Who are Suitable For Standing Frames
The provision of standing programmes and the prescription of standing equipment is common practice amongst paediatric physiotherapists. The following is a broad outline of when and to whom standing frames are issued:
- Children who are not weight bearing through their legs are assessed for a standing frame at the age of one year.
- Children who are standing when assisted but not making sufficient progress with their standing and walking to enable them to do so independently, even with support, will be assessed for a standing frame after the age of two years.
- Children who can stand while holding on or even balance independently but do not achieve full extension at the hips and knees in standing.
- For some children use of a standing frame is only necessary for a limited period of time whilst they progress onto independent standing. In these cases assisted standing is a crucial part of promoting their independent standing
- Some children will continue to require a standing frame for as long as they maintain the ranges necessary to enable standing. As they grow they will need to have their frame adjusted according to their changing needs or to have a new size frame. Usually by the age of sixteen years they will use the largest size frame available to children or possible an adult size frame.
Contraindications to standing / weight bearing
A small number of children should not stand at all e.g.
- Extreme or uncontrollable pain
- Extreme brittle bones
- Fragile/friable skin conditions
- Unable to achieve because of posture, tone, contractures etc e.g. severe Spastic quadriplegia
- Orthostatic hypertension or hypotension
- Safety of child / carer e.g. epilepsy, insurmountable MH risk
- If the child’s consultant advises against standing
Contraindications to provision of Specific Standers
Upright Stander |
Prone Stander |
Supine Stander |
High manual handling risk (hoisting in sitting or lying) |
High manual handling risk (Requires written Risk Assessment) |
Adverse reaction to position e.g. Poor vestibular function → fainting |
Significant pressure points in stander |
Significant pressure points in stander |
Orthopaedic Consultant recommends NO standing |
Extensor tone/spasm |
Combined high tone & hip/knee contractures |
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