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 Disability, people with disabilities and the elderly. Disabled people often have difficulty performing activities of daily living (ADLs) independently, ...

that can be used by a person who relies on 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), ce ...

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 In grammar, a supine is a form of verbal noun used in some languages. The term is most often used for Latin, where it is one of the four principal parts of a verb. The word refers to a position of lying on one's back (as opposed to ' prone', l ...

, 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 whee ...

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, ...

such as

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 br ...

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 sens ...

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, men ...

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 af ...

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 ...

stroke A stroke is a disease, medical condition in which poor cerebral circulation, blood flow to the brain causes cell death. There are two main types of stroke: brain ischemia, ischemic, due to lack of blood flow, and intracranial hemorrhage, hemorr ...

, 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 neur ...

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 S ...

and

Mike Utley Michael Gerard Utley (born December 20, 1965) is a former American football player. He played for the Detroit Lions of the National Football League from 1989 through 1991, when he was paralyzed during a game. Early life and college career A gra ...

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 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 a ...

are common consequences after

. 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, or bone mineral density, is the amount of bone mineral in bone tissue. The concept is of mass of mineral per volume of bone (relating to density in the physics sense), although clinically it is measured by proxy according to optic ...

. 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 Special education (known as special-needs education, aided education, exceptional education, alternative provision, exceptional student education, special ed., SDC, or SPED) is the practice of educating students in a way that accommodates th ...

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 i ...

, 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 su ...

(a detailed

medical prescription A prescription, often abbreviated or Rx, is a formal communication from a physician or other registered health-care professional to a pharmacist, authorizing them to dispense a specific prescription drug for a specific patient. Historicall ...

) 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