Standing is so important for every child, and has a wide range of benefits for their health and development.Parent Hub
A standing frame is a piece of equipment that can support an individual to maintain a standing position.
They generally consist of a solid frame, normally with wheels at the bottom so the frame can be moved, and then more comfortable pads and straps that support the child in the desired position.
Standing frames are available in three base configurations - although some are designed to transition between all three configurations. These are:
When it comes to choosing the correct standing frame, you will be guided by your therapist on the correct standing frame for your child and their stage of development.
Regardless of the style of the standing frame, the most important element is the achievement of desirable postural alignment. However, if you would like to know more about these frames and their key differences, the posters below will help you to understand the factors that come into consideration when choosing the correct frame for your child.
Upright standing frames are designed to support children in a fully upright position so that their head and trunk is balanced over their pelvis.
They can sometimes be called ‘dynamic standing frames’ dependent on what wheels or base they have. For example, there are upright standing frames with large wheels so the user can move themselves around or there are frames that have rocker-type base that enables the user to rock backwards and forwards which, if used under the guidance of a therapist can help develop head and trunk control.
Supine Standing Frames are those in which a child or young person is lifted or hoisted into a lying position, with the standing frame supporting them from the back. The frame is then brought upwards to a more upright position, depending on ability.
In Prone Standing Frames, a child or young person is tilted slightly forward and supported from the front.
It is important to keep activities fun and engaging when your child is in a standing frame. This helps them remain active in the frame rather than just taking all the support that the frame gives them.
Each child's preferred activities will be completely personal, based on what they enjoy. Some children love messy activities such as baking or paiting, whilst other might prefer to listen to a story or play with toys whilst in the frame.
Activities will also be dependent on the level of support they need. For example, if your child is working on their head control, activities such as turning their head to choose a toy, or indicate that they want a page turned in a book might be challenging enough; whereas children working on their trunk control might be able to use their hands to pop bubbles or swipe at toys.
Standing is so important for every child, and has a wide range of benefits for their health and development. Conversations around standing typically start in consultation with medical professionals, but many parents or carers find themselves researching the answers to their questions online between appointments. We’ve put together some of the most common questions and answers, to ensure that you can find accurate and relevant information in one place.
The decision to start using a standing frame is one that you will make with your physiotherapist or another medical professional. However, generally speaking, children who are not pulling-to-stand, or weight-bearing by the age of 12-14 months should be encouraged to use a standing frame to help them weight bear.
If appropriate, children can start using standing frames from as young as 9 months, but you will be guided by your medical team on the best time for your child.
The question of how long to stand is one of the most common questions, but also a very difficult question to answer. This is because children use standing frames for lots of different reasons, and the optimum times can vary depending on their focus.
Typically, the average recommendation would be to gradually work up to standing for 30-60 minutes daily, for a minimum of 5 days per week. However, your child’s physiotherapist will advise you on what is most appropriate for your child and their goals.
There are very few reasons not to stand, but some reasons include:
Children can still use a standing frame if their hips are subluxed (where the ball has partially come out of the socket) or dislocated (where the ball has completely come out of the socket), in the absence of pain. However this decision should be taken in consultation with your orthopaedic consultant. As with anything, if in doubt, always check with your child’s medical team.
At the moment, there is no definitive guidance of at what point a child should stop using a standing frame if they struggle to fully straighten their knees or hips.
Inability to straighten a joint is known as a joint contracture, and there is a common perception that if a child’s knees or hips have 30 degrees contractures or less then they are still able to use a static frame. However, you should always liaise with your child’s orthopaedic consultant if you have concerns about this.
The “best” angle (also known as inclination or tilt) for standing all comes down to your child’s abilities. The more upright a child can tolerate standing, the greater the load bearing through the feet and therefore the greater the impact of the benefits of standing.
On average, children bear 76% of their body weight when positioned in a standing frame, but there is a large range and there are many differences between standing frames, with each offering their own benefits. Generally speaking, the inclination or tilt of the standing frame does not significantly impact weight bearing, as long as the tilt is 70 degrees or more upright.
One useful rule of thumb is that you should not be able to move your child’s foot, once they are in a standing position.
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