Standing frame
Encyclopedia
A standing frame is assistive technology
that can be used by a person who relies on a wheelchair
for mobility. A standing frame provides alternative positioning to sitting in a wheelchair by supporting the person in the standing position. Standing frames are advertised as increasing independence, mobility, and self-esteem.
, upright, multi-positioning standers, and standing wheelchairs
. Long leg braces are also a standing device but not used often today.
, traumatic brain injury
, cerebral palsy
, spina bifida
, muscular dystrophy
, multiple sclerosis
, stroke
, Rett syndrome
, and post-polio syndrome
.
Spinal cord injury:
Standers are used by people with both paraplegia
and quadriplegia
since a variety of support options are available to accommodate for mild to severe disabilities. Doug Betters
and Mike Utley
are both former NFL football players who are quadriplegics due to spinal cord injury. They both stand using active standers.
Bone mineral loss and osteoporosis
are common consequences after spinal cord injury
. Therapeutic standing, a weight-bearing intervention that can be applied using a standing frame, has traditionally been incorporated into rehabilitation programs for those with chronic spinal cord injury in order to prevent osteoporosis. A systematic review of the literature conducted by Biering-Sorenson et al. (2009) shows that therapeutic standing in the chronic phase of injury, defined as one year after injury, has no effect on maintaining bone density
. Results on the effectiveness of therapeutic standing during the first year of injury are conflicting and show that shorter, less aggressive intervention is less effective. If therapeutic standing is to be incorporated into treatment, it should be more aggressive and initiated in the early stages of injury if any beneficial impacts on bone mineral density are hoped to be achieved.
veterans' hospitals.
(a detailed medical prescription
) written by a physical therapist or medical professional.
Assistive technology
Assistive technology or adaptive technology is an umbrella term that includes assistive, adaptive, and rehabilitative devices for people with disabilities and also includes the process used in selecting, locating, and using them...
that can be used by a person who relies on a wheelchair
Wheelchair
A wheelchair is a chair with wheels, designed to be a replacement for walking. The device comes in variations where it is propelled by motors or by the seated occupant turning the rear wheels by hand. Often there are handles behind the seat for someone else to do the pushing...
for mobility. A standing frame provides alternative positioning to sitting in a wheelchair by supporting the person in the standing position. Standing frames are advertised as increasing independence, mobility, and self-esteem.
Types and function
Common types of standers include: sit to stand, prone, supineSupine position
The supine position is a position of the body: lying down with the face up, as opposed to the prone position, which is face down, sometimes with the hands behind the head or neck. When used in surgical procedures, it allows access to the peritoneal, thoracic and pericardial regions; as well as the...
, upright, multi-positioning standers, and standing wheelchairs
Standing wheelchair
A standing wheelchair is assistive technology, similar to a standing frame, that allows a wheelchair user to raise the chair from a seated to a standing position...
. Long leg braces are also a standing device but not used often today.
- Passive (static) stander: A passive stander remains in one place. They sometimes have casters, but cannot be self-propelled.
- Mobile (dynamic) stander: User can self-propel a mobile stander if they have the strength to push a manual wheelchair. Some standers are also available with powered mobility.
- Active stander: An active stander creates reciprocal movement of the arms legs while standing.
Diagnoses and users
Standers are used by people with mild to severe disabilities such as spinal cord injurySpinal cord injury
A spinal cord injury refers to any injury to the spinal cord that is caused by trauma instead of disease. Depending on where the spinal cord and nerve roots are damaged, the symptoms can vary widely, from pain to paralysis to incontinence...
, traumatic brain injury
Traumatic brain injury
Traumatic brain injury , also known as intracranial injury, occurs when an external force traumatically injures the brain. TBI can be classified based on severity, mechanism , or other features...
, cerebral palsy
Cerebral palsy
Cerebral palsy is an umbrella term encompassing a group of non-progressive, non-contagious motor conditions that cause physical disability in human development, chiefly in the various areas of body movement....
, spina bifida
Spina bifida
Spina bifida is a developmental congenital disorder caused by the incomplete closing of the embryonic neural tube. Some vertebrae overlying the spinal cord are not fully formed and remain unfused and open. If the opening is large enough, this allows a portion of the spinal cord to protrude through...
, muscular dystrophy
Muscular dystrophy
Muscular dystrophy is a group of muscle diseases that weaken the musculoskeletal system and hamper locomotion. Muscular dystrophies are characterized by progressive skeletal muscle weakness, defects in muscle proteins, and the death of muscle cells and tissue.In the 1860s, descriptions of boys who...
, multiple sclerosis
Multiple sclerosis
Multiple sclerosis is an inflammatory disease in which the fatty myelin sheaths around the axons of the brain and spinal cord are damaged, leading to demyelination and scarring as well as a broad spectrum of signs and symptoms...
, stroke
Stroke
A stroke, previously known medically as a cerebrovascular accident , is the rapidly developing loss of brain function due to disturbance in the blood supply to the brain. This can be due to ischemia caused by blockage , or a hemorrhage...
, Rett syndrome
Rett syndrome
Rett syndrome is a neurodevelopmental disorder of the grey matter of the brain that almost exclusively affects females. The clinical features include small hands and feet and a deceleration of the rate of head growth . Repetitive hand movements, such as wringing and/or repeatedly putting hands into...
, and post-polio syndrome
Post-polio syndrome
Post-polio syndrome is a condition that affects approximately 25–50% of people who have previously contracted poliomyelitis—a viral infection of the nervous system—after the initial infection. Typically the symptoms appear 15–30 years after recovery from the original paralytic attack, at an age of...
.
Spinal cord injury:
Standers are used by people with both paraplegia
Paraplegia
Paraplegia is an impairment in motor or sensory function of the lower extremities. The word comes from Ionic Greek: παραπληγίη "half-striking". It is usually the result of spinal cord injury or a congenital condition such as spina bifida that affects the neural elements of the spinal canal...
and quadriplegia
Quadriplegia
Tetraplegia, also known as quadriplegia, is paralysis caused by illness or injury to a human that results in the partial or total loss of use of all their limbs and torso; paraplegia is similar but does not affect the arms...
since a variety of support options are available to accommodate for mild to severe disabilities. Doug Betters
Doug Betters
Doug Betters is an American football player who played defensive end for the Miami Dolphins from 1978 to 1987.After graduating from Arlington Heights High School in Illinois, Betters played college Division I football for the University of Montana Grizzlies from 1974 to 1976, then transferred to...
and Mike Utley
Mike Utley
Michael Utley is a former American football player. He is known for being paralyzed during an NFL game.-NFL career:...
are both former NFL football players who are quadriplegics due to spinal cord injury. They both stand using active standers.
Bone mineral loss and osteoporosis
Osteoporosis
Osteoporosis is a disease of bones that leads to an increased risk of fracture. In osteoporosis the bone mineral density is reduced, bone microarchitecture is deteriorating, and the amount and variety of proteins in bone is altered...
are common consequences after spinal cord injury
Spinal cord injury
A spinal cord injury refers to any injury to the spinal cord that is caused by trauma instead of disease. Depending on where the spinal cord and nerve roots are damaged, the symptoms can vary widely, from pain to paralysis to incontinence...
. Therapeutic standing, a weight-bearing intervention that can be applied using a standing frame, has traditionally been incorporated into rehabilitation programs for those with chronic spinal cord injury in order to prevent osteoporosis. A systematic review of the literature conducted by Biering-Sorenson et al. (2009) shows that therapeutic standing in the chronic phase of injury, defined as one year after injury, has no effect on maintaining bone density
Bone density
Bone density is a medical term normally referring to the amount of mineral matter per square centimeter of bones. Bone density is used in clinical medicine as an indirect indicator of osteoporosis and fracture risk.This medical bone density is not the true physical "density" of the bone, which...
. Results on the effectiveness of therapeutic standing during the first year of injury are conflicting and show that shorter, less aggressive intervention is less effective. If therapeutic standing is to be incorporated into treatment, it should be more aggressive and initiated in the early stages of injury if any beneficial impacts on bone mineral density are hoped to be achieved.
Common settings and applications
Standing devices are used in a variety of settings including:- In the home and workplace,
- Early intervention centers,
- Schools (special educationSpecial educationSpecial education is the education of students with special needs in a way that addresses the students' individual differences and needs. Ideally, this process involves the individually planned and systematically monitored arrangement of teaching procedures, adapted equipment and materials,...
classes or the inclusive classroom), adapted physical educationAdapted Physical EducationAdapted physical education is the art and science of developing, implementing, and monitoring a carefully designed physical education instructional program for a learner with a disability, based on a comprehensive assessment, to give the learner the skills necessary for a lifetime of rich leisure,...
classes, - Children's hospitals and therapy centers,
- Rehabilitation facilities and hospitals,
- Extended care units, nursing homes, assisted living centers and group homes, and
veterans' hospitals.
Obtaining a standing frame
Funding (government funding or health insurance) for standing equipment is achievable in most developed countries, but usually requires medical justification and a letter of medical necessityMedical necessity
Medical necessity is a United States legal doctrine, related to activities which may be justified as reasonable, necessary, and/or appropriate, based on evidence-based clinical standards of care. Other countries may have medical doctrines or legal rules covering broadly similar grounds...
(a detailed medical prescription
Medical prescription
A prescription is a health-care program implemented by a physician or other medical practitioner in the form of instructions that govern the plan of care for an individual patient. Prescriptions may include orders to be performed by a patient, caretaker, nurse, pharmacist or other therapist....
) written by a physical therapist or medical professional.
Sources
- Able data factsheet on standing aidshttp://www.abledata.com/abledata_docs/standaid.htm
External links
- National Registry of Rehabilitation Technology Suppliers - nrrts.org
- Mobile Standers is an article giving information on various makers of manual and power mobile standers.
- Standing and gait therapy can be a winning combination for SCI patients
- List of research articles documenting the benefits of standing frames