Last week I was involved in a few EasyStand evaluations which are generally good experiences. This time I was working with the EasyStand Evolv Glider with the new pullback seat for extended range. One client was contracted in one hip which limited his ability to get fully upright in the Glider without sliding the knee support on the contracted side forward. His contracture also limited his ability to move through the extended “gliding” range. Although this client may not be a candidate for the Glider at this current stage he will be able to use it if his contracture can be reduced.
A great tool for reducing a contracted hip is an EasyStand fitted with an Independent Kneepads Option (available on most EasyStand standers). The idea is to get an extended weight bearing stretch through the contracted leg as much as possible, increasing extension gradually. The way this is done in the EasyStand is to drop the footplate on the contracted side into the plantar position and raise it slightly in relation to the opposite footplate. Then adjust the independent kneepad on the contracted side back away from the knee so that it can be bent, accommodating for the hip contracture.
It may take a few times up and down in the EasyStand to get the settings just right. The target is to find the correct adjustment so that the upper body is upright and aligned above the hips and not compensating by leaning away from the contracted hip. Once you find that position you can reduce the degree of plantar flexion in the footplate and bring the knee pad back toward the body increasing the stretch through the leg as the client progresses. Keep in mind that any time you are adjusting the footplates the client should be brought back down to the seated position.
An extended passive stretch is key to dealing with contractures, and the EasyStand provides a safe and effective way to get it done.
Clinicians, have you tried this method of accommodating contractures in the EasyStand? What has worked or not worked for you in accommodating special needs like this?