Why Standing Is Worth the Weight

by Kathy Wechsler

We all know the benefits of standing. Weve heard over and over how "important" it is to be able to have eye-to-eye conversations with people and how standing positions give us greater access in employment, education and social settings.

But for those of us who use wheelchairs, are comfortable with our shorter stature and demand respect in spite of it, there are still some major physical benefits to standing devices.

Medical Reasons for Standing

Levo USAs manually propelled standing wheelchair has a manual stand-up function thats easy to take with you wherever you go.

"Standing is, of course, natural for human beings and so many systems of the body work a little more naturally if the person is vertical," said Wendy M. King, clinical assistant professor at Ohio State University Medical Centers Department of Neurology and physical therapist at the universitys MDA clinic in Columbus.

Devices that help with standing, also called standers or standing frames, are excellent for most wheelchair users with neuromuscular diseases.

Being upright has a direct impact on many of our bodily systems, King said. Standers can help improve the users bladder function by assisting in the flow of urine through the urethra. Standing devices also help with digestion, respiration and circulation by putting the organs involved in more natural positions.

Non-wheelchair users may take smoothly functioning internal systems for granted. Theyre extremely important to a persons overall health, and should be kept in mind by those of us who are comfortable remaining seated while interacting with others.

In addition, standing is good for the musculoskeletal system.

	The Econostand from Stand Aid of Iowa delivers the benefits of standing with a hand-operated hydraulic lift.

"The joints of the body were meant to be put through the full range on a regular basis," said King. Exercise may briefly put joints through their range of motion, but joints need to be positioned at various angles for longer periods of time than an exercise program may allow. This builds flexibility thats good for the hips, spine, knees and ankles decreasing the likelihood of contractures.

Many physicians think that standing devices benefit wheelchair users because putting weight on the long bones of the legs promotes bone density. And using a stander reduces the chance of pressure sores by changing a seated persons position. This is especially helpful for those with sensory loss, such as people with Friedreichs ataxia or other peripheral neuropathies, who may not be able to feel discomfort.

Words of Wisdom

If you havent stood in a long time, it isnt a good idea to suddenly start standing; it may be uncomfortable or even painful. Weak muscles, joint limitations and bones that have been damaged by osteoporosis can rule out the option of a standing device for those with long-term neuromuscular disease.

King points out the importance of checking with a physician to make sure theres no medical reason why you shouldnt stand. Find out what kind of standing device your body can tolerate and how long you should stand, and work with a therapist to develop a program that will help you build your tolerance for standing.

Though they may be good for you, standers can be expensive. Whether or not you can qualify for financial assistance with a standing device depends on your medical insurance and your eligibility for medical or social services. Getting coverage wont happen overnight, or with your first request. You must always be patient and persistent.

Dont forget to check the loan closet at your local MDA office. There may be a used standing device with your name on it.

Another option is to get a slightly used demonstration unit at a discounted price. Altimate Medical can put you in touch with the right medical supplier in your area. For answers to your funding questions, check out www.altimatemedical.com/funding.aspx or call (877) 844-1172.

Types of Standing Devices

The EasyStand 6000 Glider provides an active standing session with reciprocal movement of the arms and legs.

If your physician gives you an OK to use a vertical or upright standing device with 100 percent weight bearing, there are many options to choose from.

Most standing devices have a handy work table so you can conduct your business or other activities while standing.

Stand Aid of Iowa offers three models that dont require transfers. Priced at $1,995, the Econostand uses a hand-operated hydraulic lift that brings the user from his or her wheelchair to a standing position while offering comfort and support. The Model 1501 Stand Aid uses a battery-powered electric lift operated by a conveniently placed toggle switch and costs $5,600.

Costing $9,300, the model 1503 Stand Aid meets the need for mobility by combining the electric lift function and a joystick-controlled power drive system to let the user move independently while standing securely.

In both of the EasyStand models from Altimate Medical, the user must transfer into the seat and fasten the calf straps. Then youre ready to use the hydraulic lift to stand.

The EasyStand 5000 is a stationary stander that costs $2,695. For an extra $770, you can add the mobility option and propel the device by using your upper body strength. Priced at $5,995, the EasyStand 6000 Glider is a stationary stander that allows you to move your legs by pushing one handle and pulling the other.

The Ovation Strap Stand is Altimate Medicals solution to the transfer problem. From your wheelchair, position the strap under your buttocks and attach it to the lifting arms. Keep pumping the actuator handle until youre in a comfortable standing position. The Ovation Strap Stand is priced at $2,695.

Going Part of the Way

	The Giraffe from Snug Seat can be used as a prone, supine or upright standing device, and is perfect for children up to 5 feet tall.

Your physician may not recommend putting you in an upright position. Maybe you arent able to tolerate full standing because you havent been on your legs in a long time. In such a case, there are a number of prone (leaning forward) and supine (leaning backward) standers with ranges and tilts at different angles, allowing the gradual increase of weight bearing as tolerance increases.

Adaptivemall.com carries prone and supine standers such as the Pronestander by James Leckey Design and the Buffalo Stander from Snug Seat. Suggested retail prices are around $2,000.

Many standing devices are available for children and may prove perfect for weight bearing and inclusion at school.

Whats So Great About a Standing Wheelchair?

"Standing wheelchairs would probably be the number-one first choice because youd have it all," said King, who realizes that finances play a major part in choosing a standing device. "Youd have the mobility, but if you wanted to stand at home by yourself you could still do that."

The C2K Stander power wheelchair from Permobil combines the C2K power base with a seat that lets you stand to improve circulation and enjoy work or play from a standing position.

Priced at $25,000, Permobils C2K Stander is a full-sized, adult power wheelchair that lets you enjoy the medical and accessibility benefits of standing. The Chief 107SRX from Redman Power Chairs is a power standing wheelchair that costs $18,545. It goes a step further by compensating mechanically for body position.

Levo USA offers manual and power standing wheelchairs for all ages and sizes. Manually propelled standing wheelchairs with a manual stand-up function are $7,595, while the electric stand-up function on the manual wheelchair costs $9,895. The power standing wheelchairs are estimated at $21,500. This company sells a manual wheelchair for children that has a powered stand-up function.

Theres a lot of freedom attached to the extra cost of a standing wheelchair.

The beauty of standing wheelchairs is that they give the user the option of going from sitting to standing whenever desired. The transition is easy and convenient, and the user can complete it without any assistance.

It all comes down to practicality. You can reach much more from a standing position, making standing wheelchairs a huge advantage for accessibility. They could also make a difference in housing opportunities.

"If somebodys standing is sometimes an option versus never an option, there might be less expense involved in adaptations," King said.

And then there are those of us who are tired of always looking up at everything and everyone. It hurts either our necks or our pride. Finally, some wheelchair users would like the option of seeing the world as others see it.

Which Standers Right for Me?

King recommends seeing an occupational therapist, physical therapist or other health professional who has some knowledge of standing devices.

The perfect standing device is the one that meets all or most of your needs. If youre only concerned with the medical benefits of standing, then a stationary stander may be best.

On the other hand, mobile standers and standing wheelchairs are probably more practical in terms of accessibility. If youll be standing regularly for a long period of time, a mobile stander would allow you to get something accomplished while you stand. For those who arent limited by price, standing wheelchairs provide many more options by putting the world at reach while benefiting the body.

Resources

	The Rand-Scot Personal Folding Stander offers flexibility and circulatory benefits in a lightweight device thats easy to fold for storage and transport.

ABLEDATA
Informed Consumers Guide to Funding Assistive Technology
(800) 227-0216
www.abledata.com/Site_2/funding.htm

Adaptivemall.com
Mobile and stationary prone, supine and vertical standers
(800) 371-2778
www.adaptivemall.com

Altimate Medical
Mobile and stationary vertical standers
(800) 342-8968
www.altimatemedical.com
(877) 844-1172
www.altimatemedical.com/funding.aspx for funding information

Barrier Free Lifts
Mobile stander
(800) 582-8732
www.barrierfreelifts.com

Davis Made
Mobile pediatric standers
(810) 742-0581
www.standingdani.com

Innovative Products
Mobile prone and supine standers
(800) 950-5185
www.iphope.com

Levo USA
Manual and power standing wheelchairs
(888) 538-6872
www.levousa.com

Lifestand
Manual and power standing wheelchairs
(800) 782-6324
www.lifestand-usa.com

Permobil
Power standing wheelchairs
(800) 736-0925
www.permobilusa.com

Prime Engineering
Mobile and stationary prone and vertical standers
(800) 827-8263
www.primeengineering.com

Rand-Scot
Stationary vertical standers
(800) 467-7967
www.randscot.com

Redman Power Chairs
Power standing wheelchairs
(800) 727-6684
www.redmanpowerchair.com

Rehabilitation Engineering and Assistive Technology Society of North America (RESNA) Technical Assistance Project
(703) 524-6686
www.resna.org
Click on Technical Assistance Project.

Rifton Equipment
Mobile and stationary prone, supine and vertical standers
(800) 777-4244
www.rifton.com

Sammons Preston
Mobile and stationary prone, supine and vertical standers
(800) 323-5547
www.sammonspreston.com

Stand Aid of Iowa
Mobile and stationary vertical standers
(800) 831-8580
www.stand-aid.com

Theradapt Products
Mobile and stationary prone, supine and vertical standers
(800) 261-4919
www.theradapt.com