Contraindications may include orthostatic intolerance syndrome: orthostatic hypotension, elevated heart rate or other cardiovascular conditions. Yet, standing devices have been prescribed by physicians to help strengthen an individual’s cardiovascular system. Immobilization puts the cardiovascular system at risk. Case studies show standing tolerance can be increased over a relatively short period of time with compliance to a standing program.
People with impaired skeletal structure may be contraindicated for a standing program. Osteogenesis imperfecta, osteoporosis or other forms of brittle bone disease may be a clear contraindication for certain people. Yet, standing devices have been prescribed by physicians and therapists for individuals with impaired skeletal structure with a desired outcome of maintaining or increasing bone mineral density.
Impaired range of motion or severe contractures can be a contraindication of standing in some cases. However, a regular standing program has shown to improve range of motion and decrease contractures. Again, individual client assessment is necessary.
Standing clients with hip subluxation may be another contraindication. However, there are highly respected therapists who, when working together with a physician, determined a standing program was indicated for that individual with better hip socket location as a desired outcome.
Other contraindications may exist; medical professionals must be consulted in determining each individual’s indications and contraindications for a standing program.
Use Clinical Judgment to Evaluate the Individual Needs
Implementing a standing program must be determined on an individual basis by the team (physician, physical therapist, RTS, consumer). Consider the contraindications and indications of each of your clients individually to determine if weight bearing/standing is an option for them. Don’t rule a standing program out because your last client with a similar diagnosis couldn’t stand.