Page 16 - Mobility Management, February 2019
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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            ATP Series
                                          Standing Connections
in the risk of all-cause mortality.
Since then, we have a seen a flurry of inventions infiltrate our
lives in the form of standing desks in the office and smart watches that ping us when it’s time to get up and move — all meant to disrupt our sedentary lifestyles and encourage us to stand more and sit less. But the mainstream popularity of standing has revolved around able-bodied people who can exercise some level of choice over their daily sit-to-stand ratio. Wheelchair users and people with disabilities who require assistive technologies to stand are often deprived of that choice, not because of their disability or a lack of innovation, but because payors continue to decline funding for standing wheelchairs and standing frames.
Perlich said that some payors are “still saying that [standing] is experimental and investigational, and there’s no proven efficacy, which we know is not true. There are plenty of studies that do have their merits. That’s a great frustration.”
As early as 2007, five years before the mainstream panic began about sitting, the Rehabilitation Engineering and Assistive Technology Society of North America (RESNA) published its position in support of standing, citing positive outcomes in enhancing independence, maintaining vital organ capacity, bone mineral density, circulation, and range of motion, reducing tone
and spasticity and decreasing the occurrence of pressure injuries and skeletal deformities.
Ironically, it is likely that the success of the able-bodied market around standing has potential to change minds and influence the opinion of funding sources. Pryles thinks that the groundswell of popularity in standing will have positive effects on the CRT industry. “I think that the thing that’s helped our industry the most isn’t necessarily our own research, our own outcomes around standing, but it’s been through the furniture industry and all the stuff people are finding out around the dangers of sitting,” he said. “I think as the general consensus as a society moves forward and people recognize it as a benefit, so too ultimately will those payor sources follow.”
For seating and mobility clinicians who have been advocating for the necessity of standing long before smart watches could, it can be frustrating to see opinions on standing change only when able-bodied people have found they can benefit from standing as well. But the critical role of the clinician in ensuring their clients receive the technology they need remains.
“Keep on advocating for your clients, it’s important,” said Perlich. “It’s very necessary for their health. Don’t let a policy get in the way. There’s always an appeal that can be addressed, and there are alternative payors out there.” m

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