Wednesday, October 27, 2010

Positioning Standers Improve Health


Positioning standers play a very important role for people who are unable to weight bear independently, especially children and people with neurological disorders. Positioning standers not only provide alternative ways of positioning besides sitting, but there is also a long list of health benefits.

The most obvious benefit of standing is weight bearing. Weight bearing increases bone density, which is so very vital to people in wheelchairs. Without weight bearing, bones become brittle. Weight bearing also is the main premise of a very effective therapeutic intervention, NDT (Neurodevelopmental Treatment), which is widely used with people with neurological issues.


With children whose bones are still growing, standing is vital. Bones will often become deformed without weight bearing because the bones grow faster than the muscles. The muscles will then begin to contort the bones - especially at the joints. We’ve all seen feet that are severely deformed due to growing bones and muscle imbalances. Ankle foot orthotics can provide positioning to slow down deformities, but positioning combined with weight bearing is by far more effective.

Positioning standers that provide weight bearing through the long bones and joint also assist in preventing hip subluxation and dislocation by improving muscle tone around the joint and assisting in proper development of a the ‘bowl’ of the acetabulum. The hip joint requires muscles to hold the femur securely in place and without weight bearing; the bowl of the acetabulum (the femur receptacle on the pelvis) tends to flatten, allowing the femur more freedom of movement.

Positional standing also has many benefits for people with neurological issues such as traumatic brains injuries, strokes, or severely impaired children who present with primitive reflexes such as ATNR (Assymetrical Tonic Neck Reflex) or STNR (Symmetrical Tonic Neck Reflex). These reflexes often dominate movement. Weight bearing in prone assists the brain in integrating these reflexes and promotes volitional movement.

Above are a few of the benefits from positional standing further benefits are as follows:
Medical Benefits of StandingHuman  Anatomy Diagram
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:
  1. Prevention of contractures (ankles, knees, and hips)
  2. Improvement of range of motion (spine, hips, knees and ankles)
  3. Prevention or reversal of osteoporosis and resultant hypercalciuria
  4. Reduction in spasticity
  5. Improvement of renal function, drainage of the urinary tract, and reduction in urinary calculi
  6. Prevention of pressure ulcers through changing positions
  7. Improvement in circulation as it related to orthostatic hypotension
  8. Normalization of respiratory function
  9. Improve hip integrity
  10. Develop or improve motor skills
  11. Improvement in bowel function
  12. 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)


    There are many different standing options from which to choose such as: prone standers, supine standers, dynamic standers, vertical standers, standing boxes, standing wheelchairs and sit to stand standers. The type of stander that is most appropriate depends on the tone, postural control, movement patterns and needs of the individual. What are your favorite standers?

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