Is supported standing safe?

Author: SCIRE Community Team | Reviewer: Darryl Caves | Published: 17 January 2018 | Updated: ~

Supported standing is considered to be a relatively safe treatment for use after SCI. However, there are some situations in which standing may not be appropriate and some possible risks. This is not a complete list; please consult a health provider for further safety information.

Standing should not be used in the following situations:

By people with recent broken bones (fractures) or a high risk of fractures (such as people with severe osteoporosis)

Diagram comparing bone with normal bone mineral density to bone with osteoporosis.

People with osteoporosis have weaker bones which can pose a risk during supported standing.6

Where the standing equipment places excess pressure on areas where there are injuries, sores, and wounds; or areas of skin prone to pressure injuries

By individuals whose limbs cannot be brought into a good standing position due to other conditions like joint contractures, spasticity, or

heterotopic ossification

By people with medical conditions where heart rate or blood pressure are uncontrolled, such as those who are unable to stay upright without a major drop in blood pressure (severe

orthostatic hypotension

)

By people with muscle or joint injuries or other conditions that may be worsened by standing

Risks of standing may include:

  • Pressure injuries if the position and equipment used for standing creates too much pressure or shear while standing – it is essential that the equipment used for standing is appropriately fitted to prevent skin damage
  • Blood pooling in the legs may lead to feelings of light-headedness, dizziness or fainting (orthostatic hypotension)
  • Broken bones (fractures) are possible in weight-bearing positions in people with osteoporosis
  • Increased spasticity or autonomic dysreflexia in some people
  • Pain in the standing position

For more information on these topics, see our articles on Pressure Injuries, Orthrostatic Hypotension, Osteoporosis, Spasticity, and Autonomic Dysreflexia

If using electrical stimulation, the safety precautions and risks associated with use of functional electrical stimulation (FES) also apply.