The value and importance of standing for individuals with disabilities are well documented as part of the 24-hour posture management approach. This approach encompasses lying, sitting and standing. These postural orientations are all linked and have an impact on each other. Individuals with movement limitations, unable to independently reposition themselves, may be at greater risk of developing secondary complications such as body-shape asymmetry, pressure injuries, constipation, bowel incontinence, and respiratory issues.
 
Our bodies were never designed to be in a single position all day. Standing can facilitate musculoskeletal, respiratory, digestive, and urinary system functioning.
 
Standing Devices
 
There are several types of standing AT; each of which should be accompanied by a consultation with a physician and clinical team - who are vital in the assessment and determination of the most appropriate solutions for achieving a vertical posture. The devices are varied in their nature, and function ranging from static to dynamic standing frames to mobile standing AT devices. Determination of precautions, along with an individually-tailored standing and weight-bearing the regime, should always take place under the supervision of the healthcare team. A home program, along with follow-up and review is necessary to ensure optimal set-up, adjustment, and maintenance of equipment.
 
The Benefits of Standing
 
The opportunity to change posture and position through the introduction of standing allows for pressure redistribution between the body and the supporting surfaces. The pressure between sitting and standing are re-distributed to different weight-bearing surfaces. This can help to reduce the risk of developing pressure injuries. For those with injuries, standing can assist with improved blood circulation, and with the healing process. Furthermore, the ability to stand allows gravity to assist with digestion, colon motility, and regularity of bowel movements. Evidence shows that individuals with disabilities who use standing devices may be able to reduce the number of urinary tract infections (UTIs).
 
Standing can play an important part in the reduction of skeletal asymmetries, specifically the reduction of contractures that can occur at the heel cords, knees, and hips. A reduction in back and neck pain, associated
with prolonged periods of sitting, was reported with the incorporation of vertical positioning.
 
In addition to the physical health benefits noted, improved mental health, social interaction and confidence levels are associated with standing. Individuals who have the ability to stand with Assistive Technology (AT) report improved mood when they are able to stand and communicate with others. The psychological benefits of standing have been reported as improved self-esteem and a decrease in depression.
 
Standing can promote independence at home and in the community. With activities of daily living such as grooming and cooking, standing can make facilitate the ease of these tasks and by providing access when
compared to executing tasks from the seated orientation. Accessing and reaching items located in higher cabinets, the top shelf or back of the refrigerator, reaching elevator buttons, grocery shopping, and other everyday vertical-tasks which may have required the assistance of others, can be completed independently when an individual has access to standing AT.
 
Types of Standing Devices
 
Standing frames: These can be static or dynamic. Many of these devices have a tray or a platform and can accommodate a tablet or laptop. Others offer the option to be able to do upper body exercises while standing.