Sit to Stand. The sit to stand maneuver assisted by the Up n Free accomplishes three important functions:

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1 Sit to Stand The sit to stand maneuver assisted by the Up n Free accomplishes three important functions: 1. Raising the user by supplementing their lower extremity strength 2. Learning/reinforcing the complex timing needed to stand 3. Strengthening the lower extremities Raising The User The Up n Free supplements the lower extremity strength of the user and can enable them to stand with little to no assistance from a caregiver. The Up n Free allows the care giver to primarily perform a coaching role. The caregiver is not required to use any force to lift the user. Because the Up n Free fits under most wheelchairs, typical home chairs, commodes and even beds, it can be used in many settings. While not an intended function of the device, some home users have discovered that the Up n Free can be used to transfer from their bed to standing and then to sitting in a wheelchair all without requiring lifting by a caregiver. Learning To Stand The physical act of moving from sit to stand requires complex timing. The user must learn to lean forward and then push with their legs at the appropriate moment. Leaning either too far forward or back makes the act of standing impossible even if leg strength is completely sufficient. The Up n Free facilitates learning the stand maneuver in two important ways: 1. The unit safely supports the user and so mistakes in timing will not lead to falling. The confidence that comes from this secure feeling can be an important element in the trial and error of learning the proper timing. 2. The caregiver can coach the proper timing by slightly raising the support arms at the critical moment. This process can lead to the user acquiring the muscle memory necessary to carry out the maneuver on their own.

2 Strengthening By supplementing the strength of the user s lower extremities, individuals without adequate leg strength can be enabled to stand. Repeating this activity can lead to improved muscle tone in the lower extremities. As strength is built up, the amount of support provided by the Up n Free can be reduced. Each model of the Up n Free provides three levels of force adjustment so that a user can be provided only the minimum amount of supplemental support that they require to stand. Posture Achieving proper posture is a key precursor to learning to walk. The Up n Free can be used to coach proper posture in three important ways: 1. Standing without relying on hand support 2. Learning proper trunk control 3. Learning to lock the knee Hands Free Standing The natural instinct to avoid falling can be an important impediment to learning proper posture. With some weight bearing devices users sometimes focus on using their hands reflexively to give them a feeling of greater security. Often this leads to a bent forward trunk position that makes walking with a normal gait much more difficult. The secure feeling users get in the Up n Free quickly allows them to feel comfortable without using their hands. ( Convenience handholds are provided on the Up n Free, but these are not required to move or otherwise use the device.)

3 Trunk Control Because the user is partially supported and stabilized by the Up n Free, the caregiver can focus on coaching proper trunk position with shoulders back and pelvis forward. Just as the user is hands free, so too is the caregiver. Without having to focus on supporting or stabilizing the user, the caregiver can move the users legs and trunk as required to teach the proper body position. Locking The Knee Learning to lock the knee is a key precursor to learning to walk. As with trunk control, the caregiver can coach the required leg and trunk position to achieve knee locking. Squatting Squatting is a key exercise to build lower extremity strength. The support piston of the Up n Free performs several key functions to assist in this exercise. 1. The support piston moves freely up and down while supplying a constant amount of lifting support. The user can perform knee bends over a wide range of motion from shallow bends to 90. As the lifting piston moves up and down the support provided by the Up n Free remains about the same. 2. As the user s strength builds, the amount of support provided by the Up n Free can be reduced.

4 3. Squats can be performed with both legs or with either leg separately. Working with each leg independently allows the caregiver and user to work on conditioning based on the need of each leg. Range of Motion Many patients who have been wheelchair bound lose hip extension range. The hip extension exercise made possible by the Up n Free is an important step along the path to achieving a normal stride and balance.

5 Weight Shifting Weight shifting is an important precursor to walking with a normal gait. The caregiver can use the Up n Free as an environment to coach the desired behavior. By having the user practice this exercise, the caregiver can teach the sensation of carrying weight on each leg.

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