Our muscles, bones, organs and nervous system function optimally when we stand upright. This is why assistive devices are essential in the lives of those who aren’t able to stand on their own. But what is the difference between standing devices and walking aids?
It’s recommended that children with disabilities such as cerebral palsy are introduced to assistive devices as early as possible. Introducing assistive devices early enables children to explore their environment, helps them develop socially and cognitively, and to participate in daily activities.
There are several types of assistive devices, but in this article we will mainly focus on standing and walking aids.
Standing devices are assistive aids, which can be used by a person who is dependent on support to be in a standing position and relies on a wheelchair for mobility. It provides alternative positioning by supporting the individual in the standing position.
Walking devices are assistive technology with multiple supports added to the walker, e.g. seat, hip harness, and forearm supports. These devices are available in simple versions with little support, where the goal is to support balance and confidence in walking. There are also more advanced walking technology available that provide substantial support to enable walking movements.
Both standing and walking aids are used to improve an individual’s stability and mobility, and offer more stability than other devices such as crutches. So how do standing and walking devices differ – and which device is most appropriate in which situations?
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Different devices for different needs
Though it’s normal to distinguish between standing and walking aids, it’s important to acknowledge that using these devices is not a case of either/or. In fact, persons with cerebral palsy will often make use of both types throughout the day, as needs at school vary from those at home.
Still, what type of aids an individual needs comes down to abilities and suitability. Standing devices are suitable for those who need help to stand up and maintain balance in an upright position. Walking devices on the other hand, are suitable for individuals who are not able to fully support their own body-weight and ambulate. Supports can easily be added or removed to adapt to differing abilities. In other words, these devices can be customized to the needs of each individual, which can allow chair-bound persons to walk and move around (source).
There are a few indicators that can help you as a therapist to assess an individual’s need for walking devices:
- The individual has adequate range of motion to support mobility.
- The individual’s foot and ankle must tolerate a standing or upright position, and independent reciprocal movement.
- The individual does not have complete paralysis of legs and hips.
(source)
That being said, the ability to walk independently is not a requirement for the most advanced walkers. As walkers can be adapted, choosing the right devices (or the right combination of them) is a question of assessing needs, rather than looking at what limitations can disqualify an individual from using certain walkers.
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Setting therapeutic goals
First and foremost, by using assistive devices, an individual will be able to reap certain benefits from more physical activity and a reduction in sedentary time. Physical activity can improve physical and mental health, and decrease the chances of developing chronic diseases. For people who spend most of their time in sedentary positions, getting the opportunity to move and be physical active becomes even more important in order to obtain a healthy lifestyle.
During the assessment, you as the therapist will have to get a good picture of the individual’s abilities and lifestyle. Is he able to walk? Is she participating in self-care, play, education, or work? Or perhaps all of the above? Assessing how and where the device will be used is also important, as it might have to be moved between locations, and withstand tasks with longer durations. Say the child does not only move between home and school, but also participates in different activities throughout the week. That’s at least three locations and conditions in which the device will have to work, not to mention the duration of which it will have to last.
Last but not least, devices need to comply with physical goals as well. Is the goal pressure relief, decreased muscle tone, or both? As you can imagine, each case can be quite complex, so it’s quite understandable that many people choose several devices for different goals.
