Stander use is beneficial for promoting good posture and skeletal alignment as well as decreasing spasticity. Orthotic intervention is also frequently done with these same objectives in mind. Because even the best standers are not able to provide the full trunk and distal extremity support some individuals may require, orthotics are a valuable and often essential adjunct to supported standing programs. Bony alignment develops as a result of the forces placed upon the body, so achieving a desirable standing position is especially important for growing children and adolescents.
If you are beginning a standing program with a child and are unsure whether lower extremity orthotics are necessary, I recommend placing the child in the stander in his or her bare feet. If foot pronation or supination is significant and intrinsic muscle motion is minimal or absent, discussing a referral for consultation with an orthotist with the child’s physician is likely in order. In the case of progressive neurological disorders a child may initially maintain a desirable position, but should be re-checked on occasion. Read more