Retraining standing

Why is it important?

Standing is a feature of normal human movement, and forms the foundation for more complex activities such as walking, standing on one foot and running. In many instances the ability to stand can be retrained to be straighter, stronger and for longer with the right therapy, intensity and programs.

Standing enables the upper limbs to be free to be used for fine and gross motor activities, because the trunk is extended and the range of the shoulders are free.

Standing also is important for the maintenance of upright posture, muscle strength and length, bone density and prevention of joint contractures and pressure injuries. It also improves our lung, heart and digestive function.

Common challenges:

• Difficulty generating the force to stand
• Shortened muscles, especially at the hips, knees and ankles
• Stiffness in the joints limiting the range needed to stand
• Asymmetrical standing or pushing behaviour (such as seen in stroke)
• Increased muscle tone behaviour making standing unsafe
• Hyperextending joints
• Needing to use the arms to bear weight
• Needing assistance or equipment to stand

The role of the neurological physiotherapist in retraining standing:

It is important that the contributing factors impacting the ability to stand be identified and assessed. From there a physiotherapist can develop an individualised rehabilitation program to target and retrain these specific areas. Interventions could include strengthening muscles, retraining the motor movement pattern, practice and part practice as well as the use of equipment as needed.

What our skilled therapists can offer:

• A thorough assessment of your sitting and standing postures
• Critical analysis of your movement preferences and postural control
• Hands-on treatment, with the aim of improving sensory feedback and balance
• Training of your postural control and transitioning between postures
• Hands-on facilitation of optimal movement patterns
• Soft tissue mobilisation and/or stretching for specific areas as part of a sequence of treatment
• Advice on the neuroscience of skill development and transfer into your daily life
• Prescription of a home exercise program
• A home visit or pool visit to maximise treatment effectiveness beyond the clinic
• Education on how to best support your own health and recovery