How to Choose a Stander – Top 5 Considerations

How to Choose a Stander – Top 5 Considerations

Which Orientation?
Orientation refers to starting position when placing a child in a stander:

Stomach first.

Back first.

Sitting position first.
Vertical Stander
Positions the child in a full upright position with all gravitational forces acting on the child. For this position, a child needs to be able to tolerate standing upright with full weight bearing through the legs and hips. Many standers can be adjusted up to a full vertical position.

Single Position
Refers to a stander that only performs one function (i.e. supine only).

Combination Stander
Can be set up for more than one position (i.e. supine or prone)
    Static or Dynamic?
    A static stander is a stationary stander; there are no opportunities for movement. For example, the Leckey Freestander is a static stander. A dynamic stander incorporates some type of movement. It may be on a mobile base so that the stander can be moved throughout the environment, which is a great feature to have for storage and to make the stander more versatile. The stander may also have large wheels that allow the child to propel the stander throughout the room for independent mobility even while standing. This is a great option for a child that is an independent wheelchair propeller but still needs to stand.
    Level of Support?
    There is a hierarchy of standers that exists from most supportive to least supportive. The most supportive standers are the supine standers. These standers offer the most assistance and positioning support for helping against gravity. These standers work best for those that may not tolerate full weight bearing, have limited to infrequent head control, decreased tolerance for full upright positioning, and weaker trunks. Examples of the supine standers include the Superstand by Prime Engineering and the Leckey Horizon by Leckey. Next in line, are the prone standers. Prone standers still provide significant positioning assistance and postural supports and generally require more head control than the supine standers. These standers are great for children who can use extensor tone and/or push through their arms onto a tray for upright trunk posture. It helps to further strengthen the muscles for against gravity positioning. Many times chin prompts are available as an accessory to assist with fatigue if needed. Lastly, there are the sit-to-stand standers that offer the ability to weight bear along any point from a sit to a stand. These standers typically require better trunk control and head control than the prone and supine, although, trunk supports are available. Many times, these standers are able to accommodate knee contractures since one is able to stop at any point during the standing process.  Examples of sit-to-stand standers include the Easy Stand Bantam and the Easy Stand Evolv. Just to reiterate, it is imperative not to over stretch or put too much pressure on overly tight muscles and restricted joints; doing so may cause severe injury or damage to joint/bone and muscle integrity.
    The average stander is designed to last for 5 years of growth. Pay close attention to height ranges for the stander. Then choose one that will allow for use now and plenty of growth in the future.
    Accessories include positioning aids and upper extremity support surfaces (trays) which offer for engagement in the environment.
    Standing is a wonderful tool, but it has to be respected for the potential dangers and contraindications as well as the benefits. This is the reason it is imperative to have a physician’s approval and work closely with a therapist to determine the proper equipment and standing program. Hopefully, no one is running scared for the hills because we are now going to discuss the types of standers, funding, and tidbits for a successful standing program.
    If at any time, it becomes too confusing or difficult to navigate through the world of standers or any other piece of equipment, please do not hesitate to contact us here at Tadpole Adaptive. We are always willing to provide unbiased and informed guidance.