OVERVIEW.

Gravity-assisted compression devices (GACD) are devices that allow persons with disabilities to stand or achieve some level of assisted vertical orientation. The purposes include (1) accommodating their cardiovascular system to an upright posture following a period of bed rest (tilt tables), and (2) offering alternative positioning for children with disabilities (supine stander; prone stander), or providing standing support during vocational and avocational endeavors (stand-up type wheelchairs).^1,2 The device is typically comprised of a flat support surface, a foot support for weight bearing, straps and bolsters to secure and properly align the body, and either a manual or electric mechanism to raise and lower the individual to and from a vertical position.

SUMMARY: CONTRAINDICATIONS AND PRECAUTIONS.

Published guidelines for GACDs are sparse. The two sources cited here express concern about standing an individual too upright in the device.^1,2 One source stressed the importance of monitoring vitals.¹ Warnings/cautions listed from a manufacturer’s product guide^3,4 are also included below for a prone and supine stander.^3,4

SUMMARY: ADVERSE EVENTS.

The FDA⁵ reported one death an five injuries between 1990 and 1998. Incidents often involved falls or trips while an individual was in the GACD.

Note: Perhaps (1) guidelines can emphasize supervision requirements while patients are on GACD (as reflected in product manuals); (2) weight-bearing precautions for persons with hip subluxations, hip dislocations, or severe osteoporosis are lacking and may be useful in future GAPD guidelines.