Indications for a home standing program for individuals with spinal cord injury.

Additional analyses were conducted on a recently published survey of persons with spinal cord injury (SCI) who used standing mobility devices. Frequency and duration of standing were examined in relation to outcomes using chi square analyses. Respondents (n = 99) who stood 30 minutes or more per day had significantly improved quality of life, fewer bed sores, fewer bladder infections, improved bowel regularity, and improved ability to straighten their legs compared with those who stood less time. Compliance with regular home standing (at least once per week) was high (74%). The data also suggest that individuals with SCI could benefit from standing even if they were to begin several years after injury. The observation of patient benefits and high compliance rates suggest that mobile standing devices should be more strongly considered as a major intervention for relief from secondary medical complications and improvement in overall quality of life of individuals with SCI.

Follow-up assessment of standing mobility device users.

The use of standing devices by spinal cord-injured subjects was investigated through a national survey of a sample of individuals who returned their manufacturer's warranty card to two companies. We obtained a 32% response rate (99/310). The majority of respondents were male (87%) with a median age between 41 and 50 years. Seventy-seven percent were paraplegic and 21% were quadriplegic. Forty percent had between 1 and 5 years experience with their device, and 84% of those responding were currently using their standing device. Forty-one percent used their standing device one to six times a week; two-thirds stood between 30 minutes and 1 hour for each use. Less than 10% of subjects experienced any side effects, such as nausea or headaches, from standing. Twenty-one percent of subjects reported being able to empty their bladder more completely. There was also a favorable response by some individuals on the effects of the standing devices on bowel regularity, reduction of urinary tract infections, leg spasticity, and number of bed sores. Finally, 79% of subjects highly recommended use of standing devices to other people with spinal cord injury. The positive responses of individuals using standing devices is a strong recommendation for the assistive technology community to make these devices more available to individuals with spinal cord injury.

Cardiopulmonary responses during arm work on land and in a water environment of nonambulatory, spinal cord impaired individuals.

Six handicapped and six nonhandicapped subjects were given exercise tolerance tests on land and in a water environment. The subjects exercised with their arms only and had their cardiopulmonary performance evaluated. Based upon the results observed in this study, it appears that nonambulatory individuals with low fitness levels were able to experience greater cardiopulmonary work outputs when exercising in a water environment. The less severely handicapped individuals displayed similar patterns to those observed in the NH subjects (i.e., no observable pattern) and thus, may not receive as great a benefit as the more severely handicapped. The water environment appears to improve venous return, cardiac output and lung ventilation, which assists the H subjects to be more efficient during exercise.