Cerebral Palsy Standing Frame Brief

Background

I became interested in design as a career out of a desire to create useful, aesthetically-pleasing additions to the everyday world. Talking to some friends who are both Physiotherapists it became clear that some areas receive less development than others. I started on a scheme for a massage table which permitted the patient’s head to be supported in a variety of positions. This opportunity was cut short by my relocation to Melbourne.

After moving, a chance conversation led to a visit to Yooralla where I met Brooke. I was lucky enough to spend a couple of hours at Yooralla and the Glenroy School with Brooke and their resident Engineer Andrew who modifies so much of their equipment.

Areas in need of attention were these:

Wheelchairs.
They currently cost $10K and last about 2-3 years – these aren’t motorised either. The issue is that they have to be sturdy, have a great range of adjustability and incorporate a tilt-and-lock feature.

Tables and chairs.
Ergonomics are crucial to the students and incorrectly proportioned furniture can cause problems. Despite having only two days per week at that site, Andrew had managed to convert the furniture to a degree of height adjustability. Unfortunately each leg is adjusted independently so getting a quick, reliable adjustment is an issue.

Trolleys.
Yooralla use a number of ex-hospital trolleys which average two metres in length. While one or two students need this size, the majority who need to be transported by trolley only take up a metre. Navigating corridors with unnecessarily large trolleys can be a nuisance as is their storage.

Standing frames.
Many students experience difficulty standing by themselves. There have been numerous attempts to meet the many requirements at a reasonable price, however some issues appear not to have been addressed by manufacturers. Standing frames have the most potential for development and the right complexity as a project for my level of experience.

Price is a major consideration. Some standing frames on the market retail for upward of $5000 while the government subsidy is only $550.

The Task

Design a standing frame for Glenroy students and Yooralla clients. The prototype should be scaled for a 1000 - 1200mm tall student

Features (Essential)

Stability.
Safety.
Quick and wide adjustment.
Easy (single staff member) student transfer from wheelchair to standing frame and back.
Vertical to 20° forward body positioning.

Features (Desirable)

Easy cleaning.
Friendly aesthetic.
Accommodate unequal leg lengths.
Foot boards to swing up to 800mm apart.
Foot boards to have fore-aft and lateral adjustment.
Permit full supine or prone positions

Features (Optional)

Theme-based aesthetic.

Constraints

Minimise cost.
Footprint 900 x 800mm

Users

Children with disabilities
Parents on a budget
Physiotherapists who may not have an aide present.

Concepts

Enable
Accommodate
Convenience

Production expectation

Batches of 10.

Presentation Form

Full scale prototype
Presentation drawing
Full documentation
Research

Use

The current method for helping the student into the frame is to face the standing frame to a solid surface (such as a wall) so that it can’t move then to bring the wheelchair to the frame. The student’s feet are fastened to the standing frame then they are lifted upright and secured to it by means of a back-board or padded strap around the hips. Students ‘with tone’ may not always be as co-operative as they might be. The ‘access’ procedure is usually carried out by one person

Existing Products

Example One

For:
Lateral support
Stability
Mobility
Cost

Against:
No facility to secure the student’s feet to assist access.
Hip strap needs two hands to operate, meanwhile the student can become unstable.
Hip strap does not address some students tendency to lean back beyond their limits of control.

Example Two

For:
Tool-free adjustment
Easy transition from sitting to standing
Easy to clean
Acts as occasional wheelchair

Against:
Fails to fully replace wheelchair
Difficult access
Vinyl upholstery may cause excessive heat buildup and discomfort

Example Three

For:
Height adjustable
Back-board provides good support
Tool-free adjustment

Against: Difficult to locate back-board at pommel
Back board fastener requires two handed operation
Outriggers (intended for stability) almost impossible to move under a student’s weight.
Foot-boards too far from rear edge, complicating access