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Standing principles

Wheelchair users are at high risk of developing secondary conditions because they often sit for long periods of time. These secondary conditions can reduce their quality of life significantly. The advantages of putting users into a standing position include increasing bone mass, strengthening muscles, furthering respiration, and enhancing development of the hip socket. The upright position also increases a users viewing area and enhances their feeling of well-being. Weight bearing is important to the user when developing and strengthening the hip joints.

Standing can:

  • increase bone density
  • decrease joint contractures
  • improve cardiopulmonary function
  • improve digestion
  • increase bone growth
  • increase alertness

Many CP patients are users of standing frames. They say the spasticity in their legs decreases after regular use of the standing frame. In recent years science has shown that standing has a positive effect on reducing and preventing spasticity. Standing frequency is more important than the length of time standing. In normal development the child starts crawling/pulling themselves at eight months, standing at ten months and walking at 12-15 months. We recommend that children with special needs get their first standing frame at about the same time most children start total weight bearing on their legs, i.e. around the age of one year.

When standing:

When positioning children in standing frames it is important to use the pelvis as a key point. The pelvis must be symmetrical and it must be neutrally tilted. The user must stand symmetrically with equal weight on both legs and with pelvis in a neutral position. Head and body should be in midline.

Prone standing:

Prone standing stimulates the user to more active extension, epecially if the frame is tilted a few degrees forwards. Standing supine is choosen if the user has poor head control or to make transfer easier to the standing frame.