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Using Functional Tasks to Improve Standing
Consider the following to facilitate and improve your patient's ability to stand safely during functional tasks:
|Provide a safe environment. Choose a task with a solid, stable surface in front of the patient. Position their wheelchair behind them and yourself on their weak side. Avoid standing in open spaces (middle of the gym) or near unstable surfaces (the bedside table).|
|If your patient has poor lower extremity control provide surface contact in front of their knees (such as the kitchen cabinets or the car)|
|Consider the height of the surface. Your patient's height and their key problem areas help determine the task and the location. For patients needing forward flexion, stand at a table (approx. 30"/76 cm high). For patients needing trunk extension, stand at the kitchen counter (approx 36"/92 cm high).|
|Offer a variety of heights to work from. As your patient progresses choose activities that encourage greater postural control.
Don't forget to watch for signs of fatigue. Offer your patients a chance to sit down before they become too tired.
For helpful hints on facilitating "sit to stand", "if the knee buckles", "standing the low level patient" and more see: Teaching Independence: A Therapeutic Approach to Stroke Rehabilitation (TI).
For more treatment ideas using function in standing see: Functional Treatment Ideas & Strategies in Adult Hemiplegia (FTI).