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For children with additional needs, specialist equipment can open up opportunities for physical development much like those available to typically developing children. Two of the most impactful devices are standing frames and walking frames. Both encourage an upright posture, but they serve different purposes and offer unique benefits. In this blog, we will explore the benefits of each and highlight why it's important to have separate standing and walking frames.
Standing Frames vs Walking Frames
Standing frames provide strong postural support, promoting weight-bearing through the legs while keeping the child safely positioned. These frames allow children to stand with varying levels of support, using padded straps and supports to achieve an upright posture. In contrast, walking frames are designed for children with some ability to bear weight, offering support for balance and movement during walking.
Because standing and walking frames serve different purposes, children often use them for different activities. For example, a child may use a standing frame to participate in a school choir, as they can sing more confidently and easily in an upright position. Later, they may switch to a walking frame to enjoy active play, like kicking a ball with friends at lunchtime.
This differentiation allows therapists to create personalized treatment plans that align with each child’s unique goals.
Evolving Therapeutic Goals
Traditionally, both standing and walking frames were prescribed to address the 'body structure and function' (BSF) component of the International Classification of Functioning, Disability and Health Framework (ICF)[1], or the 'fitness' aspect of the 'F-words.' Therapists prescribed these devices primarily to address physical needs, such as improving bone density, increasing range of motion, or aiding hip joint development. However, recent research has broadened this view, demonstrating that these frames have a positive impact on a child's participation and social inclusion.
Livingstone and Paleg’s recent paper[2] noted that, since 2015, no new experimental studies have examined the use of walking frames for non-ambulant children and adults with Cerebral Palsy (CP). Nonetheless, interviews and case studies indicate supportive walking frames have a positive psycho-social impact, improving emotional well-being and engagement. Similarly a scoping review by McClean, Paleg, and Livingstone[3] which explored the outcomes and lived experiences of children and young adults with non-ambulant CP using standing frames, found that they significantly boost self-esteem, allowing children to engage with peers at eye level, thereby enhancing their inclusion in home and educational settings.
Conclusion
In summary, children with additional needs benefit from both standing and walking frames - each serves a different, though equally important, role. Standing frames support alignment and weight-bearing, positively affecting engagement, while walking frames promote active movement and contribute to overall health and social participation. For therapists and caregivers, understanding the distinct benefits of each device is crucial to achieving the best outcomes for children.
[1] World Health Organization. (2007). International classification of functioning, disability and health: children and youth version: ICF-CY. World Health Organization.
[2] Livingstone, R. W., & Paleg, G. S. (2023). Use of overground supported-stepping devices for non-ambulant children, adolescents, and adults with cerebral palsy: A scoping review. Disabilities, 3(2), 165-195.
[3] McLean, L. J., Paleg, G. S., & Livingstone, R. W. (2023). Supported‐standing interventions for children and young adults with non‐ambulant cerebral palsy: A scoping review. Developmental Medicine & Child Neurology, 65(6), 754-772.
