­cally fixed to the armrests while
the movements of the user are
dynamic.

19

Model: Netti Dynamic System
Language: English Version: 2016-03

3. EVERYDAY USE OF
THE NETTI DYNAMIC
SYSTEM

TRANSFER TO/FROM THE CHAIR

Techniques for transferring to / from
the wheelchair should be practiced
well with the persons involved.

Some important advices for prepara­tion of the chair:

n The wheelchair should be placed as

close as possible to the destination of
the transfer.

n Pull the wheelchair 5-10 cm back-

wards in order to have the front cas­tors turned forward.

n Make sure the anti-tips are turned

downwards.

n Remove the foot support and re-

volve /remove the arm support on the
side of the transfer.

n Make sure the brakes of the wheel-

chair are in use so it does not roll away.

USING A PATIENT HOIST:

n Tilt the chair backwards

n Open the back support angle

slightly

n Option: Remove the arm supports

and get closer to the patient

n Remove the foot support

n Replace the components when the

transfer is finished.

20

Model: Netti Dynamic System

Language: English Version: 2016-03

ATTENDANT USE

PUSH BOWS AND PUSH HANDLES

For safe manoeuvring the wheel­chair, and preventing injuries for the
attendant, the push bow or push
handles should be adjusted accord­ing to attendants arm height when
the elbow is in an 90 degree angle

Open the latch holding the push
handle and push or pull it to de­sired height before fixing it again.
Repeat on the other side.

Adjusting the push bow is done
similarly; open the latches, pull the
push bow to desired height and
lock the latches.

ANTI-TIPS

Always use anti-tips to ensure a
safe and stable wheelchair. When
the “OK-C” Netti Dynamic System
parts are active, it is essential to
use the anti-tips at all times.

The anti-tips are pulled and swung
away when passing obstacles etc.

BRAKES

Always use the brakes when
the wheelchair is left without
attendant standing behind.

Push the red brake handle
forward to lock the brake.

21

Model: Netti Dynamic System
Language: English Version: 2016-03

ARM SUPPORT

When the user is to leave the chair,
the arm support can be removed or
swung away, depending on which
type of wheelchair you have. This
makes the transfer much easier.
Please, see the illustration of a chair
with swing-away arm support.

FOOT SUPPORTS

Netti Dynamic foot supports are
mounted and removed like this:

Push the foot support fixing bolt
vertical into the extension piece on
the wheelchair - keeping the foot
support slightly turned outwards.
The foot support will fall in place
and turn into place itself.

FOOT BOARD LOCK

With both foot supports in place,
let the foot board swing down
and put the bolt into the lock, see
below:

22

!

LOCK

Model: Netti Dynamic System

Language: English Version: 2016-03

The foot board lock is operated by
turning the ribbed wheel to open or
closed position. It ensures a sturdy
foot board for restless feet.

Always lock the foot board to ensure
it is stable!

THE FOOT SUPPORT ANGLE

The Netti Dynamic System Foot sup­port angle can be locked by tighten­ing the red wheel on the outside of
the foot support. See illustration:

HARNESSES

are to be opened or closed with tra­ditional car belt lock or by backpack
clips.
Use harnesses, ankle huggers and
shoe shells to give the user stabilizing
support when needed.

KEY WORDS REGARDING
TILT AND RECLINE OF STATIC
COMFORT WHEELCHAIRS,
AND COMMON FEATURES OF
DYNAMIC WHEELCHAIRS

Tilt and recline are the basic benefits
of a comfort wheelchair. It allows for
varying seating positions during the
time in the wheelchair.

We have reviewed the clinical eviden­ces regarding tilt and recline, and
found there are several studies or best
practice guidelines suggesting that
the tilt and recline sequence is impor­tant to reduce shear and sliding:
First tilt then recline afterwards. When
bringing the client upright again, the
sequence should be recline first then
tilt. It would seem that the most shear
would be induced when going upright
from a recline and tilted position.

23

Model: Netti Dynamic System
Language: English Version: 2016-03

DECREASE THE POSSIBILITY OF
SLIDING, SHEAR AND PRESSURE
SORES:

Only use the tilt angle to achieve vari­ation of the seating position for the
user.
It is common knowledge that recline
should not be adjusted after the back
angle is accommodated to the user’s
best seating position.
The muscle tone of the neck and back
should be as low as possible for the
user to prevent sliding, and a change
of the recline angle from the original
position will interrupt and destroy the
correct body position, and cause an
increased muscle tone in the neck.

If the recline function is used during a
transfer situation or other situations, it
is very important that the recline angle
is adjusted back to the correct, origi­nal position when the user is back to a
normal seating position.

Wrong usage of recline causes an in­creased possibility of sliding, and this
means an increased danger of shear
(vertical and horizontal forces) and
pressure sores.

ASSURE THAT THE USER IS SAFE
WHEN THE TILT OR RECLINE
FEATURES ARE GOING TO BE
ADJUSTED:

The tilt and recline functions of all
Netti comfort wheelchair models is a
«one hand operation», including the
dynamic wheelchair models. This is
a great benefit for the user: The care
giver is able to establish eye contact
with the user when the tilt or recline
function is going to be used. The care
giver is also able to communicate
with the user before the tilt or recline
function is used. The user will feel
more safe when he/she is aware that
the tilt or recline function is going to
be used.

TILT OG RECLINE OF DYNAMIC
COMFORT WHEELCHAIRS WITH
«OK-C» MOVEMENT

The Dynamic System with full free
cylinder continues to be active if the
chair is tilted, allowing full extension
of the back- and the foot supports.

If you recline and lock the chair back
on a wheelchair with full free cylinder,
it is only the Dynamic foot supports,
seat plate and head support that will
respond to a spastic movement.

A wheelchair with Variolock cylinder
has a 15 degree flexing wherever the
recline angle is positioned.

The functions recline and tilt are op­erated with the handles on the back
of the chair. See details next page.

24

Model: Netti Dynamic System

Language: English Version: 2016-03

OPERATING TILT HANDLE:
TILTING THE SEATING UNIT

Press the left handle on the push bar
and put pressure to the push bar to
tilt the seating unit with one of your
hands, while you have eye contact
with the user and put the other hand
on the arm support.

The correct relative angle between
the body parts remain the same when
the seating unit is tilted.

Wherever you let the handle loose,
the seating unit will stay in this
position.
To bring the seating unit up, press the
handle and the tilt cylinder will assist
you lifting the seating unit up.

A backward tilted seat unit gives a
steeper seating angle in relation to
the surface, and prevent sliding of the
wheelchair user.

The tilt sign sits on the push bar, and
it looks like this:

25

FIXED

DYNAMIC

Model: Netti Dynamic System
Language: English Version: 2016-03

OPERATING RECLINE HANDLE:
RECLINING THE CHAIR BACK

Press the right handle and put pres­sure to the push bar to recline the
back with one of your hands, while
you have eye contact with the user
and put the other hand on the arm
support.

Wherever you let the handle loose, the
chair back will stay fixed and locked.

Wheelchair with Variolock will how­ever still allow for 15 degrees flexing.
The illustration shows a recline handle
position for a locked back.

DYNAMIC BACK:

To have the back behave dynamic,
you have to activate the recline
handle with the smaller, red handle
attached to it.
Version A: Press the recline handle
tight to the push bar and push the
little, red handle away from the push
bar, still holding the main handle
pressed. Let go.
Version B ( since spring 2016):
Pull the recline handle tight to the
push bar, the red handle automatically
clics in. Let go.
The handle stays close to the push
bar and the back can be freely moved
backwards.

To stop the dynamic recline, simply
press the handle again, the little, red
handle is released and the back is
fixed.
The recline sign sits on the push bar,
it looks like this:

On the recline handle there is a label
reminding you that the back is behav­ing dynamic when the recline handle
is activated and the back is fixed
when the handle is open.

26

Model: Netti Dynamic System

Language: English Version: 2016-03

SAFETY GUIDELINES WHEN LEAVING
A USER IN THE WHEELCHAIR

If you are leaving a user in a wheel­chair, make sure that the brakes are
locked, the anti-tips are active and
that harnesses (when used), are
closed.

WHEELCHAIR USED AS SEAT IN A
CAR

When a wheelchair with Netti Dynamic
System is to be used as seat in a car,
make sure that:

• Thefootsupportarelockedin

vertical position.

• Theseatplateislocked.

• Thebacksupportislockedinan

upright position.
All to make sure the user does not
hurt himself or others by sudden
spastic movements.
NB: The wheelchair is to be fixed in
the car as described in the user manu­al for the similar product model as for
the static comfort wheelchair (Netti III,
Netti 4U CED etc.).

Warning: Netti Dynamic System
wheelchair with Variolock gas cylinder
is not approved for being used as a
seat in a vehicle.

LIFTING THE WHEELCHAIR

Avoid lifting a wheelchair with the user
in it. Always lift a wheelchair holding
on to the marked lifting points on the
frame. Keep a sturdy, well balanced
stand lifting from your legs.
Never lift alone.
Never lift a wheelchair in its foot
support, arm support or push handles.

DRIVING A WHEELCHAIR WITH
NETTI DYNAMIC SYSTEM

When driving a wheelchair with Netti
Dynamic System, careful driving is
mandatory. Watch out for obstacles that
could be in the reach if the dynamic
parts of the wheelchair is fully extended.
Otherwise the user, third parties or
surroundings may get hurt. Always
obtain good balance of the chair as it
may be challenged when suddenly full
extension happens.

27

Model: Netti Dynamic System
Language: English Version: 2016-03

4. MOUNTING
DESCRIPTION

CHANGING THE BACK GAS
CYLINDER
Described on hand of Netti III. The

functionality on other dynamic
wheelchairs is the same.

n Recline the chair back back-

wards at least 15°.

Disconnect the cylinder hinge from
gas cylinder by pulling the quick
release bolt (locking pin), and
then pulling the gas cylinder hinge
outwards. There may be dierent
styles to the cylinder hinges, but
the function is the same.

See the cut illustration showing the
cylinder hinge in orange and the
cylinder in green.

28

C

A

Model: Netti Dynamic System

Language: English Version: 2016-03

Fold the chair back forwards.

Remove the old gas cylinder. Use a
17 mm open end spanner to open the
nut C.

Connect the gas cylinder locking
head A, if not mounted, to the new
cylinder.

29

B

C

Model: Netti Dynamic System
Language: English Version: 2016-03

Screw the gas cylinder into the
head until it touches the cross bolt
B, no play. Leave the nut C loose
till the cylinder has correct depth.

If the cylinder sits too loose, you
cannot release it with the operat­ing handle; when it is too tight,
the operating handle will not lock
the cylinder.

Tighten the nut C close to the
head with the 17 mm open end
spanner and fix the gas cylinder
firmly.

Connect the gas cylinder locking
head to the cylinder hinge, recon­nect the quick release bolt.

TABLE FOR GAS CYLINDER
MODEL SUITING USER STRENGTH
AND WEIGHTS ON PAGE 14.

C

30

KOMPONENTER OG
TILBEHØR TIL

Netti Dynamic System

Artikkel
nummer

Beskrivelse Bilder

HODESTØTTER

Hodestøtte Dynamic

Hodestøttelås





Flekser bakover

SETEPLATER

Seteplate Dynamic

Se vår
reservedels-
katalog på
hjemmesiden
for full oversikt
over alle
varianter

Setebredder:

35– 38– 40–
43– 45 and
50 cm

Seteplate Dynamic – hengslet
med belteinnfesting, setelås,
vinkelstopper og setedemper

Se vår
reservedels-
katalog på
hjemmesiden
for full oversikt
over alle
varianter

Setebredder:

35– 38– 40–
43– 45 and
50 cm

SYLINDER FOR
RYGGREGULERING

Sylinder med fullt utslag

Se side 14 for
full oversikt

Variolock – med 15 grader fleksing
NB: Ikke godkjent for bruk som
sete i bil

Se side 14 for
full oversikt

RAMMEFORLENGER

Rammeforlengersett Netti
III famile

Rammeforlengerssett Netti
4U

20824

82391 12”-16”
85013 22”-24”

ANTITIP

Antitip lang-lang m fjær til Netti III

Antitip Netti 4U

25418 26056

28972

Model: Netti Dynamic System

Language: English Version: 2016-03

5. NETTI DYNAMIC COMPONENTS
AND ACCESSORIES

COMPONENTS AND
ACCESSORIES FOR

HEAD SUPPORTS

SEATING PLATE

BACK ANGLE CYLINDERS

FRAME EXTENDERS

ANTI-TIPS

Article
number

Description

Pictures

Head support Dynamic

Head support lock

Seat Plate Dynamic

Seat Plate Dynamic ­hinged, with belt fixing,
seat plate lock, seat plate
angle stopper, and seat
plate bumper

Full free cylinder

Variolock with 15 degree flex ­not approved for wheelchairs
used as a seat in a vehicle

Frame extender Kit Netti III
family

Frame extender Kit Netti 4U

Anti-tips long-long
with spring - Netti III

Anti-tips 4U

Please see
page 14 for
full program

Please see
page 14 for
full program

Please study
the spare part
catalogue on
our home­page for all
alternatives

Please study
the spare part
catalogue on
our home­page for all
alternatives

Seat widths:

Seat widths:

Flexes back­wards

31

KOMPONENTER OG
TILBEHØR TIL

Netti Dynamic System

Artikkel
nummer

Beskrivelse Bilder

BENSTØTTER

Netti Dynamic DUAL
fotstøtte

Se egne
brukermanual
for Netti
Dynamic
System
benstøtter

Tillater ujevn
styrke eller
asymmetriske
bevegelser av
bena.

Netti Dynamic Parallel

fotstøtte

Se egne
brukermanual
for Netti
Dynamic
System
benstøtter

Tillater bruk
med jevn
styrke og
symmetri med
bena.

BELTER / Støttesystem

H-belte beslag - Liten



Setebredde

25- 40 cm

H-belte beslag – Medium



Setebredde

43- 45 cm

H-belt beslag - Stor



Setebredde

50- 60 cm

Bekken støtte Evoflex M



Medium

Bekken støtte Evoflex L



Stor

4-punkts belte polstret M



Medium

4-punkts belte polstret L



Stor

Model: Netti Dynamic System
Language: English Version: 2016-03

COMPONENTS AND
ACCESSORIES FOR

LEG SUPPORTS

BELTS

Article
number

Description Pictures

Netti Dynamic DUAL foot
support

Netti Dynamic PARALLEL
foot support

H-belt adaptor kit - Mini

H-belt adaptor kit Medium

H-belt adaptor kit - Large

Pelvic support Evoflex ­Medium

Pelvic support Evoflex ­Large

4-point belt padded M

4-point belt padded L

Large

Large

Please study
the separate
user manual
for Netti
Dynamic
System foot
support

Please study
the separate
user manual
for Netti
Dynamic
System foot
support

Allows for
uneven forces
from the legs

Allows for
even forces
from the legs
parallel ex­tension

Seat widths:

Seat widths:

Seat widths:

32

VESTER

Vest Stayflex m/u glidelås

45015

Medium

Vest Stayflex m/u glidelås

45016

Stor

Skulderbelte Pivotfit M

45017

Medium
unisex

Skulderbelte Pivotfit L

45018

Stor
unisex

BEN OG FOT BELTER/ Støttesystem

Leggstøtte pute

45019

Medium

Leggstøtte pute

45020

Large

Ankelstøtte S

44863

Liten
17-20 cm

Ankelstøtte M

44864

Medium
19-23 cm

Ankelstøtte L

44865

Stor
22-29 cm

Ankelstøtte XL

44904

Ekstra stor
28-33 cm

For komplett og oppdatert oversikt, vennligst se vår hjemmeside – produkt katalog –
www.My-Netti.com

Model: Netti Dynamic System

Language: English Version: 2016-03

HARNESSES

LOWER EXTRMITIES

Stayflex vest w/o zipper

Stayflex vest w/o zipper

Pivotfit M

Pivotfit L

Large

Large

Large

Extra Large

Small

For complete and anytime updated overview, please see the product catalogue on our home page
www.My-Netti.com

Calf support

Calf support

Ankle huggers S

Ankle huggers M

Ankle huggers L

Ankle huggers XL

33

Model: Netti Dynamic System
Language: English Version: 2016-03

6. TRANSPORT

Wheelchairs with Netti Dynamic System
can be used as seat in a car if the wheel­chair has been tested and approved to
ISO 7176-19. Please follow the descrip­tion for fixing the chair and the user as
described in the User manual for the
wheelchair.

The Netti Dynamic System and Foot
support has to be locked when the
wheelchair is used as a seat in a car.

Warning: Netti Dynamic System wheel­chair with Variolock gas cylinder is not
approved for being used as a seat in a
vehicle.

7. MAINTENANCE

All wheelchairs equipped with Netti Dy­namic System will require special
attention to maintenance compared with
wheelchairs without dynamic system,
due to the heavy and strong use.

Follow the wheelchair maintenance
description in the wheelchair User
Manual and pay special attention to
tightening all screws and inspecting all
joints regularly on a weekly basis.

Inspect the belts and harnesses on tear
and wear. Replace if necessary.

In some cases it can occur sound from
the moving parts if they are not regularly
lubricated.

8. TROUBLE­SHOOTING

Please study the recommendations in
the User Manual for the wheelchairs
where the Netti Dynamic System has
been adapted to.

34

Model: Netti Dynamic System

Language: English Version: 2016-03

9. TESTS &
WARRANTY

The guarantee claims stated in the
User Manual for the wheelchair also
applies for wheelchairs with Netti
Dynamic System when the Netti
Dynamic System or parts are
mounted and adjusted for the user
under supervision of a Netti Dynamic
System certified person.

Contact your local dealer if you have
questions regarding certified persons
for Netti Dynamic System.

Updated data about the wheelchair
and the Netti Dynamic System is
found on www.My-Netti.com

10. APPENDIX

- Medical terms and diagnosis with
reference to Netti Dynamic System
and relevant user groups:

- CP: Cerebral palsy is a disorder
that aects muscle tone, movement,
and motor skills (the ability to move
in a coordinated and purposeful way).

- ALS: Amyotrophic Lateral Scle­rosis (ALS) is a rapidly progressive,
neuromuscular disease. It attacks the
motor neurons that transmit electrical
impulses from the brain to the volun­tary muscles in the body. When they
fail to receive messages, the muscles
lose strength, atrophy and die.

- CVA: Stroke or Cerebral Vascu­lar Accident (CVA). A stroke is the
sudden death of brain cells due to a
problem with the blood supply.

- Intellectual disorders: Intellectual
disability is a disability characterized
by significant limitations in both intel­lectual functioning and in adaptive
behavior, which covers many everyday
social and practical skills.

- Parkinson’s Disease: a progressive
disease of the nervous system marked
by tremor, muscular rigidity, and slow,
imprecise movement. It is associated
with degeneration of the basal ganglia
of the brain and a deficiency of the
neurotransmitter dopamine.

- MS: a chronic, typically progres­sive disease involving damage to the
sheaths of nerve cells in the brain and
spinal cord, whose symptoms may
include numbness, impairment of
speech and of muscular coordination,
blurred vision, and severe fatigue.

- TBI: Or traumatic brain injury is
an intracranial injury, generally the
result of a sudden blow to the head.
The brain is launched into a collision
course with the inside of the skull,
resulting in possible bruising of the
brain, tearing of nerve fibers and
bleeding.

- SCI: or spinal cord injury sult of a
sudden, violent blow or is damage to
any part of the spinal cord or nerves
at the end of the spinal canal.

- Huntington’s disease: A hereditary
disease marked by degeneration of
the brain cells and causing chorea and
progressive dementia.

35

Model: Netti Dynamic System
Language: English Version: 2016-03

Alu Rehab AS
Bedriftsvegen 23
4353 Klepp Stasjon
NORWAY

T: [phone]
[e-mail]

My-Netti.com

Alu Rehab ApS
Kløftehøj 8
DK-8680 Ry

T: [phone]
F: [phone]
[e-mail]

IN DIALOGUE WE CREATE
SIMPLE SOLUTIONS AND

ENABLE JOY OF LIFE

This product conforms to
93/42/EEC for medical products.

FEEL FREE TO CONTACT US:

UM0116UK

2016-03