ParaQuad News • Autumn 2020 25 America) states that standing devices may have the following benefits for wheelchair users: 3 • Promotion of bone health • Promotion of bowel and bladder function • Reduction in occurrence of pressure ulcers, improved circulation • Reduction in the occurrence of skeletal deformities • Improved reach, facilitating access for activities of daily living (for example: grooming, cooking, cleaning) • Improved mobility and lower limb function in clients with preserved muscle strength in lower limbs • Improved range of motion and reduction in the risk of contractures • Improved quality of life benefits, such as participation in leisure activities and social situations. Real life experience: meet Sue Sue, a ParaQuad member, recently received her own TEK RMD to help her to achieve her goals around activities of daily living. Sue has incomplete T6 paraplegia and can weight bear through her lower limbs, although she is unable to walk due to her impaired sensation and movement. Keen to experience the benefits of a standing device, Sue referred herself to the ParaQuad Clinical Services team. Sue wanted to investigate whether such a device would increase her independence, as there were many tasks she was unable to complete seated in her manual wheelchair. Following extensive trials with ParaQuad Occupational Therapists and equipment suppliers, the TEK RMD was recommended as it was appropriate and safe for Sue, as well as the most suitable piece of assistive technology to help her meet her goals. The TEK RMD was successfully requested and approved through the NDIS. Sue was pleased with the outcomes: • The device allows increased independence; as tasks such as cleaning, gardening and washing could not be completed seated in her wheelchair • Sue can transfer independently on and off chairs using the TEK RMD • The device allows Sue to stand to reach items at a higher level which she would be unable to otherwise reach – including all areas in her wardrobe, pantry and linen cupboards • Sue can reach and carry items between rooms, as the device frees up her hands • She can stand for as long as she desires, alternate between sitting and standing, and do so safely and independently • Sue was able to independently access her back veranda and was very excited to see a different perspective of the view from her back deck. Most importantly, Sue reports her joy at being able to hug her family, standing. Sue was extremely happy with the TEK RMD and discussed how delighted she was with her increased functional independence around the house. She reported she was ‘beyond excited’ to be able to hug her husband whilst standing, and to answer the front door and be at eye level with her visitors. Sue reported, ‘the TEK RMD absolutely achieved my goals, and I already feel so much happier in myself knowing I can stand anytime I want. It’s helped with the swelling in my ankles… the benefits are way more than this though. It’s hard to put into words. It’s given me a massive sense of independence and freedom which I didn’t expect.’ Despite the benefits described above, standing devices may not be suitable for all wheelchair users. RESNA explains that experienced clinicians must be involved with all aspects of assessment, prescription, trials and education for clients who wish to use standing devices. 4,5 Considerations of risks such as those for skin health, bone and joint strength, practicality, safety and environmental factors will need to be considered when establishing if this is the right kind of device for the person . 6 Please discuss with your Occupational Therapist to assess the suitability of such a device for you. 3 Rehabilitation Engineering and Assistive Technology Society of North America, op.cit. 4 Rehabilitation Engineering and Assistive Technology Society of North America, op.cit. 5 Arva, J., Paleg, G., Lange, M., Lieberman, J., Schmeler, M., Dicianno, B., & Rosen, L. (2009). RESNA position on the application of wheelchair standing devices. Assistive Technology, 21(3), 161-168. 6 Lifetime Care and Support Authority, op.cit.