Standing device for children with cerebral palsy: description with photos, purpose, help for children and features of use

A verticalizer is a device that can be used independently or in addition to other rehabilitation means. Designed to support the body in an upright position for people with limited mobility. The main purpose is to prevent and mitigate the negative consequences of a sedentary or recumbent lifestyle, such as bedsores, renal and pulmonary failure, and osteoporosis.

In this article, special attention will be paid to the features of verticalizers for children with cerebral palsy.

Existing types of verticalizers

Let's look at the types of verticalizers on the market.

A device in which the patient has support on the stomach is especially common and is called anterior. Designed for patients without problems with holding their head.

Creating the correct position in the verticalizer (stander)

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Neurophysiological rationale for choosing a stander

Some children with cerebral palsy will never learn to stand on their own, or may learn this position much later than other children. Why do we strive to provide such children with auxiliary devices in advance? The goal of physical therapy for children with cerebral palsy is to help the child master physiological movements. Pathological movements and postures should not predominate so that further motor development is possible without pathological elements of movements, or at least not only with them...

Example. A boy with a fixed foot equinovarus deformity experiences more difficulties in a standing position than a child who rests on his entire foot.

To achieve our goal, we begin at an early age to use assistive devices to maintain the correct position of the lower limbs. This can be an inclined board or a stander.

Advantages of a verticalizer (stander)

The verticalizer facilitates control over the position of the head, since by limiting pathological motor patterns, it becomes possible to straighten the body vertically and facilitate isolated movements of the head.

Dangers of Using a Tilt Board

Changes in tone and the presence of generalized movements often interfere with isolated head movements; on the other hand, head movements cause pathological movements and postures. For example, if a child with severe cerebral palsy lifts his head from a prone position, the movement of the head causes hyperextension of the torso (extensor spasm). Excessive extension can also affect the arms, but it is especially pronounced in the legs, causing increased adduction and internal rotation in the hip joints. If we place the child on an inclined board, fixing his torso and limbs, then when trying to straighten there will be a greater load on the head, since When raising your head you have to overcome the force of gravity. In our experience, increasing the load when straightening the head increases the occurrence of pathological and asymmetric motor reactions. And this is the threat of developing scoliosis.

Manufacturing

There are many models of standing machines available, so consult with a rehabilitation technology specialist about which model is best for your particular case. When choosing, pay attention to whether the model in question makes it possible to support the joints in the correct position and whether the torso receives symmetrical support and support. It is also necessary to use auxiliary devices that are sufficiently rigid and do not change shape under the influence of the child’s body weight. For example, a stand is well complemented by a table attached to it.

Requirements for the verticalizer

1) When using a verticalizer, the situation for a child changes significantly, so it is necessary to provide for the possibility of additional correction for straightening the hip joints. 2) If the pelvis is asymmetrical, use a stander with a special additional belt or a rigid pelvic fixator. 3) It should be possible to correct the different lengths of the child’s legs .4) It should be possible to change the degree of abduction in the hip joints. The knee brace should be installed depending on the desired abduction of the lower extremities. 5) The degree of straightening of the legs in the knee joints must be selected so that there is no excessive pressure on the kneecap. 6) The verticalizer must have a foot brace or guides for them, ensuring their correct position . At the same time, remember that in the stander it is often necessary to put on orthopedic shoes for the child. In this case, the cups of the foot braces should be wider, sometimes even wider than those offered as standard. In children with insufficient control over body position, this should be added to: – a device that allows extension of the spine (torso brace); – attachments for hands and devices for fixing the hands on the table; - a head stop to prevent excessive extension in the cervical spine. After the child has stood in the verticalizer for a while, the position of the pelvis and joints of the lower extremities should be corrected again; Placing the child in the “maximum correction” position from the very beginning can lead to excessive tension and increased muscle tone. When muscle tension decreases after some time, subsequent corrections will become possible. In no case should this lead to painful overstretching of the muscles. If we use a stander to prevent contractures, the child will need to stand every day for a long time. In this case, the stand must meet additional requirements: – it must be portable (even with a child standing in it); – it must be equipped with a table that varies in height and angle of inclination and has a limiting edge (so that toys do not fall from it) – in case of epilepsy, you need to consider the possibility of additional soft upholstery of the rigid elements of the stander.

Functions and action

1) When using a verticalizer, the occurrence of contractures can be avoided.2) The stander helps a child with significant motor impairments to see most of the surrounding space, helps improve the functioning of the hands: the child gets the opportunity to better grasp, lean on his hands, etc.3) Physiological position in the hip joints contributes to the formation of the roof of the acetabulum. To form the roof of the acetabulum of the hip joint, it is necessary that the child begins to feel the weight of his body in the physiological position as early as possible and experience the corresponding load on his legs. This also applies to children with severe multiple disabilities. It is recommended to place such children in a vertical positioner relatively early in order to gradually accustom them to an unusual position. Therefore, when using for the first time, it is possible to set the stander in a more horizontal position than will be done in the future.4) In addition, an active standing position has a positive effect on blood circulation.

Target groups

1) Children who predominantly crawl or sit in a “W” position and have a tendency to form flexion contractures in the hip and knee joints. Counteraction to their formation should begin as early as possible.2) If children independently reach up, trying to take a vertical position, but can only stand by taking pathological poses and making pathological movements, among other things, they are recommended to use a verticalizer.3) Children with hip dysplasia should start using the stander as early as possible. Children after surgery on the hip joint are often immediately put back into a standing position to preserve the results of the operation. 4) For children who, due to cognitive impairment, do not want to go into a vertical position (at least out of curiosity), the stander provides a new position and new opportunities for gaining experience.

Application

This girl can crawl (note the frayed toes of her shoes) and stretches upward to try to get into a vertical position, but cannot straighten her knees sufficiently on her own. In this case, the corrective effect of the verticalizer is in the direction of the hip, knee and ankle joints along the physiological axis of the lower limb. A special recess is made in the knee braces so that the device presses on the kneecap only from the outside. The inner pad of the knee braces is wedge-shaped so as not to put too much pressure on the thigh.

The girl does not have a tendency to have an asymmetrical position of the pelvis, so other fixations are not needed. In this position, she can make body movements in any direction (Fig. 47).

Rice. 47

The boy (Fig. 48.1–48.2) can stand without problems in terms of the position of the hip, knee and ankle joints. In this case, the torso, which tends to tilt to the left, requires more attention. In this position, the child requires a special support for the body. LENY is one of the types of such fastenings, used everywhere. It can be quickly attached to the edge of any table.

Rice. 48.1 and 48.2

The fastening has a joint and therefore does not prevent the child from tilting forward and straightening to its original position. If the child leans predominantly in one direction, then the fastening can easily be made somewhat asymmetrical (Fig. 48.1). In this case, the child will quickly feel that he is falling onto his side. There are two types of torso attachments:

For this boy, the table was attached relatively high to reduce the tilt towards the upper torso. The LENY torso mount wraps around the front of the chest, thereby helping the child maintain a symmetrical position (Fig. 48.2). Finally, the LENY torso mount can be secured so that it will be located right at the edge of the table, and the child will be able to put his hands completely on the table. The boy (Fig. 48.3–48.4) stands in the stander every day. The position of his hip, knee and ankle joints is correct. In addition, this standing position makes it difficult to retract the shoulders.

Rice. 48.3 and 48.4

The boy stands in a verticalizer with a LENY torso mount and a sternum clamp. His body is additionally held in place by a special belt (Fig. 48.3). The child's mother wrapped the LENY binding in sheepskin. To prevent shoulder retraction in this boy, we use a shoulder scarf (in a slightly modified form). We equipped both ends, which were originally tied, with a clasp so that they are now attached crosswise to the table (Fig. 48.4). Thanks to this fastening, the child’s mother can, depending on the boy’s capabilities, slightly loosen or tighten the scarf, thereby bringing the child’s arms forward more or less. In this position, the boy willingly listens to music. The boy in Fig. 49 – contractures in the elbow and knee joints (minor in the elbows), he received a verticalizer. The child's movements are stereotypical (highly asymmetrical): they begin with adduction and internal rotation at the hip joint or with excessive extension of the head.

Rice. 49

In this case, it is important to maintain the pelvis in a symmetrical position with the help of a fixator (see p. 175), which is applied from the lower thoracic spine to the pelvic bone. Due to the fact that the brace is applied to the lower thoracic and lumbar vertebrae, the structure can “grow with the child”. A front attachment (LENY) and a back attachment that encourages maintaining posture (uses part of the Ergoline model, which is described on p. 190), reduce asymmetric rectifying reactions. If necessary, you can use a head restraint that will restrain the head from throwing back. The photo clearly shows that the symmetrical position of the pelvis and torso allows the boy to relax and lean forward, and he enjoys his new capabilities. The table is covered with soft upholstery, as it serves as a support for elbows. Upholstery is also necessary during attacks of epilepsy, accompanied by sudden movements. The table is installed at such a height that the boy can lean on it with his elbows and forearms.

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Table of contents

Further

Correct selection of device

Only a specialist doctor can give the correct recommendations on choosing a verticalizer. To do this, the patient must undergo an examination, which will allow the doctor to identify underlying diseases, determine the type of device and level of body fixation, physical capabilities and permissible loads.

If possible, the patient should also participate in the choice of the device, because only he can determine the degree of comfort of the proposed device. However, the main criteria should be the doctor’s recommendations, since the device is intended to correct existing problems, and this may cause additional discomfort.

Which type of verticalizer is better suited - the doctor or the patient, who has the choice?

Igor Goldin, surgeon, chiropractor

Of course, we as doctors are obliged to recommend TSR to the patient, especially when it comes to preparing an IPR. What type of verticalizer a patient needs depends on his condition and prospects. For severe injuries and illnesses, the posterior one is usually recommended. The person is placed on his back, gradually brought to a “standing” state, observing his reaction. This type is usually used in medical institutions, rehabilitation centers, classes are carried out under the supervision of experienced specialists. It is important that moving a patient from a wheelchair to a horizontal bed is not so easy; this requires a special lift or at least two people to help. The front type of verticalizer will be useful for patients with, let's call it formally, an average condition - at least they can hold their head up. In this case, the body is fixed in the chest area, from the back, if necessary - side and knee supports.

The most effective type of verticalizer in terms of rehabilitation is an active one (dynamic, parapodium, walking trainer). This type of device is suitable for patients who have at least partially preserved movement in the lower extremities. Although there may be exceptions, for example, with spinal cord injuries, when there is no sensitivity, impulses do not pass, but due to compensatory-preserved functions, the prospect of getting back on your feet is still possible. Rehabilitation specialists recommend it as an effective TSR, capable of not only transferring into a standing position, but also being used as a simulator - a multifunctional verticalizer. Now there are models on the market that are equipped with a lifting device, and the patient can exercise independently without involving trainers and loved ones.

Therefore, I repeat, the choice remains with the person - only he can accurately feel his potential, measure his strengths, assess his prospects, and, most importantly, his financial capabilities. Unfortunately, judging by my experience of living and working in Israel, Russian disabled people are still poorly provided with innovative TSR. But, it should be noted, there is dynamics; worthy analogues of imported equipment for the disabled are appearing on the Russian market.”

Correct size choice

The following parameters can help you select the device size:

weight and height,
foot length,
hip width,
chest volume,
the distance from the foot to the shin and from the shin to the thigh on both legs.

It is also important to measure the distance from the foot to the chest. All measurements should be taken in clothes that are comfortable for the patient and usual shoes. If a child wears special orthopedic shoes, then measurements and fittings should be made in them. How to take measurements correctly, you should consult with your doctor, who will help determine possible measurement difficulties.

Average prices

The cost of such a device may vary depending on its type and manufacturer. On average, prices for verticalizers start at 10 thousand rubles and can reach several hundred thousand rubles.

It is better to purchase verticalizers by contacting a medical equipment store or directly to the company that manufactures them.

Before purchasing, you need to carefully inspect the device, or even better, try it on the child for whom it is intended.

Using modern equipment, the life of a child with cerebral palsy can be made better and brighter!

Important to remember!

Before each use, you should carefully check the serviceability of all clamps, as well as the reliability of the brakes.

The greater the angle of inclination of the verticalizer, the greater the load on the legs and spine. That is why it is unacceptable to start training immediately from 90°, and the time of the first training should not exceed 2-3 minutes.

The verticalizer is installed only on a horizontal surface without possible inclinations. If the device is not intended to be used, it must be put on the brake.

Standing machines for children with cerebral palsy

The problem of cerebral palsy is currently relevant. The number of children suffering from this pathology remains high. Modern medicine makes it possible to significantly achieve positive results from treatment and improve the patient’s quality of life.

Mechanism of action and features

The verticalizer refers to devices used by patients with pathologies of the musculoskeletal system caused by cerebral palsy. It allows you to maintain the patient’s previously unstable position in an upright state.

Due to regular use of the device, an improvement in the quality of life is observed. This is largely due to the fact that the process of stimulation of muscle fibers occurs, due to which musculoskeletal functions are activated.

Important! The main task of the device is to activate supporting loads in the foot area.

Regular use of the verticalizer in patients prevents muscle atrophy and early thinning of bone elements.

Rehabilitators, together with parents, achieve positive dynamics of the disease, due to the ability to independently lift or sit down, as well as grab a spoon or other manual manipulations that were previously impossible.

Patients become more adapted, they can not only care for themselves, but also receive a specialty in the future.

Basic recommendations for selection

Choosing the right verticalizer will help not only achieve the desired result, but also prevent serious consequences associated with inconvenience of use. The selection is carried out by the patient together with a specialist, who identifies the main characteristics of the required device.

They are assessed on the severity of the pathological process, the physical parameters of the patient, the required level of fixation, and the load that is subsequently imposed. At the same time, the patient’s condition, which he experiences in a verticalizer with these parameters, is also taken into account, especially if these are children.

Not only the level of comfort is assessed, but also other degrees of muscle tension.

Size selection

The choice of the size of the verticalizer should be given special importance, since the effect of the device largely depends on the selected parameters. It is recommended that all measurements be taken by a specialist or relative under the strict supervision of a doctor. This is due to possible difficulties due to the patient's condition. The following values are taken into account, including the following data:

Measurements are taken in the clothes and shoes that the patient wears in everyday life. A child suffering from this diagnosis and regularly using orthopedic shoes needs to wear them when taking parameters, as they will change the values.

Rules of application

It is important for the patient’s relatives to receive recommendations from a specialist on the use of a verticalizer for a child. This is largely due to the presence of certain operational difficulties in the early stages.

Before each use of the device, the condition of the locking apparatus and brakes is checked. The verticalizer should be installed on a surface that has a horizontal coating.

If the device does not move, the brake setting and the child holder must be checked regularly.

It is prohibited to use a verticalizer for children with cerebral palsy if the surface on which it stands is tilted.

The load level is checked by tilting the device; the load increases in proportion to the angle. This explains the gradual change in inclination, since the initial installation at 90 degrees vertical can cause overvoltage. The duration of training should also be increased as treatment progresses. The first experiment should not exceed 2–3 minutes.

Modern verticalizers not only improve health, but also help the child adapt to the environment.

Currently, the choice of device is made between six existing varieties, depending on the mechanism of their action and the achievement of effect, and selection is carried out. Among them can be used:

Hyaluronic acid in the joint

Flaws

Despite the clear advantage of using this device for people suffering from cerebral palsy, there are also disadvantages that are caused by various factors.

Attention! The primary one is the relatively high cost of the verticalizer.

In the absence of additional financial assistance to the patient, as well as restrictions on the rehabilitation program, independent purchase of the device is difficult. This is due to the relatively high cost of the equipment, as well as the need for replacement depending on age or the required load.

In some cases, relatives try to make it with their own hands in order to improve the prognosis for the patient and prevent serious complications. A self-made standing support for children with cerebral palsy does not always have a positive effect on the musculoskeletal system.

In more rare cases, the lack of the desired effect from using a verticalizer is noted. As a rule, this is associated with the beginning of its use at stages of pronounced irreversible changes, when such correction can no longer correct the condition.

A self-assembled device does not always fit the exact dimensions of the patient.

Children's verticalizers for patients with cerebral palsy

Since the child will spend a lot of time in this device in the future, the choice should fall on verticalizer supports for children with cerebral palsy, equipped with tables with limiting sides, with the ability to change the angle of the table.

If a child experiences epileptic seizures or develops convulsive readiness, it is worth softening all hard edges with dense material.

It is worth noting that a large number of models of verticalizers have been produced for children suffering from cerebral palsy. Some manufacturers give their product the appearance of an animal, a car, a dinosaur, so that the treatment of a small patient takes on an element of play. If you have the funds, there will be no problems in choosing.

What can you pick up for a disabled child so that he can walk on his own?

Ermilova Evgenia Konstantinovna, great-grandmother, raising a boy with cerebral palsy alone

“It’s been 4 years since I was left completely alone in my arms with a paralyzed great-grandson. I am 70, the boy is 15, he has cerebral palsy.

We have been with him since birth. We visited all hospitals, centers, paid and free, and performed several operations. The result is zero. I have long come to terms with the fact that Kirill will never walk. Previously, we forced him to move with the help of a regular walker, he tried until he worked up a sweat. As it turned out, we did nothing useful by doing this. A properly selected exercise therapy complex could have given good results, but at that moment we did not know about it and wanted the best. Now the child is constantly in a wheelchair, he studies like everyone else, plays computer games. I didn’t think about the need for a compact active verticalizer, because I couldn’t handle it, I couldn’t put or move the child on any exercise machine myself. But it turned out that there are exercise machines with an electric lifting seat. And now several times we have gone to practice on such a verticalizer, I shot a video of how, with a smile on his face, my grandson gets up, pressing the remote control, fixes himself and walks, not afraid of falling. We also use a special table as a desk to do our homework while standing, and when you’re tired you can sit down. Kirill likes it, he asks: “Bab, when will we go again?”

Of course, I understand that this will not replace full-fledged exercise therapy, but as a prevention of contractures and normalization of blood circulation, the verticalizer is very valuable. And the most important thing is the great joy of being on your feet, albeit with support, but walking on your own. I see it on his face, he is happy, proud, and it makes my heart beat faster and my soul becomes warmer. Thanks to our Russian developers."

Stander Shifu Ocean

For example, the Shifu Ocean verticalizer for children with cerebral palsy is a combined device in which a sick child can be restrained either with the emphasis on the stomach or with the support on the back. In addition, it has several stages of fixation adjustment, as well as a soft orthopedic base, which makes the device additionally comfortable.

This device has a removable table that can be attached to both the front and rear. Its position can also be adapted to the different needs of the child using special regulators.

This line of products for children provides three sizes, taking into account the height of the patient.

Is it possible for a disabled person to receive a verticalizer or exercise machine for free?

Olga Stoletova, accountant-consultant

“Only those who are far from this topic say that “everything they need is given to people with disabilities for free.” In fact, the situation with providing disabled people with TSR in Russia is not simple. But the problem is not that there is no money in the budget, but in the very mechanism for issuing free TSR and paying compensation. There are still strict lists, a long and incomprehensible procedure for registering IPR, confusion in ITU regulatory documents, their endless updating not in favor of patients, incompetence of doctors and specialists from social institutions. Pilot projects for issuing certificates have not gone far from the lists: there are still restrictions on the amount, by region, by the list of suppliers, TSR models, etc. In general, the situation is typical for medicine in general.

Briefly about who has the right to free verticalizers, lifts, exercise machines and other expensive equipment for the disabled that are not included in the Federal list of TSR:

— victims of industrial accidents and occupational diseases;

— disabled children at the expense of maternal capital;

— disabled people living in regions where an additional list of technical means of rehabilitation is in effect, the most active procurement region is the Sverdlovsk region;

- veterans, honored pensioners and other people who have served the Fatherland can count on help, for example, from local or regional authorities;

Whether it needs to be included in the IPR and how – this issue needs to be decided individually, depending on the specific situation. You can ask for a free consultation: how to include, for example, a stroller with additional functions in the IRP, who is entitled to a lift, an uprightizer, a walking trainer, how to receive compensation for TSRs made to order. We will be happy to share information and experiences with our customers.”

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Stander Robin

Robin devices are rear-supporting verticalizers for children with cerebral palsy and are available in two sizes for age categories 3-14 years. It is considered a compact device suitable for the rehabilitation of children with cerebral palsy. It has several supports, which, thanks to their ergonomic shapes, allow you to surround the child with an individual comfortable frame on all sides and give the body a stable vertical position. The support frame is equipped with tilt angle adjustment.

At the bottom of the device there are sandals with fasteners, the angle of which can be adjusted according to the physiological characteristics of the small patient. With the help of a low footrest, the stroller quickly becomes a verticalizer for children with cerebral palsy. If a child is unable to control his body or suffers from seizures, a strong, wide belt is provided for him.

The Robin verticalizer for children with cerebral palsy is characterized by quick and easy adjustment. It folds up effortlessly and stores compactly. The package does not include a removable table; it must be purchased separately.

Which verticalizer to choose for children with cerebral palsy

A verticalizer for children with cerebral palsy is a design that will allow a child to stand without assistance. When choosing a specific model, you need to take into account the specifics of the child’s condition, so before purchasing a device, you need to consult a doctor who will help you choose the best option.

Currently, there are many models that differ in size and fixation methods. Cerebral palsy is often aggravated by epilepsy, and in order for the child not to injure himself, the structure must be very stable, and all parts must be covered with soft upholstery.

How to choose a verticalizer?

Thanks to the vertical position, the satisfactory condition of the muscle corset is maintained. This allows children and teenagers to carry out many activities independently: play, eat, work at the computer. Children with cerebral palsy are characterized by a violation of the symmetrical position of the pelvis, and to compensate for this violation, the verticalizer fixes this area.

It is possible to rent a device, test it for a week or ten days, and then either purchase it or return it to the manufacturer.

Renting a verticalizer will help you become familiar not only with its capabilities, but also with the likely disadvantages of the model. Since the child and teenager are at the age of active growth, the device will have to be periodically replaced with a new one. Most manufacturers produce 3 age lines to cover as many children as possible with various musculoskeletal disorders:

Before reaching 10 months of life, there is no need to burden the child with an upright position. Some manufacturers start counting at 1.5 or 2 years.

The time to start using a standing support should be discussed with your doctor.

Cross age values allow the use of verticalizers for children with underdevelopment or severe asymmetry of individual parts of the body, suffering from obesity or dwarfism.

Since verticalizers are used not only for chronic diseases of the musculoskeletal system, but also as a means of rehabilitation after spinal injury, intermediate sizes allow all children to receive support in recovery.

A standard verticalizer looks like a table around which the child is secured in a standing position. The table can be removable or non-removable. Other options are also possible, for example, equipped with a seat, folding or transforming into a couch.

According to their fundamental functions, verticalizers are:

Static ones can be equipped with wheels to make it convenient for parents to change the location of the device. Most children's stand-up beds are made using soft and hypoallergenic materials.

In order for the child to develop a positive attitude towards the device, their design is usually bright and colorful, reminiscent of a children's playground. Often the models are made in the form of supporting animals, for example, “Kitten” or “Dinosaur”.

Thanks to the animation of the device, it becomes possible to motivate the child to stay in a standing position.

Regardless of the convenience of the design, the vast majority of children have an adjustment period, during which they have to be persuaded and encouraged to use the device.

How to make a verticalizer with your own hands

Despite all the positive aspects of this device, it has a significant drawback - the price. New verticalizers for children with cerebral palsy cost from 25,000 rubles, many, slightly more equipped, cross the threshold of 100,000 rubles. You can purchase the unit secondhand after your child has grown out of the device, but it is worth noting that each patient with cerebral palsy has its own specific deviations; you will have to search for a very long time or take what you have and adjust it to your size.

Or you can immediately decide and make a verticalizer for a child with cerebral palsy with your own hands. However, you will still have to spend money on materials and professional engineering drawings.

However, these costs will still be several times less than purchasing a ready-made device. First, decide what material the support will be made of. Based on the selected material, contact an engineer who will prepare a professional drawing of the device according to individual measurements. Next, you should consult a doctor for possible amendments and recommendations that will be given according to the physiological characteristics of the child.

If you have the skills to work with the selected material, you can begin self-assembly. If you don’t have such skills, you should contact a specialist.

Don’t forget that in addition to the verticalizer itself, a child with cerebral palsy needs softening covering and adjustable clamps. For this work it is also worth using high-quality material that will not create additional problems. The covering should not be too soft, and the fastening belts should not be rigid. Foam rubber and cotton wool are not recommended in this case, as is polyurethane foam, although these are the cheapest materials used in orthopedic mattresses. Cotton wool tends to fall off, foam rubber crumbles and deforms, polyurethane foam absorbs moisture, but drying it is almost impossible.

A more or less suitable material - both in terms of properties and budget restrictions - is latex. For cladding it is also worth choosing a hypoallergenic material. It should be strong enough, but not rough in structure. You can use cotton teak. Belts can be purchased as a set from medical supplies or assembled yourself. As a rule, they are made using cordo-nylon tape, which can be purchased at a hardware store or sewing store. They are fastened to each other with special fasteners of suitable size.

Photos of verticalizers for children with cerebral palsy are presented in this article.

Dynamic verticalizers

In order for a child or teenager to move with the support of a dynamic verticalizer, the following can be used:

wheels that roll the device when pushing off the floor with your feet;
mechanical structures that are driven by hand force;
electric drive

When choosing dynamic models, you must first take measurements and evaluate the dimensions of the room. To prevent a child from getting injured by hitting his elbow on a door frame or falling down a flight of stairs, you need to prepare the room in advance and make it safe. Due to its maneuverability, the device should easily fit into all turns and doorways of the apartment where the child is planned to be admitted. For safe use, the floor must be clean and non-slip. Before the child begins to move around the apartment, you need to remove all carpets and rugs from the floor that could create an obstacle in his path.

Depending on the specific violations, the drive for the verticalizer can be mechanical or electrical. Before giving preference to any option, you need to find out from the doctor what will be optimal for the child. Typically, with cerebral palsy, there is an asymmetrical position of the feet, so you will need to wear orthopedic shoes while in the device. You need to find out in advance the size of your child’s feet and check whether the size of the foot in the shoes will fit into the foot cups or on the stand.

To ensure that the clamps located at the level of the chest, waist and pelvic bones do not exert excessive pressure, you need to choose the most comfortable ones, and then adjust them normally. The child can take an active part in this and give feedback on his feelings.