Page 15 - Mobility Management, February 2019

upgrade,” she said. “They make their insurance pay for a majority of it, and then that component of the standing upgrade is just line-itemed out, and the patient provides the funding, whether it’s alternative or private.”
Yet, no matter where or how clients seek out funding, the multiple psychosocial and clinical benefits of standing are not considered necessities to justify funding. “Unfortunately, justification is all [based] on the medical [outcomes],” said Pryles. “There are some things standing can do that tilt and recline cannot.”
Pryles pointed out that using tilt and recline can be disruptive, requiring users to take time to do a weight shift every 30 to 40 minutes. “Most of the people in our demographic are working. Most of them are raising kids. Most of them lead very full lives. If you allow somebody to do a weight shift while being functional, so they can stand and look around, or stand and cheer at a soccer game, or stand at a lab at school, I think people are much more compliant to doing that.”
Tiskus also emphasized the psychosocial aspect of standing, particularly its integral role in how humans communicate with each other. “It’s not just verbal,” he said. “It’s being able to look into somebody’s eyes, looking to see what type of facial expressions they have as we communi- cate, and giving that ability to somebody who’s typically in a seated position.”
People in the industry like Pryles and Tiskus, who spend time with wheelchair users, understand the therapeutic side of standing. Detterbeck, who spent 14 years in a clinic prior to joining Permobil, acknowledged how difficult it can be for clients, some for the first time in their lives, to be unable to access things or participate in activities and daily life in the way that they’re accustomed. But currently, research just isn’t being done to investigate the connection between mental health
and mobility.
“We’ve tried to pull articles on clinical depression in relationship to wheelchair usage, and
there’s nothing,” said Detterbeck. “Unfortunately, our funding sources are so medically-only driven that they don’t take into consideration the patient’s well-being and quality of life.”
Standing in the Mainstream
In 2012, a group of researchers from the United Kingdom published the first comprehensive study on the dangers of a sedentary lifestyle titled “Sedentary time in adults and the associa- tion with diabetes, cardiovascular disease and death: systematic review and meta-analysis.” In their meta-analysis of 18 studies with an overall 794,577 participants, they concluded that people who spent most of their day sitting or lying down had a 112-percent increased risk for diabetes, a 147-percent increase in cardiovascular events and a 49-percent increase
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