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 provides alternative positioning to sitting in a wheelchair by supporting the person in the standing position.
Common types of standers include: sit to stand, prone, supine, upright, multi-positioning standers, and standing wheelchairs. Long leg braces are also a standing device but not used often today.
Standers are used by people with mild to severe disabilities such as spinal cord injury, traumatic brain injury, cerebral palsy, spina bifida, muscular dystrophy, multiple sclerosis, stroke, Rett syndrome, and post-polio syndrome.
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. [1] 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. [2]
Standing devices are used in a variety of settings including:
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 (a detailed medical prescription) written by a physical therapist or medical professional.
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 assistance. ADLs are self-care activities that include toileting, mobility (ambulation), eating, bathing, dressing, grooming, and personal device care. Assistive technology can ameliorate the effects of disabilities that limit the ability to perform ADLs. Assistive technology promotes greater independence by enabling people to perform tasks they were formerly unable to accomplish, or had great difficulty accomplishing, by providing enhancements to, or changing methods of interacting with, the technology needed to accomplish such tasks. For example, wheelchairs provide independent mobility for those who cannot walk, while assistive eating devices can enable people who cannot feed themselves to do so. Due to assistive technology, disabled people have an opportunity of a more positive and easygoing lifestyle, with an increase in "social participation," "security and control," and a greater chance to "reduce institutional costs without significantly increasing household expenses." In schools, assistive technology can be critical in allowing students with disabilities access the general education curriculum. Students who experience challenges writing or keyboarding, for example, can use voice recognition software instead. Assistive technologies assist people who are recovering from strokes and people who have abstained injuries that effect their daily tasks.
Tetraplegia, also known as quadriplegia, is defined as the dysfunction or loss of motor and/or sensory function in the cervical area of the spinal cord. A loss of motor function can present as either weakness or paralysis leading to partial or total loss of function in the arms, legs, trunk, and pelvis; paraplegia is similar but affects the thoracic, lumbar, and sacral segments of the spinal cord and arm function is spared. The paralysis may be flaccid or spastic. A loss of sensory function can present as an impairment or complete inability to sense light touch, pressure, heat, pinprick/pain, and proprioception. In these types of spinal cord injury, it is common to have a loss of both sensation and motor control.
Functional electrical stimulation (FES) is a technique that uses low-energy electrical pulses to artificially generate body movements in individuals who have been paralyzed due to injury to the central nervous system. More specifically, FES can be used to generate muscle contraction in otherwise paralyzed limbs to produce functions such as grasping, walking, bladder voiding and standing. This technology was originally used to develop neuroprostheses that were implemented to permanently substitute impaired functions in individuals with spinal cord injury (SCI), head injury, stroke and other neurological disorders. In other words, a person would use the device each time he or she wanted to generate a desired function. FES is sometimes also referred to as neuromuscular electrical stimulation (NMES).
A mobility assistance dog or mobility service dog is a dog trained to assist a physically disabled person who has mobility issues, such as poor balance or being a non-ambulatory wheelchair user. Roles include "providing balance and stability" picking up and carrying objects, pulling wheelchairs, opening and closing doors, and operating light switches. Mobility assistance dogs can have significant positive impacts on the lives of their handlers.
The Shirley Ryan AbilityLab, formerly the Rehabilitation Institute of Chicago (RIC), is a not-for-profit nationally ranked physical medicine and rehabilitation research hospital based in Chicago, Illinois. Founded in 1954, the AbilityLab is designed for patient care, education, and research in physical medicine and rehabilitation (PM&R). The AbilityLab specializes in rehabilitation for adults and children with the most severe, complex conditions ranging from traumatic brain and spinal cord injury to stroke, amputation and cancer-related impairment. Affiliated with Northwestern University, the hospital is located on Northwestern’s Chicago campus and partners on research and medical efforts.
Rehabilitation engineering is the systematic application of engineering sciences to design, develop, adapt, test, evaluate, apply, and distribute technological solutions to problems confronted by individuals with disabilities. These individuals may have experienced a spinal cord injury, brain trauma, or any other debilitating injury or disease. Functional areas addressed through rehabilitation engineering may include mobility, communications, hearing, vision, and cognition, and activities associated with employment, independent living, education, and integration into the community.
Aquatic therapy refers to treatments and exercises performed in water for relaxation, fitness, physical rehabilitation, and other therapeutic benefit. Typically a qualified aquatic therapist gives constant attendance to a person receiving treatment in a heated therapy pool. Aquatic therapy techniques include Ai Chi, Aqua Running, Bad Ragaz Ring Method, Burdenko Method, Halliwick, Watsu, and other aquatic bodywork forms. Therapeutic applications include neurological disorders, spine pain, musculoskeletal pain, postoperative orthopedic rehabilitation, pediatric disabilities, and pressure ulcers.
Shepherd Center is a private, non-profit hospital in Atlanta, Georgia. Founded in 1975, the hospital focuses on rehabilitation for people with spinal cord injury and disease, acquired brain injury, multiple sclerosis, chronic pain and other neuromuscular problems.
A mobility aid is a device designed to assist walking or otherwise improve the mobility of people with a mobility impairment.
DMC Rehabilitation Institute of Michigan (RIM) is one of the eight hospitals affiliated with the Detroit Medical Center. RIM is one of the largest, academic, rehabilitation hospitals in the United States specializing in rehabilitation medicine and research. RIM offers clinical treatment in spinal cord injury, brain injury, stroke, complex trauma and orthopedics and catastrophic injury care. The institute is home to the Center for Spinal Cord Injury Recovery, a facility designed to implement and study innovative treatments in spinal cord injury recovery.
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. The standing wheelchair supports the person in a standing position and enables interaction with people and objects at eye level.
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.
Magee Rehabilitation Hospital, part of Jefferson Health, founded in 1958, is a 96-bed specialty medical rehabilitation hospital providing physical and cognitive rehabilitation services. Magee's flagship facility is located in Center City Philadelphia. In addition to the main campus that offers comprehensive services for spinal cord injury, brain injury, stroke, orthopaedic replacement, amputation, pain management and work injury, Magee provides an expanding outpatient network serving the surrounding communities. In 1985, Magee's brain injury rehabilitation program became the first in the nation to be accredited by the Commission on the Accreditation of Rehabilitation Facilities. Magee partnered with Jefferson Hospital to create one of the nation's 14 federally designated centers for spinal cord injury rehabilitation. Magee has been rated one of America's leading rehabilitation hospitals by U.S. News & World Report. Magee provides treatment to more than 5,000 individuals annually. Magee is authorized to treat wounded military personnel returning from war. Magee is not an Obligated Group Affiliate.
Spinal stenosis is an abnormal narrowing of the spinal canal or neural foramen that results in pressure on the spinal cord or nerve roots. Symptoms may include pain, numbness, or weakness in the arms or legs. Symptoms are typically gradual in onset and improve with leaning forward. Severe symptoms may include loss of bladder control, loss of bowel control, or sexual dysfunction.
Ekso Bionics Holdings Inc. is a company that develops and manufactures powered exoskeleton bionic devices that can be strapped on as wearable robots to enhance the strength, mobility, and endurance of industrial workers and people experiencing paralysis and mobility issues after a brain injury, stroke, or spinal cord injury. These robots have a variety of applications in the medical, military, industrial, and consumer markets. It enables individuals with any amount of lower extremity weakness, including those who are paralyzed, to stand up and walk.
When treating a person with a spinal cord injury, repairing the damage created by injury is the ultimate goal. By using a variety of treatments, greater improvements are achieved, and, therefore, treatment should not be limited to one method. Furthermore, increasing activity will increase his/her chances of recovery.
The goal of physical and occupational therapy in Duchenne muscular dystrophy is to obtain a clear understanding of the individual, of their social circumstances and of their environment in order to develop a treatment plan that will improve their quality of life. Individuals with DMD often experience difficulties in areas of self-care, productivity and leisure. This is related to the effects of the disorder, such as decreased mobility; decreased strength and postural stability; progressive deterioration of upper-limb function; and contractures. Occupational and physical therapists address an individual's limitations using meaningful occupations and by grading the activity, by using different assessments and resources such as splinting, bracing, manual muscle testing (MMT), ROM, postural intervention and equipment prescription.
F8, also SP8, is a standing wheelchair sport classification open to people with spinal cord injuries, with inclusion based on a functional classification on a points system for lower limb functionality. Sportspeople in this class need to have less than 70 points. The class has largely been used in Australia and the United States. F8 has largely been eliminated because of a perceived lack of need internationally for a standing wheelchair class. Sports this class participates in include athletics, swimming and wheelchair basketball. In athletics, participation is mostly in field events.
Wheelchair sport classification is a system designed to allow fair competition between people of different disabilities, and minimize the impact of a person's specific disability on the outcome of a competition. Wheelchair sports is associated with spinal cord injuries, and includes a number of different types of disabilities including paraplegia, quadriplegia, muscular dystrophy, post-polio syndrome and spina bifida. The disability must meet minimal body function impairment requirements. Wheelchair sport and sport for people with spinal cord injuries is often based on the location of lesions on the spinal cord and their association with physical disability and functionality.
Rebecca D. Jackson is a medical researcher, medical practitioner and professor of endocrinology, diabetes and metabolism. Her research has been significant in the understanding and treatment of osteoporosis. She also researches the opioid crisis in Ohio.