Permobil logo
Permobil logo

Permobil White Paper: power standing update 2023

Aim:

To describe the impact that standing can have on an individual who uses a power standing wheelchair.

Methods:

The primary source was a systematic literature review. A total of ten original scientific publications on power standing wheelchairs were identified, of which five were clinical trials.

Other sources were:

  • Scientific publications on other standing devices
  • A survey amongst 137 individuals who use a Permobil power standing wheelchair and answered questions about how they use power standing and which impact they experience.
  • Motion capture data to indicate displacement of individual body markers representing the way that movement occurs when going into a standing position and returning to a seated position.
  • Three interviews with individuals using a power standing wheelchair.

Results:

Identified benefits for using a power standing wheelchair supported with higher quality evidence include:

  • Pressure redistribution
  • Bladder, bowel, digestive functions
  • Range of motion and muscle length
  • Activities of daily living, personal/medical care, and leisure activities
  • Functional reach
  • Communication
  • Participation in social, work, and educational settings
  • Independence

Identified benefits for using a power standing wheelchair supported by lower quality evidence include:

  • Bone health
  • Spasticity
  • Mental health

Additional discussion included how power standing leads to more benefits compared to standing with other non-powered standing devices (such as a stander or standing frame) because of less limitations in daily use, including e.g., that there is no need to transfer between devices. Considerations include that health-related benefits can be dependent on the amount of time spent  in standing, shear forces may be of concern when moving in and out of stand, pain needs to be monitored when individuals start standing and when children grow, and some individuals may perceive that they “stand out” when they use the standing function.

Conclusion:

The impact that power standing wheelchairs can have include multiple health-related benefits, as well as what activities people can participate in and how independent they are.

 

Implications for clinical practice:

Based on the comprehensive nature of this white paper and all the resources presented, clinicians can utilize this paper to support their clinical decision-making when matching individual needs with the benefits and considerations of power standing wheelchairs. In addition, the connection between self-reported experiences and the clinical evidence can provide confidence in setting goals and expectations throughout the evaluative process.