How Long Should Standing Frames be Used For
Current recommendations for the duration of standing in order to positively influence are based on a review of the literature primarily from animal research, along with studies of CP children. On study demonstrated that an eight week standing programme performed four to five times per week for 60 minutes each session produced significant increases in bone mineral density in the bones of the leg i.e. patella, tibial plateau, and supracondylar femur. When the standing frame programme was stopped even for a short time, or when the programme was reduced to 30 mins three times per week, bone mineral density was reduced.
Another study looked at the effect of weight-bearing standing programmes on bone mineral density in non-ambulant CP children. Children were given approximately a 50% increase in duration of prone or vertical standing over a one year period and compared to a control group whose programme remained the same. Results indicated a 5% mean increase in vertebral trabecular bone mineral density in the intervention group. However, no changes were observed for bone mineral density in the proximal tibia. Based on these findings the author concluded that longer duration of static standing ‘is not likely to reduce the risk of lower limb long bone fractures in children with CP’. However, no details are given for the individual time periods prescribed for standing or the rationale behind these times, the optimal times to promote increases in bone mineral density or the levels of bone mineral density necessary to have a clinically significant effect on bone mineral density.
