Standing Wheelchair
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A standing wheelchair (also known as a standing chair, a wheeled stander or a stander) 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 ...
, similar to a
standing frame A standing frame (also known as a stand, stander, standing technology, standing aid, standing device, standing box, tilt table) is assistive technology that can be used by a person who relies on a wheelchair for mobility. A standing frame provide ...
, that allows a
wheelchair A wheelchair is a chair with wheels, used when walking is difficult or impossible due to illness, injury, problems related to old age, or disability. These can include spinal cord injuries ( paraplegia, hemiplegia, and quadriplegia), cerebr ...
user to raise the chair from a seated to a standing position. The standing wheelchair supports the person in a standing position and enables interaction with people and objects at eye level.


Types and function

Standing wheelchairs can be either manually operated, have power-operated wheels but manual lifting mechanisms or be fully powered with, for example, hydraulic lifting mechanisms. They are used both to achieve regular mobility and to stand the person up using hydraulics or other power sources. Some standing wheelchairs may be driven from the standing position, however there is some medical concern of an increased risk of long bone fractures while driving due to the legs being under a heavy load.


Diagnosis and users

Standing wheelchairs 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 ...
including:
spinal cord injury A spinal cord injury (SCI) is damage to the spinal cord that causes temporary or permanent changes in its function. Symptoms may include loss of muscle function, sensation, or autonomic function in the parts of the body served by the spinal cor ...
,
traumatic brain injury A traumatic brain injury (TBI), also known as an intracranial injury, is an injury to the brain caused by an external force. TBI can be classified based on severity (ranging from mild traumatic brain injury TBI/concussionto severe traumatic b ...
,
cerebral palsy Cerebral palsy (CP) is a group of movement disorders that appear in early childhood. Signs and symptoms vary among people and over time, but include poor coordination, stiff muscles, weak muscles, and tremors. There may be problems with sensa ...
,
spina bifida Spina bifida (Latin for 'split spine'; SB) is a birth defect in which there is incomplete closing of the spine and the membranes around the spinal cord during early development in pregnancy. There are three main types: spina bifida occulta, me ...
,
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 Rett syndrome (RTT) is a genetic disorder that typically becomes apparent after 6–18 months of age and almost exclusively in females. Symptoms include impairments in language and coordination, and repetitive movements. Those affected often h ...
,
post-polio syndrome Post-polio syndrome (PPS, poliomyelitis sequelae) is a group of latent symptoms of poliomyelitis (polio), occurring at about a 25–40% rate (latest data greater than 80%). These symptoms are caused by the damaging effects of the viral infection ...
and more. Standing chairs 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 standing options are available to accommodate for mild-to-severe disabilities.


Health benefits

Numerous studies have shown evidence that standing wheelchairs may provide specific health benefits. Some of these health benefits include improved circulation, urinary health, bowel function and bone density. Standing wheelchairs may also improve overall quality of life and independence among users.


Documentation and funding

Medicare may help fund some portion of a standing wheelchair, while
Medicaid Medicaid in the United States is a federal and state program that helps with healthcare costs for some people with limited income and resources. Medicaid also offers benefits not normally covered by Medicare, including nursing home care and pers ...
funding varies from state to state in the U.S. Many insurance companies, vocational rehabilitation organizations, and medical case managers are increasingly funding standing wheelchairs because of the long-term health and quality of life benefits that come from passive standing.


Effective documentation

Funding (government funding or insurance) for standing equipment is achievable, 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 prescription) written by a physical therapist or medical professional.


Funding sources

In the U.S. there are various funding options for purchasing
durable medical equipment Durable medical equipment is any medical equipment used in the home to aid in a better quality of living. It is a benefit included in many insurance policies and in some cases covered by Medicare benefits. The item is defined by Title XIX for Med ...
(DME) such as standing wheelchairs: * Public insurance/government funding (i.e.
Medicaid Medicaid in the United States is a federal and state program that helps with healthcare costs for some people with limited income and resources. Medicaid also offers benefits not normally covered by Medicare, including nursing home care and pers ...
, Waivers, etc.) * Private insurance companies (i.e. Blue Cross,
health maintenance organization In the United States, a health maintenance organization (HMO) is a medical insurance group that provides health services for a fixed annual fee. It is an organization that provides or arranges managed care for health insurance, self-funded healt ...
s (HMOs), PPOs, etc.) *
Worker's compensation Workers' compensation or workers' comp is a form of insurance providing wage replacement and medical benefits to employees injured in the course of employment in exchange for mandatory relinquishment of the employee's right to sue his or her emp ...
* Disability insurance * Liability insurance (i.e. car, home, etc.) *
Out-of-pocket An out-of-pocket expense (or out-of-pocket cost, OOP) is the direct payment of money that may or may not be later reimbursed from a third-party source. For example, when operating a vehicle, gasoline, parking fees and tolls are considered out-of ...
(cash or credit card) * Possible payment plan through supplier * Child's school purchase for use at school (i.e. standing is part of child's
Individualized Education Program An Individualized Education Program (IEP) is a legal document under United States law that is developed for each public school child in the U.S. who needs special education. It is created through a team of the child's parent(s) and district person ...
(IEP)) * Purchase by workplace for use while on the job * Purchase through
VA Hospital Veterans' health care in the United States is separated geographically into 19 regions (numbered 1, 2, 4-10, 12 and 15–23) In January 2002, the Veterans Health Administration announced the merger of VISNs 13 and 14 to create a new, combined netw ...
* Assistance from local groups such (i.e. Rotary clubs, Lions, etc.) * Assistance from disability groups (i.e. MDA, MS Society, etc.) Most states have resources such as PAAT (Protection Advocacy for Assistive Technology) and State Technology Assistance Projects that are resources for consumers seeking funding or going through the appeals process.


References

{{commons category Assistive technology Wheelchairs Accessibility Medical equipment