A stander is a specialized piece of assistive technology designed to support individuals who cannot stand independently in an upright, weight-bearing position. This equipment is used by people with mobility impairments resulting from conditions like cerebral palsy, muscular dystrophy, or spinal cord injury. By facilitating supported standing, the stander provides a safe way for users to experience the physical and psychological benefits of being vertical. This device offers a posture that differs significantly from prolonged sitting or lying down.
The Mechanical Function of Standers
The fundamental purpose of a stander is to hold the user securely while maintaining proper skeletal alignment against gravity. A system of straps, pads, and supports provides stability around the trunk, hips, and knees. Trunk support often includes adjustable lateral pads and harnesses that can be fine-tuned to address postural asymmetries.
The device ensures the body’s weight is correctly distributed through the long bones of the legs, mimicking natural standing. This is achieved through footplates and knee blocks that stabilize the lower extremities in an aligned posture. Supported standing facilitates weight-bearing, which is a crucial mechanical load on the skeleton.
Weight-bearing stimulates cellular processes responsible for bone remodeling and maintenance. The goal is to maximize this load safely, though the percentage of body weight borne can vary depending on the stander’s angle. The stander’s design precisely controls joint position to prevent contractures and promote healthy hip socket development, especially in growing children.
Physiological and Developmental Advantages of Standing
The sustained, supported upright posture in a stander yields numerous measurable health benefits. One of the most documented effects relates to skeletal health, specifically promoting bone mineral density (BMD). Non-ambulatory individuals are at an increased risk for bone fragility, but research suggests standing for 60 to 90 minutes per day can positively influence BMD.
Standing helps maintain or improve the range of motion in the lower extremities by providing a prolonged stretch to muscles like the hip flexors and hamstrings. This passive stretching reduces muscle spasticity and lowers the risk of developing painful joint contractures. Furthermore, the upright position encourages the proper formation and seating of the hip joints, which is important in early development and helps reduce the risk of hip subluxation.
The effects of gravity while standing aid both circulatory and digestive function. An upright position improves blood pressure regulation, enhances circulation, and reduces swelling in the lower limbs. In the gastrointestinal system, standing uses gravity to assist with peristalsis, encouraging more regular bowel and bladder function. The expanded chest cavity and improved diaphragm mechanics also lead to better lung capacity and more effective respiration.
Standing offers substantial developmental advantages. Being at eye level fosters social interaction with peers, teachers, and family members, promoting a sense of inclusion and participation in daily activities. This elevated perspective improves environmental exploration, visual-motor skills, and overall alertness. The independence gained from using a stander contributes to a user’s self-esteem and body awareness.
Variations in Stander Design and Application
Standers are available in several configurations designed to meet a user’s specific physical ability and therapeutic goals. The choice is determined by the amount of trunk and head control and the capacity for weight-bearing.
The supine stander provides the most extensive support, accommodating those with minimal head or trunk control. This design is often used for individuals with significant muscle weakness. Conversely, the prone stander supports the user from the front, encouraging a forward lean. This angle challenges the user to engage their neck and trunk extensor muscles, making it suitable for improving upper body control.
The upright or vertical stander requires greater independent trunk stability and facilitates full weight-bearing through the legs. A final variation is the sit-to-stand stander, which allows the user to be transferred into the device in a seated position before being raised to standing. This design simplifies the transfer process.