Stander device use in children: Parent and practitioner perspectives
Mazzone, Margaret A.
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Purpose. This study investigated the provision and impact of stander devices for children with disabilities. Methods. Data were collected from parents and therapists in separate surveys. Parents were recruited through two manufacturers and one distributor of stander devices. Practitioners were recruited electronically through professional email lists. Each group completed survey questions that queried device prescription, delivery of services, device usability issues, and positive and negative impacts resulting from use. Results. Completed surveys were received from 224 parents and 179 practitioners. The majority of children were using their stander device 4 or more days per week, for greater than 30 minutes per session. Assistance and time pressures of family, were often or sometimes a barrier to device use for greater than 50% of parent respondents. Hassle of adjustment and transfer were substantial barriers to device use for infrequent users. The most frequently reported benefits to body structures and functions were improved range of motion, increased muscle strength, and increased bone density. Frequency of use was statistically associated with many barriers to use. Relatively few negative impacts were reported, with pain or discomfort most common. Among practitioners, who were primarily physical therapists, improved range of motion and increased bone density were most frequently a rationale for recommendation of stander devices. Impact of standers was most commonly measured using range of motion assessment. The most frequently identified barriers to recommendation and acquisition of stander devices were limited availability of devices to trial and device usability. Barriers to use included transfer, assistance required to use the device, and time pressures of family. Conclusions. The majority of children are using their stander devices frequently and for significant durations. Parents report perceived benefits to range of motion, bone density and muscle strength. Frequency of stander use is often impeded by a number of usability issues. Practitioners are infrequently measuring device outcomes that are linked to the rationale for device recommendation.