Purpose
To ensure guests who use the standing frame, do so safely and comfortably.
Procedure
Guests must be assessed as fit to use the STF. This includes sufficient range of movement, strength, balance, co-ordination, understanding and co-operation.
It is the responsibility of the physiotherapy team to ensure that the STF is maintained and safe to use.
- Ensure the STF is accessible from all sides. Clear the surfaces of the STF and surrounding area.
- Turn on the power at the mains and ensure there that are no cables in the way. Ensure the brakes are activated on the STF.
- Familiarise yourself with the user instruction sticker on the STF.
- Ensure the guest is wearing shoes and any appropriate splints/braces.
- Adjust the table height according to guest’s height and guest’s upper body strength. The lower the table the harder it is for the guest to maintain the upright position.
- Take off the pelvis support from the side bars but keep within reach.
- Place the lifting harness in position so that the bottom edge just about touches the seat of the wheelchair (on the backside of the patient). Make sure it is the correct way up so the buckles are pointing upwards.
- Tilt the STF towards the guest to approximately 30 degree angle.
- Wheel the guest’s wheelchair as close as possible to the “wheel cut outs” on the STF footboard. Secure the feet in place using the heel cups and the Velcro straps (criss-cross straps to ensure feet don’t move). Ensure the wheel chair brakes are activated.
- Attach the 2 lift cords to the buckles on the lifting harness. The steeper the cord angle the easier it is to attach.
- Ensure guest’s knee caps are in line with the centre of the knee pads. Adjust if necessary.
- Ask guest to advise PT staff immediately if they feel light headed/ nausea when in the upright position (risk of postural hypotension!).
- Use the control to take up the slack of the 2 lift cords.
- Ask the guest to lean forward, hold on to the side bars (lifting cords to inside of guest’s arms) and rise to a standing position while the PT/Assistant uses the ‘stand’ button. This tilts the table into the upright position and draws in the 2 lifting cords simultaneously.
- Beware of the guest having to change their arm/hand position to higher up/on to the table during the manoeuvre.
- When standing, re-attach and secure the additional pelvis support in place.
- Ensure the guest’s knees are not hyperextended and the guest is comfortable while standing. Monitor guest’s wellbeing for the duration of the stand, re check pulse throughout if necessary. This applies in particular if a guest has not been standing for a while.
- Time the session.
- Consider upper body exercises when standing, in particular trunk rotation and side flexion.
- When finished, remove the additional hip support and ensure their chair is in place.
- Proceed to lower the guest by pressing the ‘sit’ button while guiding the hips centrally towards the back of the chair.
- Release the lift cords and remove the lifting harness, the foot straps and the heel cups.
- Aim to increase the duration of standing throughout the guest’s stay. Ultimately, this will depend on guest’s stamina and upper body strength. As such, a session could last between 10 and 45 minutes approx.
Posted in Therapy