At Altimate Medical, we feel that achieving the upright standing position is the optimal goal: with the head over the shoulders, shoulders over the hips, hips over the knees, and knees over the ankles. Not everyone can achieve this goal, but the natural sit to stand design of the EasyStand still allows for partial weight bearing, and a gradual progression towards full standing when physically possible.
Every disability and body is different, so we designed the EasyStand products to work well with various body types and specific support needs. With the sit to stand design of the EasyStand, the user doesn’t have to stand fully upright. Often, upright standing is the preference, but limitations of the person using the stander affect their standing position. Many times the user works towards the goal of upright standing, and other times, the goal is not to stand perfectly straight, but to stand as upright as they can (if even partially) to bear weight.
For people who have not stood in a while and/or have contractures, the EasyStand can allow their body to gradually acclimate to standing again. With the new EasyStand Bantam pediatric stander, a child can start in a supine position (or supine with hip/knee flexion if they have contractures) and eventually work their way to a full weight bearing standing position. This should be a protocol determined by the medical professional specific to the individual. It usually starts with a graduated program, slow on the way to upright, possibly stopping a couple of times before going to full standing, or maybe not going completely upright for a couple of secessions or more. Standing can help with contractures. According to Craig Kennedy, a T-12 paraplegic, standing benefits him in many ways when he does it consistently, “Thanks to the advice of my physical therapist who suggested a standing program; my legs are getting straighter every day.”
Perfect upright posture is not achievable for everyone. However, it is important to know what it looks like, and move towards the optimum standing posture when medically advised. Proper positioning in the EasyStand is needed to obtain optimum standing posture. Here are the basic steps:
1. Feet- Adjust the foot plates to match the client’s measurements. The femur should be slightly angled towards the floor (so the knee is slightly lower than the hip).
2. Seat- Adjust the seat depth to match the client’s measurements. Position the client’s hips as close as possible to the back of the stander (you should be able to fit two fingers between the front of the seat and the calf).
3. Knees- Position the kneepads snugly against the knees.
Look at the client to see that steps 1, 2, and 3 are satisfied. After your client is standing, look again and re-adjust if necessary. Remember, these are basic steps towards obtaining the optimum standing posture. Fine tuning the stander to fit the specific needs of the client may be necessary through support options or custom modifications.
What is your standing posture? What are you working towards? Have you experienced how standing can help with contractures?
Are there any guidelines for when knee flexion contractures are too great to continue standing? We’ve had students with 45 degrees or more of knee flexion limitation, contractures not expected to improve. Typically they are multi-handicapped students, non-verbal & we are wondering if standing should be continued or are we over stressing joints? Is there any research information regarding this?
Thank you!
Hi Ann,
Each standing program is geared to the needs and goals of the individual. It is essential to risk assess each individual with respect to potential problems and areas of precaution in order to address standing in an appropriate manner with appropriate observations.
At this time there is not a specific weight bearing protocal for all individuals. If you feel an individual is at risk for joint injury I strongly encourge you to stop the weight bearing program until you can discuss it with the client’s physician.
Here is a link to studies that address ROM and contractures on our website;
http://www.easystand.com/health-benefits/display.cfm?categoryID=
Best regards,
Nancy