Clinical Survey What population do you work with? Pediatric Adult Pediatric & Adult What Diagnoses do you treat most? Choose the top 3. Cerebral Palsy Developmental Delay Spinal Cord Injury Traumatic Brain Injury Multiple Sclerosis Muscular Dystrophy(s) Stroke / Cerebrovascular Accident Amyotrophic lateral sclerosis Spina bifida Other Please list the diagnosis(es)Is standing used as part of therapy in your facility? Yes No Why?Do you prescribe standing for home use? Yes Sometimes No Why Not? Select Your Top 3 Reasons Not enough time to prescribe Lack of funding/insurance Not Enough Space in home User isn’t comfortable standing User doesn’t like product Caregiver is not accepting User isn’t accepting of additional equipment What are the most important reasons to prescribe a home standing program? Choose the top 3. Improve and maintain bone integrity/skeletal development Lessen/manage the progression of scoliosis Strengthen cardiovascular system and build endurance Improve Circulation Reduce Swelling Improve bowel function and regularity Aid in kidney and bladder functions Improve/maintain range of motion Management of atrophy in the trunk and lower extremities Manage pressure (wounds) through changing positions Improve strength to trunk and lower extremities Decrease joint/muscle contractures Hip Abduction Cognitive Development How many standers do you prescribe per year? None 1-5 6-10 11-15 16+ Why don't you prescribe standing devices?Estimate the number of standers you prescribe per year.What standing products do you prescribe? EasyStand – Evolv EasyStand – StrapStand EasyStand – Glider EasyStand – Bantam Medium Rifton – Supine Large Prime Engineering – Granstand Prime Engineering – Symmetry Power Wheelchair with Standing option (i.e. Permobil F5) Manual Wheelchair with Standing option (i.e. Levo) Standaid of Iowa Other What standing products do you prescribe? Zing – MPS Zing – MPS TT Zing – Supine Zing – Prone Zing – Vertical EasyStand – Bantam EasyStand Evolv Leckey – Squiggles Leckey – Mygo Jenx – Standz Jenx – Multistander R82 – Gazelle R82 – Caribou R82 – Meercat R82 – Rabbit R82 – Toucan Rifton – Supine Rifton – Prone Rifton – Dynamic/Mobile Ormesa – Dondolino Prime Engineering – Superstand HLT Prime Engineering – Superstand Other What standing products do you prescribe? Zing – MPS Zing – MPS TT Zing – Supine Zing – Prone Zing – Vertical EasyStand – Bantam EasyStand – Evolv EasyStand – StrapStand EasyStand – Glider Leckey – Squiggles Leckey – Mygo Jenx – Standz Jenx – Multistander R82 – Gazelle R82 – Caribou R82 – Meercat R82 – Rabbit R82 – Toucan Rifton – Supine Rifton – Prone Rifton – Mobile Ormesa – Dondolino Prime Engineering – Superstand HLT Prime Engineering – Superstand Prime Engineering – Granstand Prime Engineering – Symmetry Power Wheelchair with Standing option (i.e. Permobil F5) Manual Wheelchair with Standing option (i.e. Levo) Standaid of Iowa Other Please list the other brand(s) of standers you prescribe below.What type of facility do you work in? Inpatient/Outpatient Rehab Outpatient Schools Home-Based Therapy VA Private Clinic Other Other:In your facility who prescribes the most standing devices? Inpatient Outpatient CommentsWhat are the features you value in a stander? Please select up to 5. Growth Sit to stand Easily change positions – i.e. Supine to Prone Positioning flexibility – i.e. combination of sit to stand and supine Ease of adjustment Ease of transfer Hip abduction Self-propelled – Mobile Durability Choice of support and positioning options Targeted training Active standing – Glider Anatomically correct hip pivot point Accommodate contractures Aesthetics Easily sanitized What are the most common funding issues that you encounter with standing devices? Choose any that apply. Denial due to lack of evidence/research regarding benefits of standing Partial denial of standing device – support or positioning options not covered Difficulty with clinical documentation/LMN Finding a supplier/dealer willing to provide equipment End user’s insurance does not cover standing devices I typically don’t have funding/reimbursement issues CommentsHave you used Justify It – Altimate Medical’s online documentation tool? Yes No If yes, please check all that apply. The process was easy to understand It sped up the documentation process I liked the finish product I feel it helped with device payor approval I plan to use the tool again I don’t plan to use Justify It again Other CommentsWhy haven't you used the Justify It tool? Didn’t know you had a documentation tool Looked too cumbersome I like to write my own narrative letters Other CommentsHave you used Altimate Medical's funding/reimbursement hotline? Yes No I wasn’t aware of it. CommentsAre there any improvements that you would like to see on EasyStand, Zing or Justify It products?What equipment do you need that Altimate Medical could develop? i.e. Is there a need for more bariatric standing options? More choices for pediatric dynamic standers.What else should we know?May we contact you based on the feedback provided in this survey?* Yes No As a thank you for your time and finishing the survey, we’d like to donate (in your name/or anonymously) to one of the three advocacy organizations listed at the end of the survey. Please check the box next to the organization of your choice.Now that you have finished the survey choose an organization to send your $10 donation.* Clinicians Task Force (CTF): CTF provides the voice of the clinical community in order to make a positive difference in ensuring appropriate access to assistive technology. There is clearly a need for experienced clinicians in the field of wheeled mobility and seating to share their knowledge and experience regarding Complex Rehabilitation Technology (CRT) and the CTF is that forum. National Coalition for Assistive and Rehab Technology (NCART): This is a national association of suppliers and manufacturers of Complex Rehab Technology (CRT) products and services that are used by individuals with significant disabilities and medical conditions. NCART’s mission is to ensure that federal, state, and private coverage and reimbursement policies allow individuals with significant disabilities to have adequate access to specialized and individually configured products and services. National Registry of Rehabilitation Technology Suppliers (NRRTS): NRRTS is a professional association supporting individuals who provide Complex Rehab Technology (CRT), including wheelchairs, seated positioning systems and other adaptive equipment such as standing devices and gait trainers for people of all ages and diagnoses who have postural or mobility deficits. Would you like your donation to remain anonymous?* Yes No, you can list my name Name* First Last Email*
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