A gait trainer is a device that partially unweights an individual using a rigid or flexible seat while providing lateral and posterior trunk and pelvic support to assist ambulation. Gait trainers are used to promote walking practice and may be deployed for either functional ambulation (to enable safe, sufficient mobility for activities of daily living) or as an adjunct therapeutic intervention for non-ambulatory individuals who require substantial support (e.g., moderate to maximum support where handheld devices are not feasible) [9, 3].
A standing system secures an individual in a standing position and can be static (tilt table, standing frame) or dynamic/mobile (integrated power standing or mobile standers). Standing systems may facilitate movement from supine or sitting to standing, can be mechanical or powered, and are used to achieve medical goals such as pressure off‑loading, preservation or improvement of bone mineral density (BMD), prevention of contractures, improved bowel/bladder function, pulmonary clearance, and management of progressive hip subluxation/dislocation [9, 5, 6].
Evidence includes systematic reviews and randomized controlled trials across pediatric and adult neurological populations. For gait training, systematic reviews and a network meta-analysis (Qian et al., 2023; Chiu et al., 2020) and RCTs (e.g., Gharib et al., 2011) report improvements in outcomes such as gait velocity, step length, and aspects of gross motor function (GMFM), though the body of evidence is limited by small sample sizes and heterogeneity of interventions and dosing [10, 11, 13].
For standing systems, systematic reviews and RCTs show benefits for several outcomes. Pediatric and mixed-age reviews report positive changes in BMD with static and dynamic standers (Valenzuela‑Aedo et al., 2024), and systematic reviews (Paleg et al., 2013; Glickman et al., 2010; Paleg & Livingstone, 2015b) support improvements in range of motion (ROM), reduced risk of contracture, and some activity-based outcomes. Adult RCTs (e.g., Freeman et al., 2019) have demonstrated improved motor function with home-based standing frame programs [14, 16, 17, 18, 15].
Published dosing recommendations for supported standing and gait interventions emphasize frequent, repeated sessions. Reviews suggest standing programs of approximately 30 minutes multiple times per week for positive impact on many outcomes; for bone mineral density, longer or more frequent dosing may be required (e.g., up to 60 minutes, 4–6 times per week) in some reports [16, 17]. Mechanically assisted gait training studies typically used sessions from about 15–40 minutes, 2–5 times per week over several weeks in the pediatric RCTs and systematic reviews [11, 12].