A systematic review of supported standing programs

Abstract

Objective: The routine clinical use of supported standing in hospitals, schools and homes currently exists. Questions arise as to the nature of the evidence used to justify this practice. This systematic review investigated the available evidence underlying supported standing use based on the Center for Evidence-Based Medicine (CEBM) Levels of Evidence framework. Design: The database search included MEDLINE, CINAHL, GoogleScholar, HighWire Press, PEDro, Cochrane Library databases, and APTAs Hooked on Evidence from January 1980 to October 2009 for studies that included supported standing devices for individuals of all ages, with a neuromuscular diagnosis. We identified 112 unique studies from which 39 met the inclusion criteria, 29 with adult and 10 with pediatric participants. In each group of studies were user and therapist survey responses in addition to results of clinical interventions. Results:The results are organized and reported by The International Classification of Function (ICF) framework in the following categories: b4: Functions of the cardiovascular, haematological, immunological, and respiratory systems; b5: Functions of the digestive, metabolic, and endocrine systems; b7: Neuromusculoskeletal and movement related functions; Combination of d4: Mobility, d8: Major life areas and Other activity and participation. The peer review journal studies mainly explored using supported standers for improving bone mineral density (BMD), cardiopulmonary function, muscle strength/function, and range of motion (ROM). The data were moderately strong for the use of supported standing for BMD increase, showed some support for decreasing hypertonicity (including spasticity) and improving ROM, and were inconclusive for other benefits of using supported standers for children and adults with neuromuscular disorders. The addition of whole body vibration (WBV) to supported standing activities appeared a promising trend but empirical data were inconclusive. The survey data from physical therapists (PTs) and participant users attributed numerous improved outcomes to supported standing: ROM, bowel/bladder, psychological, hypertonicity and pressure relief/bedsores. BMD was not a reported benefit according to the user group. Conclusion: There exists a need for empirical mechanistic evidence to guide clinical supported standing programs across practice settings and with various-aged participants, particularly when considering a life-span approach to practice.

Supported Standing in Boys With Duchenne Muscular Dystrophy

“…As part of a 2010 systematic review, Glickman et al 11 concluded that supported standing clinical investigations should seek to include functional, behavioral, and cognitive outcomes, alongside physiological measures. Therefore, future studies of supported standing in boys with DMD should include outcomes across all 3 components of the International Classification of Functioning, Disability and Health model, particularly those that reflect activity and participation components.…”

“…Supported standing has also been recommended, both historically 10 and as part of published clinical care guidelines for DMD. 9 Supported standing programs have been shown to improve lower extremity range of motion and BMD in children with cerebral palsy 11,12 and have also been recommended for children with neuromuscular diseases on the basis of expert opinion. 13,14 Despite potential benefits and common clinical use, no empirical studies evaluating standing in boys with DMD have been reported and no evidence-based clinical recommendations currently exist.…”

Persuasive technology and behaviour change in parent-focused eHealth interventions supporting child health: A scoping review protocol

“…The intervention does not provide a direct prompt to trigger the behaviour at any point in time. (Glickman, Geigle, & Paleg, 2010;Paleg, Smith, & Glickman, 2013;Verschuren, Peterson, Balemans, & Hurvitz, 2016), the more general literature concerning health behaviours is also included. Health behaviour is described by the World Health Organisation as "any activity undertaken by an individual, regardless of actual or perceived health status, for the purpose of promoting, protecting or maintaining health" (Nutbeam 1998, p.355).…”

Effective Assessment of Power Standing Device to Adults with Permanent Lower Limb Paralysis

“…It improves preserved muscle strength, range of motion and reduces the risk of contractures and spasticity in lower limbs. Standing can also promote vital organ capacity including pulmonary, bowel and bladder function, bone health, circulation which may in turn minimize the occurrence of pressure ulcers (Alekna et al, 2008;Damcott, Blochlinger, & Fouolds, 2013;Glickman, Geigle, & Paleg, 2010;Hohman, 2011;Paleg, Smith, & Glickman, 2013;Robling et al, 2002;Speigle, Maureer, & Sorenblum, 2010). Other than physical aspects, routine standing can provide numerous psychosocial and quality of life benefits (Arva et al, 2009;Dicianno, Morgan, Lieberman, & Rosen, 2013).…”