Nonambulatory children typically experience abnormal muscle tone, the influence of primitive reflexes, decreased cognition and muscle tightness and deformities.
• Standing with good alignment of the body as a whole (skeletal alignment) and weight bearing on the legs is important for the child who is unable to walk. Weight bearing while standing is a vital component of normal growth and development.
• Standing programs are often started at one year of age if children are not able to bear their weight effectively on their own.
• Standing has many benefits for the nonambulatory child including:
Promoting and/or maintaining musculoskeletal integrity and neuromuscular development.
Improving pulmonary functioning.
Assisting in social-emotional, visual-perceptual, visual-motor, cognitive, and motor development.
Maintaining and improving range of motion and strength in legs.
Stretching tight muscles and joints while increasing bone mineral density and improving bone development. Without normal levels of weight bearing, the child is at risk for osteoporosis.
Increasing the depth of the hip joint and contributing to a stable hip socket, which decreases the risk and/or severity of hip dislocations.
• If a child cannot stand independently, adaptive equipment such as prone standers, supine standers, mobile standers and tilt tables are utilized to position the child in good skeletal alignment and weight bearing. Standing using adaptive equipment may provide many benefits including:
Providing a psychological boost when standing next to peers in the classroom or with family members at home.
Increasing attention to tasks; facilitating play and increasing social interactions.
Facilitating upright head and neck postures, which helps the child to follow visual and auditory stimulation.
Facilitating better trunk, head and arm control, which helps children to explore their environments.