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Wednesday, November 18, 2009

Benefits of a Standing Frame

Benefits of a Standing Frame
by Jeff McDaniel, ATP
Active American Mobility




Wheelchair users rely on their wheelchairs for positioning, function, and mobility. Much time is spent on choosing the most appropriate cushion, frame, and accessories. This process typically includes demonstration equipment trials, pressure mapping, and a wheelchair clinic in order to conclude the most suitable wheelchair possible. This process is to ensure an appropriate chair that not only meets the users lifestyle needs but also addresses postural needs in order to maintain a functional posture. In a sense, a wheelchair can be used as a therapeutic device to maintain a neutral pelvis, legs, and etc. But often, we as healthcare professionals overlook another piece of equipment that can positively affect the users health and overall well being as much, if not more, than their wheelchair, a standing frame.


The body is not meant to sit. Unfortunately, wheelchair users can be in their wheelchair as much as 14 to 18 hours per day. Sitting for these periods of time creates numerous problems including:


  • Lower extremity contractures
  • Bone density loss
  • Urinary tract infections
  • Decrease in bowel function
  • Decreased range of motion
  • Spasticity
  • Decreased respiratory function
  • Increased risk of pressure ulcers
  • Decreased circulation
Therapists, ATP’s, and physicians sometimes overlook the importance and need for the user to stand in order to maintain and even improve the user’s overall health and well-being.

Individuals who rely on a wheelchair for mobility should also look to a standing device or standing frame as a way prevent the secondary complications that often result from prolonged use of a wheelchair. For years physicians and therapists have recommended assisted standing for a variety of medical and health benefits that occur when maintaining a natural standing posture. However, in addition to the physiological health benefits, many people also experience significant psychological benefits from being in the upright standing position, such as improved self-esteem and social development. Many of these health and physiological benefits of standing are listed below.

Medical Benefits of Standing

Passive standing has been demonstrated to prevent, reverse, or improve many of the adverse effects of prolonged immobilization.

The most widely accepted medical benefits of standing include:

  • Prevention of contractures (ankles, knees, and hips)
  • Improvement of range of motion (spine, hips, knees and ankles)
  • Reduction in spasticity
  • Prevention or reversal of osteoporosis and resultant hypercalciuria
  • Improvement of renal function, drainage of the urinary tract, and reduction in urinary calculi
  • Prevention of pressure ulcers through changing positions
  • Improvement in circulation as it related to orthostatic hypotension
  • Improvement in bowel function
  • Normalization of respiratory function
  • Improve hip integrity
  • Develop or improve motor skills
  • Maintain or re-gain bone density
Other specific reasons that people stand include:
  • Facilitation of a natural symmetrical standing posture
  • Development & improvement of upper body balance & strength
  • Alleviation of pain caused by prolonged or inappropriate position
  • Development of standing tolerance & endurance
  • Lessening progressive scoliosis
  • Assisting with skeletal development (in children)
Psychological Benefits of Standing:
Although funding sources rarely recognize the psychological benefits of standing, they can be some of the most important reasons to stand, especially for kids. Clinicians, parents, and stander users also recommend standing for the psychological benefits, including
  • Stimulate play

  • Increase independence self-image

  • Being active and mobile while standing
  • Be more alert
  • Increase cognition
  • Enhance social development & interactions with peers
  • Participate in activities that are meant to do standing up
  • Increase activities of daily living
  • Be more vocal & responsive
  • Encourage inclusion in school
  • Decrease fatigue from inactivity
  • Help prevent depression
Finally it is extremely important to understand that with the amount of justification and supportive documentation, a stander can be readily funded. Of course there are certain funding sources that can be difficult, but taking the time to document the alternatives of not having a standing program available to your patient should carry a great deal of weight with the funding source. Be sure to research articles and websites that may help you with this documentation. I have included a website and article I found that has a great wealth of information.

Standing Frame Article

Jeff McDaniel, ATP
Active American Mobility
Houston Texas
281-495-4400


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Tuesday, November 10, 2009

I WILL LEAVE A MARK

I Will Leave a Mark

By Mike Duenas, ATP
Active American Mobility

I’m constantly reminded every time I meet with a person that is need of mobility equipment whether it’s short or long term, that I have one of the most awesome opportunities a person could have. The ability to serve another person is really what defines my job responsibilities and its purpose. We have all heard how we as a society have this drive-thru mind set. We all have become impatient with being in the check-out line or having our car serviced at the local shop. However, truly great customer service can take anywhere from a few hours to a few days and sometimes months.

Whatever time frame it turns out to be, my primary goal as an ATP is to make it the best experience the client can possibly have. I realize that several other key personnel are involved with this process. It’s just that in most cases I’m the first person from my company that meets the client in person. And just like the saying goes, “you never have a second chance to make a first impression”; that first impression really does set the tone for the client’s whole experience. Most, if not all of these clients have a physical file in your office being worked on. Now imagine each of those files being that actual client (in the flesh) sitting in your office… waiting for you to finish so that they can have independence again.

Are you communicating with each client what the current status of their order is? Are you honestly providing the product that will best serve their mobility needs? For almost a decade now; the company I work for has made a huge impact on the communities it has served. I have been an employee in the Complex Rehab Division for almost 2 years. The list of our companies “10 Commitments” is printed on the back of my business card. Although I cannot take full credit for the creation of this list, it is major reason why I do what I do.

The Ten Commitments

We will:

1. Treat each client like family

2. Call the client before they call us

3. Tell the truth

4. Keep our promises

5. Inform not sell

6. See the problems as our opportunity to help

7. Be compassionate

8. Go the extra mile

9. Listen

10. Do the right thing

This all being said, I want to challenge myself to do more than I have, more than someone expects, to leave my mark behind in the most positive way I can!




Active American Mobility
aamobility.com
281-495-4400

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