Invitation to co-design standing frame intervention for a trial

Richard_Scope · September 7

Help us design a standing activity programme for children with cerebral palsy

We want to hear from families, carers and professionals.

Why this matters

Cerebral palsy is a disability that affects the way that children move. Some children with cerebral palsy need full support to move and may spend long periods sitting or lying down.

Supported standing may help children to be more active and keep fit, but we need better evidence about how it should be used.

What we are doing

We are working with families, carers and professionals to design a safe, realistic and inclusive physical activity programme in supported standing for school-aged children with cerebral palsy.

We will test this programme in a research study to see if it improves the health and quality of life for children.

Will I be paid?

Yes. Families, carers and young people with cerebral palsy can receive payment or a reward for their time.

We can reimburse expenses such as travel, accommodation and childcare costs that you need to be able to join in.

What happens next?

We are planning a face-to-face workshop day in Birmingham on Friday 13th November, 10am–3pm.

We will provide lunch and refreshments.

There will also be other ways to join in if you can’t come.

Contact

Please get in touch with Rachel Rapson.

She is a Physiotherapist and Researcher and would love to discuss how you can get involved.

Email: Rachel.rapson@nhs.net
Telephone: 07971 246592

Interested in helping? Please get in touch.

The project involves the University of Exeter, Children & Family Health Devon, Devon Partnership NHS Trust, and is funded by the National Institute for Health and Care Research (NIHR).

Richard_Scope · September 7

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Wibbles · September 17

Using AI…took 10 seconds !

A standing activity programme for children with cerebral palsy needs to be structured, safe, and evidence‑informed, combining supported standing with purposeful play, balance work, and functional skill practice. Below is a complete programme you can use or adapt, grounded in current clinical recommendations and research.

Core Takeaway

A strong standing programme for children with CP includes 30–60 minutes of supported standing daily, broken into meaningful activities that build bone density, hip development, balance, core strength, and functional mobility.

🧠 Why Standing Matters

Standing delivers measurable physiological and developmental benefits:

Bone density & hip development — weight‑bearing reduces osteoporosis and hip displacement risk.
Circulation, digestion, breathing — upright posture improves cardiovascular and respiratory function.
Spasticity reduction — extension‑based weight‑bearing can temporarily reduce flexor tone.
Social engagement — standing at peer height improves interaction and participation.

📅 Daily Standing Activity Programme (Structured Plan)

1. Warm‑up (5 minutes)

Gentle trunk stretches — seated or supported.
Weight‑shifting in sitting — prepares core muscles.
- Evidence shows sitting balance work improves trunk control and posture.

2. Supported Standing Block (30–60 minutes total)

Most guidelines recommend 30–60 minutes daily for children who cannot stand independently.

Use whichever stander is appropriate (prone, supine, upright, or mobile).

A. Static Standing (10–15 minutes)

Maintain upright posture in the stander.
Encourage visual scanning, reaching, or simple play at eye level.
Helps bone density and hip development.

B. Dynamic Standing Activities (10–15 minutes)

Reaching games — reach for toys placed left/right/up/down.
Weight‑shifting in standing — gentle lateral shifts.
Ball play — rolling or tapping a ball on a tray.
- These activities improve balance, coordination, and core strength.

C. Functional Standing Skills (10–15 minutes)

Sit‑to‑stand practice**** (if appropriate) — repeated transitions build gross motor function.
Supported stepping — in a mobile stander or gait trainer.
Toy‑based tasks — stacking blocks, pressing buttons.

🎮 Activity Ideas by Ability Level

For children with limited trunk/head control

Use supine stander or high‑support frame.
Activities:
- Switch‑activated toys
- Visual tracking games
- Music‑based engagement

For children with moderate trunk control

Use prone or upright stander.
Activities:
- Forward reaching
- Side‑to‑side weight shifts
- Ball tapping

For children with good trunk control

Use upright or mobile stander.
Activities:
- Standing balance games
- Obstacle navigation
- Functional tasks at a table

📈 Weekly Progression Plan

A structured progression helps build tolerance and skill.

Week	Goal	Activities
Week 1	20–30 min standing tolerance	Static standing + simple reaching
Week 2	30–45 min standing	Add dynamic weight‑shifting + ball play
Week 3	45–60 min standing	Introduce sit‑to‑stand, stepping, mobile stander
Week 4+	Maintain 60 min/day	Increase complexity of games and functional tasks

🛡 Safety & Monitoring

Parents/carers should watch for:

unusual fatigue
increased resistance/spasticity
skin pressure areas
pain or discomfort
If these occur, pause and consult the physiotherapist.

📌 Evidence‑Based Principles Behind This Programme

Standing frames are one of the most evidence‑supported interventions in paediatric CP care.
Balance and core exercises improve coordination, posture, and mobility.
Home programmes with repeated practice significantly improve functional motor skills.