Stander?

ally81698

Hi.  My daughter's PT recommended that she start using a stander since she doesn't bear weight on her right side due to a prenatal stroke.  Has anyone had any experience using one of these?  She is 1 year old.  Thank you.

spedrunner

Most of my students use standers.  Do you have any specific questions?

 

ally81698

About how often do your students use it a day, or does it depend on the individual?Do you think they work (do you see differences)?  Do your students like using them?  

MummyGruetzie

Where is your DD in terms of her motor development right now? 

The length of time a child uses a stander for is for is very individual and is a pretty gradual process. Ie. Starting at under 5 minutes a shot. Some kids eventually get left in a stander for several hours. I'm really not into that as I don't imagine I'd personally like being stuck for that long, so we really never went over 20ish minutes at a time while engaged in an activity and then some stretching, rubbing, and downtime before the next thing.

Some kids are super excited to use them--others not so much. There's also a careful line to follow with making sure its used for physical development, not physical restraint. I've seen a lot of teachers misuse standers over the years and absolutely cringed at the thought of my daughter being in one, because of some of the horrible memories I had. Seeing how pre-historic our loaner looked didn't help. I did everything I could to make sure we were practicing standing OUTSIDE of the stander to speed up how long we'd need that thing in our house... and of course there was the fact that we just wanted to help DD progress as much as possible. I'd ask your PT if its possible to work on standing with out the stander or in other ways in addition to it and make sure you have a good repetoire of other ways to work on it more functionally. Ie. leaning up against the couch or a short soft chair chest in, then chest out, etc.  

My DD hated that she was being strapped into something and couldn't move (her legs). But again, I have definitely know kids who are so excited to be put in one and see the world from a new angle. So that's very individual. DD transitioned through hers very quickly--a few weeks at tops and then was ready to practice moving her legs more while in a standing position. I'd recommend trying to borrow one if at all possible. If you're PT is associated with early intervention, they typically have quite a bit of loaner equipment for parents to use until they know how their child will do... If you guys decide to buy one, there will be a lot of choices. I'd look for the least restrictive one possible or one that offers options for downgrading the level of supports and increasing the level of independence. Ie. If your DD has trunk stability, make sure her arms aren't strapped down to a board where she isn't able to use her trunk stability in standing. If she's motorically ready for one with a built in table those lend themselves to more active engagement than the kind where kids are leaning on a flat board. We had a PT at one point who wanted my DD strapped down to one in a hensinger collar type set-up despite the fact that she had complete neck control. Said PT went on to be fired after quite a few other suggestions which were very restrictive in nature. 

... Hope that wasn't too much!  

MummyGruetzie

One other thought... The next step after a stander is typically a gait trainer and then a walker. Gait trainers are being exceptionally well made these days and some really lend themselves to doing what a stander used to be needed for. You might ask your PT about getting a gait trainer instead with the understanding that you'd need the supportive accessories/additions in the beginning and would eventually fade them. Especially if the issue is one-sided. My DD has a rifton pacer which has a huge range of options and comes to my mind as a great device for a child with issues affecting one side of the body since all of the accessories get put into place individually. Ie. You could give her support on her weak side but not her good side. I also like that it offers to the option to lock the wheels in the beginning to work on stationary standing or make the wheels on move forward vs. some that only have the option to roll in both directions. There are a ton of other gait trainer options out there... Good luck!

spedrunner

I agree with everything mummy said. It depends on the kid

 

some of my students LOVE some hate and cry and yes i have seen a difference when used consistently  

 

Most of my students have CP, they usually go in for 30 minutes per day, some more, some less. THis does not include any therapy they receive at home 

ToastieSimons

MummyGruetzie:

One other thought... The next step after a stander is typically a gait trainer and then a walker. Gait trainers are being exceptionally well made these days and some really lend themselves to doing what a stander used to be needed for. You might ask your PT about getting a gait trainer instead with the understanding that you'd need the supportive accessories/additions in the beginning and would eventually fade them. Especially if the issue is one-sided. My DD has a rifton pacer which has a huge range of options and comes to my mind as a great device for a child with issues affecting one side of the body since all of the accessories get put into place individually. Ie. You could give her support on her weak side but not her good side. I also like that it offers to the option to lock the wheels in the beginning to work on stationary standing or make the wheels on move forward vs. some that only have the option to roll in both directions. There are a ton of other gait trainer options out there... Good luck!

this was going to be my suggestion.  We have a gait trainer by Rifton (small pacer) and with all the wheels locked it works really well as a stander.  Especially because it works well in transitioning to learning to step.  It has great chest support and pelvic or hip support.  you can get a tray table to attach to it (but I wouldn't, it's more for a talker than a tray table for toys). 

Florak8

We used a stander before a gait trainer. To me it was an important step because it offered a lot more support than the gait trainer, through DS' bottom and legs. He has pretty extensive hypotonia. For a child with mixed or high tone in the legs, maybe you could skip that step, though?

ally81698

thank you - great advice!  my daughter just turned one.  she sits perfectly and likes to stand when we hold her in place but doesn't do any transition yet (she can't get up from laying down, she doesn't pull herself to stand, etc - we have to place her in these positions). when she stands, all of her weight is basically on her left and she doesn't have any balance.  her outpatient PT that we see 1x a month suggested a stander at her NICU follow up clinic this week. she said to ask our early intervention PT and if they don't have one, she'll find a way for us to get one.  i asked her early intervention PT if they have one for us but she said they do not.  we have her outpatient PT tonight so I will ask her about a gait trainer as well.

thanks again for your help!