A
standing wheelchair (also known as a
standing chair) is
assistive technologyAssistive technology is a generic term that includes assistive, adaptive, and rehabilitative devices for people with disabilities and includes the process used in selecting, locating, and using them....
, similar to a
standing frameA standing frame is assistive technology used by a child or adult who uses a wheelchair for mobility. A standing frame provides alternative positioning to sitting in a wheelchair by supporting the person in the standing position...
, that allows a
wheelchairA wheelchair is a wheeled mobility device in which the user sits. The device is propelled either manually or via various automated systems. Wheelchairs are used by people for whom walking is difficult or impossible due to illness , injury, or disability...
user to raise the chair from a seated to a standing position. The standing wheelchair supports the person in a standing position and enables interaction with people and objects at eye level.
Three variations of standing wheelchairs are available:
- Manual - Chair mobility and lifting mechanisms are not powered.
- Half-power - Chair features powered mobility but manual lifting mechanisms.
- Full-power - Chair features powered mobility and hydraulic or otherwise powered lifting mechanisms.
Standing wheelchairs can be either manually or power-operated, and are used both to achieve regular mobility and to stand the person up using hydraulics or other power sources.
A
standing wheelchair (also known as a
standing chair) is
assistive technologyAssistive technology is a generic term that includes assistive, adaptive, and rehabilitative devices for people with disabilities and includes the process used in selecting, locating, and using them....
, similar to a
standing frameA standing frame is assistive technology used by a child or adult who uses a wheelchair for mobility. A standing frame provides alternative positioning to sitting in a wheelchair by supporting the person in the standing position...
, that allows a
wheelchairA wheelchair is a wheeled mobility device in which the user sits. The device is propelled either manually or via various automated systems. Wheelchairs are used by people for whom walking is difficult or impossible due to illness , injury, or disability...
user to raise the chair from a seated to a standing position. The standing wheelchair supports the person in a standing position and enables interaction with people and objects at eye level.
Types and function
Three variations of standing wheelchairs are available:
- Manual - Chair mobility and lifting mechanisms are not powered.
- Half-power - Chair features powered mobility but manual lifting mechanisms.
- Full-power - Chair features powered mobility and hydraulic or otherwise powered lifting mechanisms.
Standing wheelchairs can be either manually or power-operated, and are used both to achieve regular mobility and to stand the person up using hydraulics or other power sources. Some standing wheelchairs may be driven from the standing position, however there is some medical concern of an increased risk of long bone fractures while driving due to the legs being under a heavy load.
Diagnosis and users
Standing wheelchairs are used by people with mild to severe disabilities including:
spinal cord injurySpinal cord injuries cause myelopathy or damage to white matter or myelinated fiber tracts that carry signals to and from the brain. This type of traumatic injury could also damage the gray matter in the central part of the cord, causing segmental losses of interneurons and motorneurons...
,
traumatic brain injuryTraumatic brain injury occurs when an outside force traumatically injures the brain. TBI can be classified based on severity, mechanism , or other features...
,
cerebral palsyCerebral palsy is an umbrella term encompassing a group of non-progressive, non-contagious motor conditions that cause physical disability in human development....
,
spina bifidaSpina bifida is a developmental birth defect caused by the incomplete closure of the embryonic neural tube. Some vertebrae overlying the spinal cord are not fully formed and remain unfused and open. If the opening is large enough, this allows a portion of the spinal cord to stick out through the...
,
muscular dystrophyMuscular dystrophy refers to a group of genetic, hereditary muscle diseases that weaken the muscles that move the human body. Muscular dystrophies are characterized by progressive skeletal muscle weakness, defects in muscle proteins, and the death of muscle cells and tissue...
,
multiple sclerosisMultiple sclerosis is an idiopathic disease of suspected autoimmune cause, in which the body's immune response attacks a person's central nervous system , leading to demyelination. Disease onset usually occurs in young adults, and it is more common in females...
,
strokeA stroke is the rapidly developing loss of brain function due to disturbance in the blood supply to the brain. This can be due to ischemia caused by thrombosis or embolism or due to a hemorrhage...
,
rett syndromeRett syndrome is a neurodevelopmental disorder that is classified as an autism spectrum disorder by the DSM-IV. It was first described by Austrian pediatrician Andreas Rett in 1966. The clinical features include a deceleration of the rate of head growth and small hands and feet...
,
post-polio syndromePost-polio syndrome is a condition that affects approximately 25–50% of people who have previously contracted poliomyelitis—a viral infection of the nervous system—after recovery from the initial paralytic attack. Typically the symptoms appear 15-30 years after the original infection, at an age...
and more.
Spinal cord injury - Standing chairs are used by people with both
paraplegiaParaplegia is an impairment in motor and/or sensory function of the lower extremities. It is usually the result of spinal cord injury or a congenital condition such as spina bifida which affects the neural elements of the spinal canal. The area of the spinal canal which is affected in paraplegia is...
and
quadriplegiaQuadriplegia, also known as tetraplegia, is paralysis caused by illness or injury to a human that results in the partial or total loss of use of all of their limbs and torso; paraplegia is similar but does not affect the arms...
since a variety of standing options are available to accommodate for mild to severe disabilities.
Documentation and funding
MedicareMedicare is a social insurance program administered by the United States government, providing health insurance coverage to people who are aged 65 and over, or who meet other special criteria. The medicare program also funds residency training programs for the vast majority of physicians in the...
may help fund some portion of a standing wheelchair, while
Medicaid Medicaid is the United States health program for eligible individuals and families with low incomes and resources. It is a means-tested program that is jointly funded by the states and federal government, and is managed by the states. Among the groups of people served by Medicaid are certain...
funding varies from state-to-state in the U.S. Many insurance companies, vocational rehabilitation organizations, and medical case managers are increasingly funding standing wheelchairs because of the long-term health and quality of life benefits that come from passive standing.
Effective documentation
Funding (government funding or insurance) for standing equipment is achievable, but usually requires medical justification and a letter of
medical necessityMedical necessity is a United States legal doctrine, related to activities which may be justified as reasonable, necessary, and/or appropriate, based on evidence-based clinical standards of care. Other countries may have medical doctrines or legal rules covering broadly similar grounds...
(a detailed
prescriptionA prescription is a health-care program implemented by a physician or other medical practitioner in the form of instructions that govern the plan of care for an individual patient. Prescriptions may include orders to be performed by a patient, caretaker, nurse, pharmacist or other therapist....
) written by a physical therapist or medical professional.
Funding sources
In the U.S. there are various funding options for purchasing
durable medical equipmentDurable medical equipment is a term of art used to describe any medical equipment used in the home to aid in a better quality of living. It is a benefit included in most Insurances. In some cases certain Medicare benefits, that is, whether Medicare may pay for the item...
(DME) such as standing wheelchairs:
- Public insurance/government funding (i.e. Medicaid
Medicaid is the United States health program for eligible individuals and families with low incomes and resources. It is a means-tested program that is jointly funded by the states and federal government, and is managed by the states. Among the groups of people served by Medicaid are certain...
, Waivers, etc.)
- Private insurance companies (i.e.Blue Cross, health maintenance organization
A health maintenance organization is a type of managed care organization that provides a form of health care coverage in the United States that is fulfilled through hospitals, doctors, and other providers with which the HMO has a contract. The Health Maintenance Organization Act of 1973 required...
s (HMOs), PPOs, etc.)
- Worker's compensation
- Disability insurance
- Liability insurance (i.e. car, home, etc.)
- Out-of-pocket
Out-of-pocket expenses are direct outlays of cash which may or may not be later reimbursed.In operating a vehicle, gasoline, parking fees and tolls are considered out-of-pocket expenses for the trip...
(cash or credit card)
- Possible payment plan through supplier
- Child’s school purchase for use at school (i.e. standing is part of child’s Individualized Education Program
In the United States an Individualized Education Plan, commonly referred to as an IEP, is mandated by the Individuals with Disabilities Education Act...
(IEP))
- Purchase by workplace for use while on the job
- Purchase through VA Hospital
- Assistance from local groups such (i.e. Rotary clubs, Lions, etc.)
- Assistance from disability groups (i.e. MDA, MS Society, etc.)
Most states have resources such as PAAT (Protection Advocacy for Assistive Technology) and State Technology Assistance Projects that are resources for consumers seeking funding or going through the appeals process.
Sources
External links