Standers are specialized assistive devices used primarily in rehabilitation and physical therapy to support individuals who cannot stand independently. This equipment provides a way for people with limited mobility to experience the many physical and psychological benefits of an upright, weight-bearing posture. For those who rely on wheelchairs or spend much of their time sitting or lying down, a stander offers a crucial alternative position. This article will explain the mechanics of standers, detail the different types available, and highlight the health benefits they provide.
Defining the Device and Its Purpose
A stander, often referred to as a standing frame, is a mechanical support system designed to hold an individual in a stable, aligned position between 0 and 90 degrees of vertical. Its core function is to facilitate weight-bearing through the legs, which is a fundamental requirement for maintaining healthy physiological systems. The device is constructed with a rigid frame and features multiple adjustable supports to secure the user’s body in proper alignment. These supports typically include footplates, knee blocks to prevent the knees from buckling, hip guides for pelvic stability, and chest or trunk supports. The primary goal of using a stander is to counteract the negative physical effects that arise from prolonged non-weight-bearing positions. By providing this supported standing, the device ensures the joints, muscles, and bones are loaded with gravitational force. Many models include a tray or table attached to the frame, allowing the user to engage in activities like reading, writing, or interacting with others while maintaining their upright position.
The Different Types of Standers
Standers are categorized based on the angle and direction of the user’s support, which determines the amount of physical control required from the individual.
Supine Standers
Supine standers provide support primarily from the back, making them suitable for individuals with minimal or no head and trunk control. The user is transferred into the device while lying down, and the entire frame is then tilted up. This configuration is useful for those with complex postural needs or medical fragility, and often serves as the starting point for individuals who have been bedridden or have significant musculoskeletal weakness.
Prone Standers
Prone standers offer support from the front of the body, encouraging the user to push themselves against the anterior support surface. This position helps promote better head control and upper body strength, as the user must actively work their neck and trunk muscles against gravity. Prone standers are often used as a transitional device for individuals developing more control.
Upright and Mobile Standers
Upright standers are designed for individuals who possess a higher degree of trunk and head control, placing the user in a fully vertical position. This type maximizes the weight-bearing load through the lower extremities. A variation, the sit-to-stand stander, uses a lifting mechanism to transition the user from sitting to standing, which can be beneficial for adults and adolescents who require assistance with transfers. Mobile standers incorporate wheels that allow the user to self-propel or be moved through their environment while standing, promoting exploration and social engagement.
Key Health and Developmental Benefits
The regular use of a stander offers numerous physiological advantages. One significant benefit is the positive effect on skeletal health, particularly bone mineral density. Applying axial load through the long bones of the legs is necessary to stimulate bone growth and strength. A standing program, often recommended for 60 to 120 minutes daily, can significantly help to maintain this density and reduce the risk of fractures. Furthermore, standing helps promote healthy hip joint development by ensuring the hip socket (acetabulum) develops correctly, which is important for children with mobility challenges.
Supported standing plays a role in preventing muscle contractures, which are severe shortenings of muscles and tendons that restrict joint movement. By holding the joints in a stretched position, particularly the hips, knees, and ankles, standers help maintain or improve the range of motion in the lower extremities.
The upright position improves the function of internal organ systems. Gravity assists with circulation, which can reduce the pooling of blood in the lower limbs. It also aids in respiratory and digestive function by relieving pressure on the diaphragm, allowing for better lung expansion and more efficient breathing. Gravity assists with peristalsis, the muscular contractions that move food through the digestive tract, which can help manage chronic constipation.
Beyond the physical, standers provide social and cognitive benefits. Standing allows the user to interact with peers and the environment at eye level. This participation in activities alongside others fosters a sense of independence and enhances overall environmental awareness.
Selecting the Right Stander
Selecting the appropriate stander is highly individualized and requires a thorough assessment by qualified healthcare professionals. A Physical Therapist (PT) or Occupational Therapist (OT) must evaluate the user’s current level of head and trunk control, joint range of motion, and specific postural needs. These specialists determine the most suitable stander type based on the individual’s therapeutic goals. The therapist also establishes a safe and effective standing protocol, including the recommended frequency and duration of use. Standers are highly adjustable and can be customized with various accessories, including adjustable trays, lateral supports, and specialized foot positioning components, to ensure proper alignment. A practical consideration is the stander’s capacity for growth adjustments, as many models accommodate several years of height and weight changes.