A standing frame (also known as a stand, stander, standing technology, standing aid, standing device, standing box, tilt table) is

assistive technology Assistive technology (AT) is a term for assistive, adaptive, and rehabilitative devices for people with disabilities and the elderly. Disabled people often have difficulty performing activities of daily living (ADLs) independently, or even with ...

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.

Types and function

Common types of standers include: sit to stand, prone, supine, upright, multi-positioning standers, and

standing wheelchair A standing wheelchair (also known as a standing chair, a wheeled stander or a stander) is assistive technology, similar to a standing frame, that allows a wheelchair user to raise the chair from a seated to a standing position. The standing wheel ...

s. Long leg braces are also a standing device but not used often today.

Categories of standers

By mobility

* ''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.

By type

* Prone: Prone standers distribute the body weight to the front of the individual and usually have a tray in front of them. This makes them good for users who are actively trying to carry out some task. * Supine: Supine standers distribute the body weight to the back and are good for cases where the user has more limited mobility or is recovering from injury. * Sit-to-Stand: Sit-to-Stand devices are used to enable people in wheelchairs to stand without requiring other people to lift them in. This is more commonly used by adults than children because children are generally light enough for one person to lift them.

Diagnoses and users

Standers are used by people with mild to severe

disabilities Disability is the experience of any condition that makes it more difficult for a person to do certain activities or have equitable access within a given society. Disabilities may be cognitive, developmental, intellectual, mental, physical, se ...

such as spinal cord injury, traumatic brain injury, cerebral palsy, spina bifida,

muscular dystrophy Muscular dystrophies (MD) are a genetically and clinically heterogeneous group of rare neuromuscular diseases that cause progressive weakness and breakdown of skeletal muscles over time. The disorders differ as to which muscles are primarily affe ...

multiple sclerosis Multiple (cerebral) sclerosis (MS), also known as encephalomyelitis disseminata or disseminated sclerosis, is the most common demyelinating disease, in which the insulating covers of nerve cells in the brain and spinal cord are damaged. This d ...

stroke A stroke is a medical condition in which poor blood flow to the brain causes cell death. There are two main types of stroke: ischemic, due to lack of blood flow, and hemorrhagic, due to bleeding. Both cause parts of the brain to stop functionin ...

, Rett syndrome, and post-polio syndrome. Spinal cord injury: Standers are used by people with both

paraplegia Paraplegia, or paraparesis, is an impairment in motor or sensory function of the lower extremities. The word comes from Ionic Greek () "half-stricken". It is usually caused by spinal cord injury or a congenital condition that affects the neural ...

and quadriplegia since a variety of support options are available to accommodate for mild to severe disabilities.

Doug Betters Douglas Lloyd Betters (born June 11, 1956) is an American former professional football player who was a defensive end for the Miami Dolphins of the National Football League (NFL) from 1978 to 1987. After graduating from Arlington Heights High ...

and Mike Utley are both former

NFL The National Football League (NFL) is a professional American football league that consists of 32 teams, divided equally between the American Football Conference (AFC) and the National Football Conference (NFC). The NFL is one of the major ...

football players who are quadriplegics due to spinal cord injury. They both stand using active standers. Bone mineral loss and

osteoporosis Osteoporosis is a systemic skeletal disorder characterized by low bone mass, micro-architectural deterioration of bone tissue leading to bone fragility, and consequent increase in fracture risk. It is the most common reason for a broken bone ...

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.

Common settings and applications

Standing devices are used in a variety of settings including: * In the home and workplace, * Early intervention centers, * Schools ( special education classes or the inclusive classroom), adapted physical education classes, * Children's hospitals and therapy centers, * Rehabilitation facilities and hospitals, * Extended care units,

nursing homes A nursing home is a facility for the residential care of elderly or disabled people. Nursing homes may also be referred to as skilled nursing facility (SNF) or long-term care facilities. Often, these terms have slightly different meanings to in ...

, 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 necessity Medical necessity is a legal doctrine in the United States related to activities that may be justified as reasonable, necessary, and/or appropriate based on evidence-based clinical standards of care. In contrast, unnecessary health care lacks such ...

(a detailed medical prescription) written by a physical therapist or medical professional.

Sources

Able data factsheet on standing aids
* {{cite journal , vauthors=Holland D, Holland T , title=Taking a stand , journal=Rehab Manag , volume=19 , issue=2 , pages=44–9 , date=March 2006 , pmid=16538962 , url=http://www.rehabpub.com/features/32006/5.asp

External links

National Registry of Rehabilitation Technology Suppliers - nrrts.org
Assistive technology Mobility devices Accessibility Medical equipment