Introduction to Standing Frames

Therapeutic standing is a common and accepted aspect of paediatric physiotherapy practice. Rationale for the use of adaptive equipment to aid standing in children over the age of 12 months is primarily to manage development of the musculoskeletal system in children with developmental disorders whose motor control is not sufficient to allow them to stand independently. Such disorders include: Cerebral Palsy (CP), Muscular Atrophy, Arthrogyrphosis, Spina Bifida, Osteogenesis imperfectica, Acute Brain Injury, Paediatric Stroke.

According to Bush (2006) the proposed benefits of assisted standing include:

  • maintenance/increase bone mineral density
  • maintenance of soft tissue length including muscle stretch
  • improvement of hip integrity
  • experience of upright position in good alignment
  • improved function
  • improved bladder and bowel function
  • psychological and social benefits.

What is assisted therapeutic standing?

Where a child is unable to actively stand without support, a device is provided that will enable them to maintain an upright weight-bearing position against gravity for a prolonged period of time. This may take to form of an upright standing frame, a prone standing frame, a supine standing frame or a multi-positional standing frame. Support can be provided at various ‘key points’ of the body including the thorax, trunk, pelvis, knees and ankles and can be adjusted to accommodate the child’s changing musculoskeletal status. Standers are supplied for use within the home and educational setting and instructions for their use are given to parents, children and their associated carers.

Introduction

People rarely think about the ability to stand and how it affects their daily lives. Standing is an alternative to sitting. It gives us greater access to social, vocational, and recreational activities. It improves the body's physiological functioning.  The right standing aid may also be more cost effective than customizing a job site or home because one of its primary functions is to assist people in adapting to their surroundings.

There is a vast array of standing devices to choose from. Some devices allow a person to move upright from place to place with either manual or powered propulsion. Others are stationary. Most standing aids can be adjusted for growth or changes in physical condition; most can be used by more than one person. Some devices are fairly simple, built out of plywood with foam support pads that can easily be constructed by a handy relative or friend. Others are complicated, heavy, expensive products made with high technology.  Try to find out as much as you can about the standing aids that might fit your needs, and be an active participant in the selection of any product that you use.

Components of Standing Aids

Standing aids are available in three basic types: prone, supine, and vertical. All three types of standers share certain components. A list of those basic components, with brief descriptions, appears below:

  • Growth rods for back and torso areas allow a stander to be adjusted to accommodate changes in the user's height.
  • Back tilt adjustment increases or decreases the degree of incline. Feet stabilizers permit proper foot positioning and minimize internal or external hip rotation.
  • Footplates offer added stability by bearing weight and pressure. They make it easier for users to flex and extend of the ankles (dorsiflexion and plantar flexion).
  • Adjustable chest pads encourage the user to bear weight on the lower extremities by supplying varying degrees of chest support.
  • Adjustable knee blocks improve posture by controlling the knees’ ability to bend while the user is in a passive standing position.
  • Adjustable head and neck support serves two purposes, to accommodate changes in growth and to position the head and neck properly.
  • Adjustable torso support and torso tilt knobs adjust the degree of support and the degree of incline in the user's torso area.

 

 

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