A great tool for reducing a contracted hip is an EasyStand fitted with an Independent Kneepads Option.
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?
Here is our friend and EasyStand customer Tiffiny Carlson sharing her words of wisdom. Tiff is the founder of Beautyability and the column writer for the SCI Life column in New Mobility Magazine, as well as a freelance writer for many other websites and publications. She is a quadriplegic with a lot of knowledge to share. She is spunky and fun and has some great advice for anyone who uses a wheelchair, especially for those with SCI.
Watch for more from Tiffiny Carlson, as she will be a guest contributor on the EasyStand blog!
What do you think of these 10 Commandments of Life in a Wheelchair? Do you have any that you would add or change?
On Wednesday, we went to Ryan Kane’s home to do a photo shoot with our new and upcoming pediatric stander, called the EasyStand Bantam, which is scheduled to be released this fall.
Ryan is very active, very smart, and has an adorable smile. His mom, Luann, has great things to share on how she works with Ryan and Ryan’s therapists to keep him the healthy, happy boy that he is.
Plan on seeing much more of Ryan and the new EasyStand Bantam in the months to come! And thank you Ryan for all that coffee!
Have you seen our free “Life After Spinal Cord Injury (SCI)” DVD? It might be worth your while to take a look. Scott, a Physical Therapist, from California, did and sent us this comment.
"Life After SCI" DVD
“I like the “Life After SCI” series and want to give it to some of my clients to show them that life doesn’t stop after injury, and to illustrate to parents that some SCI’s that I’ve met and seen are some of the most able-bodied people I know. Thank you for the video and the work that you do with the products you develop and sell!” Scott A. Medlin PT, MPT from Fontana, CA
This DVD covers a variety of topics like wheelchair sports, transferring tips, the importance of standing, and traveling in a wheelchair. It also has inspirational interviews discussing rehab, family reaction, and adapting.
“Life After SCI” Vol. 1 was released in 2000, later Volume 2 was created, since then tens of thousands of these videos were sent out as a free resource. Some hospitals even run the video on their closed-circuit TV systems for newly injured SCI patients to watch during rehab.
For a sneak preview of clips from the “Life After SCI” DVD, go to our Videos page or YouTube page. Or request a copy by visiting our Contact Us page. Remember, it’s FREE.
How have the Life After SCI videos to be useful to you? Would you recommend the video to others?
I recently ran across a nifty website called Linkedin. Linkedin is kind of similar to Facebook but is for professionals who want to network with others in their industry. I would encourage anyone who has a career where networking and relationships are important, to check it out.
You can find people you know by searching by name or importing your email list, then requesting that you get “connected”. When you get a “connection” in Linkedin, you can then view that person’s connections and profile. You can also ask to be introduced to a person who you don’t know. It is a bit of an online resume, but not exactly for job hunting, more for expanding your network of contacts. I have even run across a Disaboom group in Linkedin, specifically for people who have a disability or work closely with people with disabilities.
We all have different industry organizations such as NRRTS, APTA, and TXRPC which are awesome channels for networking within our respective areas of expertise. Linkedin is one more way to expand on some of those resources, by linking to some of your current contacts, or maybe discovering some contacts you have lost touch with. I would especially encourage suppliers, clinicians, and people who like to network to check out Linkedin.
Have you used Linkedin or another social media website? What traditional or non-traditional networking strategies do you use?
The most enjoyable aspect of my job at EasyStand is seeing the reaction of people standing for the first time, or for the first time in many years. My last job was working for the ROHO Cushion Company where I was concentrating my attention on people’s butts, and now I am looking at smiling faces as they stand. The fun is also to see the reaction of others as the person comes to standing. I worked with a little boy at his kindergarten school, who we put in a Magician-ei Stander and the reaction of his teachers was tremendous. They ran down the hall to get other teachers and aids so they could show him standing. But the most fun was watching his classmates come up to him and interact in a totally different way than when he sat quietly in his wheelchair. I will also, never forget seeing a husband and wife looking eye-to-eye with great emotion when the husband stood in the Evolv Stander for the first time in over 8 years. Funding agencies do not give much credence to the psycho/social benefits of standing, only to the physical benefits. But as we all know, if you lose one, you will loose the other.
What reactions have your experienced when seeing someone stand for the first time or after a long period of time?
This is a short MP3 audio file on funding resources for standers. It is one of six parts of an Evolv In-service Podcast that was created for suppliers, but we are sharing this section on funding with clinicians and consumers as well. Suppliers can download the entire in-service podcast under supplier log in on the EasyStand website, with just an account number and password.
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Listen to this MP3 for an overview of the funding resources available in our Funding Guide to Standing Technology. The Funding Guide is Free 100+ page book that is available in print format as well as PDF.
The August/September issue of Rehab Management featured an article on standing therapy, called “Stand for Health” by Amy Meyer, PT. It covers very thoroughly the benefits of a standing program, and the importance of prescribing a standing program to reduce the risk of complications and gain the benefits of weight bearing. It is a great article overall, but doesn’t really identify the differences between a standing frame and standing wheelchair.
The article lists the many different ways of standing, “tilt tables, individual standing frames, (static or dynamic), gait trainers, or other ambulation aids, and also by integrating standing into a wheelchair seating system.” But then it goes on throughout the article to only talk about wheelchair standing devices, and “incorporating a standing system into a wheelchair“. However, the photos throughout the article are of standing devices only, not standing wheelchairs, or wheelchairs that have a standing device built-in.
For most people, the choice of purchasing a standing frame or standing wheelchair comes down to a few factors:
Price - Standing frames range from $2000-$6000, standing wheelchairs can be $20,000 or more.
Function - Standing frames can provide more features since they focus on being a standing device only, but a standing wheelchair may be useful in a highly functional setting, such as the workplace to move from sitting to standing and around the office quickly.
Upright versus Supine Positioning - Typically the ultimate goal of a standing frame is a vertical upright position, where the standing wheelchair position is a slightly supine position.
The RESNA Position Paper on Standing Wheelchairs has some awesome research backing up the benefits of standing. There is also a Position paper in the works for Standing Devices, without the emphasis on the standing device having to be on a wheelchair.
Together with their therapist, a person who is looking at standing equipment should get the device that is most appropriate for their needs. Both standing frames and standing wheelchairs will provide the important medical benefits.
What factors helped you decide to buy a standing frame or standing wheelchair? What do you like best about the standing device that you chose?
Does a person benefit more from standing than from being tilted in their wheelchair? Because nothing in rehab medicine is black and white, this is a case by case answer. But usually the main benefits to tilting someone in their wheelchair are: weight shift to alleviate pressure off the ischial tuberosities and aiding in head control and body position and help with fatigue. But the disadvantage can be urine retention, contractures in the lower extremities and a limitation in sensory stimulation.
Standing, on the other hand has many documented health benefits such as, breaking up the person’s sitting posture with passive ROM, this can help maintain a good lordotic curve in the spine resulting in better head control and expanding the chest for greater lung capacity. Also, from looking at pressure images most people get significantly better pressure relief when standing, than when they are tilted back. And when someone is standing their bowel and bladder function is facilitated, pain patterns are sometimes diminished, spasticity in the lower extremities is often improved and very important, the person is in a good position to interact with their environment.
There are many other documented benefits accredited to standing but why is tilt prescribed so often? The most common reasons are force of habit, funding and convenience. Because of technology improvements standing for many people, with a variety of disabilities, is becoming easier. And as the importance of position change for the seated person gains acceptance, we will see more money allocated for standing products. Our bodies and mind were not designed to sit in one position for long periods of time. Change is good.
What are your thoughts on standing vs. tilt? How do you determine when to prescribe standing and when to prescribe tilt and recline?
Dave Nesje from Altimate Medical Customer Service meets his match with Maurice Hicks, return man of the Minnesota Vikings.
As many of you probably know, Altimate Medical is based out of Morton, a small rural Minnesota town. Most of us are loyal football fans, and those who talk about cheese during football games are likely to get the boot. Well three of our employees had the privilege of going to the Minnesota Vikings Training Camp a couple weeks ago, in Mankato, Minnesota to ham it up with some giant football players.
They topped off the day with a tour of the Corporate Graphics printing facility to see what the printing business is all about, and how all those EasyStand catalogs get printed so nice.
Find topics and personal stories on life in a wheelchair and disability, healthy living, the benefits of standing, and what's happening with EasyStand.
