Standing frame/table system, one position (e.g., upright, supine or prone stander), any size including pediatric, with or without wheels
HCPCS code
Name of the Procedure:
Standing Frame/Table System
Common name(s): Standers, Upright Stander, Supine Stander, Prone Stander
Technical/medical term: Standing Frame/Table System (HCPCS E0638)
Summary
A standing frame or table system is a medical device designed to support a person in a standing position. It is used to assist individuals who are unable to stand independently due to various medical conditions. These devices come in different sizes, including pediatric versions, and can be stationary or equipped with wheels for easy movement.
Purpose
Medical Conditions Addressed:
- Spinal cord injuries
- Cerebral palsy
- Muscular dystrophy
- Multiple sclerosis
- Other neuromuscular disorders
Goals/Expected Outcomes:
- Promote weight-bearing activities
- Enhance circulation
- Improve bowel and bladder function
- Prevent contractures and pressure sores
- Maintain bone density
- Facilitate social and environmental interaction
Indications
Symptoms/Conditions:
- Inability to stand independently
- Weakness or paralysis in lower extremities
- Need for postural support
- Requirement for therapeutic positioning
Patient Criteria:
- Medically stable
- Cleared by a healthcare professional for standing activities
- Appropriate size and weight for the device
Preparation
Pre-procedure Instructions:
- Review patient’s medical history
- Conduct a physical examination
- Complete appropriate diagnostic tests (e.g., imaging studies)
- Adjust medications as needed under medical guidance
Procedure Description
- Assessment: Evaluate the patient's condition and determine the appropriate type and size of the stander.
- Preparation: Ensure the stander is correctly sized and adjusted for the patient.
- Positioning: Transfer the patient to the stander, securing straps and supports to ensure safety.
- Adjustment: Gradually elevate the patient to a standing position, monitoring for any discomfort or signs of distress.
- Use: The patient may remain in the stander for a predetermined period, usually starting with short intervals and increasing over time as tolerated.
Tools/Equipment Used:
- Standing frame/table system
- Straps and supports
- Padding for comfort
Anesthesia/Sedation: Not applicable
Duration
The setup and positioning process typically takes about 15-30 minutes per session. The duration the patient stays in the stander varies based on tolerance, starting from 15 minutes and potentially extending to an hour.
Setting
The procedure is usually performed in a rehabilitation center, outpatient clinic, or at home under professional supervision.
Personnel
- Physical Therapist
- Occupational Therapist
- Rehabilitation Specialist
- Healthcare Aide (as needed)
Risks and Complications
Common Risks:
- Skin irritation from straps
- Discomfort or pain due to improper positioning
Rare Risks:
- Falls or injury if the device is not properly secured
- Circulatory issues such as dizziness or fainting
Management:
- Immediate repositioning or removal from stander if discomfort or complications arise
- Regular skin checks and adjustments to positioning
Benefits
Expected Benefits:
- Improved circulation and muscle tone
- Enhanced joint health and flexibility
- Better digestion and bowel function
Realization Time:
- Some benefits may be observed immediately, while long-term outcomes require consistent use over weeks to months.
Recovery
Post-Procedure Care:
- Monitor for any signs of discomfort or adverse reactions
- Gradually increase standing time as tolerated
Expected Recovery Time:
- No specific recovery time, as this is an ongoing therapeutic activity.
Restrictions/Follow-Up:
- Regular follow-up with a healthcare provider to adjust the standing regimen as needed
Alternatives
Other Treatment Options:
- Wheelchair with standing feature
- Tilting and reclining power wheelchairs
- Physical therapy exercises
Pros and Cons:
- Alternatives: May offer more mobility but less weight-bearing benefit.
Described Procedure: Provides significant health benefits from standing but requires supervision and correct setup.
Patient Experience
During the Procedure:
- The patient may initially feel discomfort as they get used to the new position.
- Mental reinforcement and encouragement are important.
After the Procedure:
- Some mild fatigue or muscle soreness may occur.
- Pain management and comfort measures include proper padding, gradual adjustments, and timely check-ins by healthcare providers.