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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 wheelchair supports the person in a standing position and enables interaction with people and objects at eye level.
While they all hold the same basic function, there is much variety within standing wheelchairs. As assistive devices, standing wheelchairs are primarily designed according to their user's needs. The lifting mechanisms incorporated can be either manually operated or powered with hydraulic devices that range in strength. Wheels can also be power-operated or manual. Steel alloys are often used in production to strike a balance of durability, strength, flexibility and lightness, however there are heavier and lighter metals available. Specific models are built to be used regularly while others only assist in specific tasks. [1] Some standing wheelchairs may even be driven from the standing position, however there is medical concern of an increased risk of bone fractures while driving due to the legs being under a heavy load. [2]
Standing wheelchairs are used by people with mild to severe disabilities including: spinal cord injury, traumatic brain injury, cerebral palsy, spina bifida, muscular dystrophy, multiple sclerosis, stroke, rett syndrome, post-polio syndrome and more.
Standing chairs are used by people with both paraplegia and quadriplegia, since a variety of standing options are available to accommodate for mild-to-severe disabilities.
Numerous studies show evidence of standing wheelchairs providing specific health benefits over their non-mechanized counterparts. Some of these benefits have included improved circulation, higher bone density, and lower risk for contractions and skeletal deformation. [2] Several researchers and users alike report that benefits are not solely physical – the greater range of movement provided by mechanized standing wheelchairs allow users to lead more independent lives, resulting in improved mental health and a higher quality of life. [3] [4]
 | The examples and perspective in this section deal primarily with the United States and do not represent a worldwide view of the subject.(January 2020) |
Standing wheelchairs come at prices many consider inaccessible, with powered versions ranging from $10,000-$15,000. This inaccessibility resulted in a push for insurance companies to incorporate this technology into their existing plans. In 2020, the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition appealed to the Centers for Medicare and Medicaid Services (CMS), requesting both standing wheelchairs and wheelchairs with power-elevated seats be covered under the Durable Medical Equipment Benefit. [5] That request was partially granted in May 2023, as CMS incorporated wheelchairs with power-elevated seats into the benefit and claimed standing wheelchairs would be considered in the future. [6]
As of Now, Medicare may help fund some portion of a standing wheelchair, while Medicaid 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.
Funding (government funding or insurance) for standing equipment is achievable, but usually requires medical justification and a letter of medical necessity (a detailed prescription) written by a physical therapist or medical professional.
In the U.S. there are various funding options for purchasing durable medical equipment (DME) such as standing wheelchairs:
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.
In the United States, Medicaid is a government program that provides health insurance for adults and children with limited income and resources. The program is partially funded and primarily managed by state governments, which also have wide latitude in determining eligibility and benefits, but the federal government sets baseline standards for state Medicaid programs and provides a significant portion of their funding.
Medicare is a federal health insurance program in the United States for people age 65 or older and younger people with disabilities, including those with end stage renal disease and amyotrophic lateral sclerosis. It was begun in 1965 under the Social Security Administration (SSA) and is now administered by the Centers for Medicare and Medicaid Services (CMS).
The Centers for Medicare & Medicaid Services (CMS) is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards. In addition to these programs, CMS has other responsibilities, including the administrative simplification standards from the Health Insurance Portability and Accountability Act of 1996 (HIPAA), quality standards in long-term care facilities through its survey and certification process, clinical laboratory quality standards under the Clinical Laboratory Improvement Amendments, and oversight of HealthCare.gov. CMS was previously known as the Health Care Financing Administration (HCFA) until 2001.
Lift chairs, also known as lift recliners or riser armchairs, are chairs that feature a powered lifting mechanism that pushes the entire chair up from its base and so assists the user to a standing position.
A mobility scooter is an electric personal transporter used as mobility aid for people with physical impairment, mostly auxiliary to a powered wheelchair but configured like a motorscooter. When motorized they function as micromobility devices and are commonly referred to as a powered vehicle/scooter, or electric scooter. Non-motorized mobility scooters are less common, but are intended for the estimated 60% of wheelchair users who have at least some use of their legs. Whilst leg issues are commonly assumed to be the reason for using scooters, the vehicles are used by those with a wide range of conditions from spinal injuries to neurological disorders.
Long-term care (LTC) is a variety of services which help meet both the medical and non-medical needs of people with a chronic illness or disability who cannot care for themselves for long periods. Long-term care is focused on individualized and coordinated services that promote independence, maximize patients' quality of life, and meet patients' needs over a period of time.
Medigap refers to various private health insurance plans sold to supplement Medicare in the United States. Medigap insurance provides coverage for many of the co-pays and some of the co-insurance related to Medicare-covered hospital, skilled nursing facility, home health care, ambulance, durable medical equipment, and doctor charges. Medigap's name is derived from the notion that it exists to cover the difference or "gap" between the expenses reimbursed to providers by Medicare Parts A and B for services and the total amount allowed to be charged for those services by the United States Centers for Medicare and Medicaid Services (CMS).
A standing frame 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.
The California Medical Assistance Program is the California implementation of the federal Medicaid program serving low-income individuals, including families, seniors, persons with disabilities, children in foster care, pregnant women, and childless adults with incomes below 138% of federal poverty level. Benefits include ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder treatment, dental (Denti-Cal), vision, and long-term care and support. Medi-Cal was created in 1965 by the California Medical Assistance Program a few months after the national legislation was passed. Approximately 15.28 million people were enrolled in Medi-Cal as of September 2022, or about 40% of California's population; in most counties, more than half of eligible residents were enrolled as of 2020.
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 Medicaid:
This article discusses the definitions and types of home medical equipment (HME), also known as durable medical equipment (DME), and durable medical equipment and prosthetics and orthotics (DMEPOS).
In the United States, health insurance helps pay for medical expenses through privately purchased insurance, social insurance, or a social welfare program funded by the government. Synonyms for this usage include "health coverage", "health care coverage", and "health benefits". In a more technical sense, the term "health insurance" is used to describe any form of insurance providing protection against the costs of medical services. This usage includes both private insurance programs and social insurance programs such as Medicare, which pools resources and spreads the financial risk associated with major medical expenses across the entire population to protect everyone, as well as social welfare programs like Medicaid and the Children's Health Insurance Program, which both provide assistance to people who cannot afford health coverage.
Medicare Advantage is a type of health plan offered by Medicare-approved private companies that must follow rules set by Medicare. Most Medicare Advantage Plans include drug coverage. Under Part C, Medicare pays a sponsor a fixed payment. The sponsor then pays for the health care expenses of enrollees. Sponsors are allowed to vary the benefits from those provided by Medicare's Parts A and B as long as they provide the actuarial equivalent of those programs. The sponsors vary from primarily integrated health delivery systems to unions to other types of non profit charities to insurance companies. The largest sponsor is a hybrid: the non profit charity AARP using UnitedHealth.
The United States spends approximately $2.3 trillion on federal and state social programs include cash assistance, health insurance, food assistance, housing subsidies, energy and utilities subsidies, and education and childcare assistance. Similar benefits are sometimes provided by the private sector either through policy mandates or on a voluntary basis. Employer-sponsored health insurance is an example of this.
A wheelchair is a mobilized form of chair using 2 or more wheels, a footrest and armrest usually cushioned. It is used when walking is difficult or impossible to do due to illnesses, injury, disabilities, or age related health conditions.
A motorized wheelchair, powerchair, electric wheelchair or electric-powered wheelchair (EPW) is a wheelchair that is propelled by means of an electric motor rather than manual power. Motorized wheelchairs are useful for those unable to propel a manual wheelchair or who may need to use a wheelchair for distances or over terrain which would be fatiguing in a manual wheelchair. They may also be used not just by people with 'traditional' mobility impairments, but also by people with cardiovascular and fatigue-based conditions.
The Healthcare Common Procedure Coding System is a set of health care procedure codes based on the American Medical Association's Current Procedural Terminology (CPT).
Health care finance in the United States discusses how Americans obtain and pay for their healthcare, and why U.S. healthcare costs are the highest in the world based on various measures.
Patient navigators educate and assist United States citizens in enrolling into health benefit plans stipulated in the Patient Protection and Affordable Care Act (ACA). Patient navigators are also called "insurance navigators" or "in-person assisters" who have defined roles under the ACA. Although their roles might overlap, patient navigators are not community health workers or health advocates. "Navigators" work in states with Federally-Facilitated Exchanges (FFEs) or State Partnership Exchanges.
As of 2017, approximately 1.4 million Americans live in a nursing home, two-thirds of whom rely on Medicaid to pay for their care. Residential nursing facilities receive Medicaid federal funding and approvals through a state health department. These facilities may be overseen by various types of state agency.
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