How to Build a Sit-to-Stand Box

How to Build a Sit-to-Stand Box

A Toolkit Resource for Caregivers and Clinicians to

Assist Children of All Ages and Sizes

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What is a Sit-to-Stand box?

• A Sit-to-Stand box is a postural support device for children to stand up independently and put

weight through both of their legs.

• Gives the child the ability to use both hands while safely maintaining a standing position.

• It allows them to practice transitional movements from a sitting position to a standing position in

a safe and fun environment.

• Creation of the device involves a modest list of materials found at local general and hardware

stores.

What box options are available?

• Simple Sit-to-Stand Box: An introduction to the Sit-to-Stand box that requires minimal supplies

to set up and allows the child to begin play and interaction in only a few hours. Recommended for

children with CP (GMFCS level I-III) or children who need an engaging device to practice sit to

stand skills at a young age. It can be a helpful starting point before the child needs a box with

more support. Note: The child should be able to sit independently in this set-up (no support from

the parent/caregiver).

• Cardboard Sit-to-Stand Box: A Sit-to-Stand box that offers options for customization and

variation as well as back support for those that require it. Recommended for all ages with any

mobility or balance ability.

• Cardboard and PVC Sit-to-Stand Box: The highest quality Sit-to-Stand box in regards to

durability and longevity. This box offers a wide range of variation and will allow a child to grow

their skills in comfortable setting that encourages play and learning with the proper support. Due

to the advanced nature, it is recommended to be built by experienced therapists or caregivers who

have experience building with PVC pipe.

Directions to:

• Device Group Data Form (therapists only): Page 2

• Simple Sit-to-Stand Box: Page 3

• Cardboard Sit-to-Stand Box: Page 7

• Cardboard and PVC Sit-to-Stand Box: Page 15

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***Please have your therapist take these measurements***

Device Group Data Form

Anthropometrics (body measurements)

Weight (lb/kg): ____________ Height (cm): ____________

Head circumference (cm): ____________

Sit-to-Stand:

Sitting:

Chest Width (cm): ____________

Pelvis Width (cm): ____________

EMG:

Standing:

Chest Width (cm): ____________

Pelvis Width (cm): ____________

Axilla to Greater

Trochanter (cm):

______________

Greater Trochanter to mid

knee (cm): ____________

Bottom of knee

to bottom of foot

(cm): ________

Floor to Axilla (cm): _________

Floor to Tibial Tuberosity

(cm): ____________

Floor to ASIS

(cm):

____________

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Simple

Sit-to-Stand

Box

Instructions created by: Jason Hubeny

Based off design by: Dr. Sandra Saavedra

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Description of Measurements: (needed for cardboard or cardboard/PVC box, optional here)

Measurements are taken in sitting with the hip and knee at or close to the 90/90 position with feet as flat

as possible, as well as standing/lying down (please consult therapist for measurements). The frame should

be built slightly larger than the child's measurements to allow for some movement. Children who require

more postural support will need a snugger fit of the frame (closer to their actual measurements). Every

box must be customized to the child to provide proper support. Measurements are typically taken in cm.

Armpit height A (hip to armpit): 1

Armpit height B (foot to armpit): 2

Chest width (armpit to armpit): 3

Hip width (one end of pelvis to other): 4

Leg length: 5

Thigh length: 6

Lower leg length: 7

Material List: (for one box)

• 1 Box: Size should match leg length

• Duct Tape: About 2-3 rolls; Brighter colors are

recommended for the outside of the box

• 1 Bolster or Foam Roller: Measurement of 6 in.

by 36 in. (recommended)

• Contact Paper: Enough that will cover the entire

inside and outside of the box

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Step by step directions - How to Build Sit-to-Stand Box Frame:

1. Assemble or purchase your box, keeping

the top open for now

a. The size of the box will depend on

the child’s measurements

b. When the child stands in the box,

the front part of the box should

reach the child’s lower to mid ribs

2. Measure where the top of the bolster will sit

a. For the simple box and a child with fair balance, this should be close to the ground to

allow for child movement on and off the bolster

3. Trace one end of the bolster onto the box.

4. Cut a hole and slide the bolster through: a. The bolster should be placed as close to the floor as possible

b. This allows the child to easily climb on to the bolster

c. The placement is necessary for a child who cannot sit independently in typical chairs

5. For a box with back support, see Cardboard Sit-to-Stand box descriptions.

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Using the Sit-to-Stand Box:

Activities and games such

as hitting a ball, as this

child demonstrates, are

how to gain the maximal

benefit from this device.

Flat surfaces for games

and papers can also be

used in this area. The

child should have enough

support to allow full arm

movement without losing

balance or posture.

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Cardboard

Sit-to-Stand

Box

Instructions created by: Ashley Klein

Edited by: Jason Hubeny

Based off design by: Dr. Sandra Saavedra and Dr. Donna Snowdon

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Description of Measurements:










Leg length: 5

Thigh length: 6

Lower leg length: 7


• 2 Cardboard Moving Boxes: Size (S, M, L, XL) will

depend on the leg length

• Duct Tape: About 2-3 rolls; Brighter colors are

recommended for the outside of the box

• 1 Bolster or Foam Roller: Measurement of 6 in. by 36 in.

• Contact Paper: Enough that will cover the entire inside

and outside of the box

• Extra Cardboard: thick, durable cardboard used to

protect wheelchairs from getting damaged in transit

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1. Assemble a cardboard moving box, keeping

the top open for now

a. The size of the box will depend on

the child’s measurements

b. When the child stands in the box,

the front part of the box should

reach the child’s lower to mid ribs

2. Measure where the top of the bolster will sit

a. Based on the child’s “lower leg length” measurement (To allow the child to stand up

more easily, set the top of the bolster at 120% of that measurement)

3. Trace one end of the bolster onto the box

4. Cut a hole and slide the bolster through a. The length of the bolster should equal the child’s “thigh length” measurement plus 1 inch

to allow room for growth

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2 3 4

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5. Measure the height from the floor to the bottom of the bolster

6. Use this measurement to build a stack of cardboard that will support the bolster. Secure the stack

with duct tape

a. The width of this stack should equal the width of the bolster so it does not get in the

child’s way

7. Using 2 pieces of cardboard that are the same dimensions of the box, create a supporting surface

for the bolster inside the box

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6

7 7

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8. Cut the part of the support surface by the hole. The bolster will sit here so that it equals the

distance from the floor to the bottom of the bolster

9. Duct tape the top flaps of the box to enclose the bolster and its supporting surface

10. Take another cardboard moving box and cut down one of the seams

a. This begins building the part of the box that the child sits in

b. The size of this box is determined by the child’s “armpit height + bottom of foot to

bottom of knee” measurement (The sides of the box to the top of the bolster should equal

this measurement).

11. Cut a piece of cardboard that equals the width of the child’s chest and the same height as the

surrounding box (armpit height + bottom of foot to bottom of knee) measurement

12. Enclose the back support and bolster using the second moving box

a. The top flaps can either fold inside or outside of the box

13. The bottom flaps of the box fold inward to create the floor of the box

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10 11

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14. Duct tape both ends together to create one whole Sit-to-Stand box; Extra Steps:

a. Extra cardboard can be added to the front of the Sit-to-Stand box to increase the height

b. Extra cardboard can be added around the back of the Sit-to-Stand box to make it sturdier

15. Cover the entire outside and inside of the Sit-to-Stand

box with contact paper

16. Use fun colors and patterns for the tray portion of the

Sit-to-Stand box to help engage the child more

Continue to next page for variations

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Sit-to-Stand Box Variations:

Door: For children who are taller and/or bigger, a “door” can be made so the child does not have to be

picked up and placed in the device. This can be accomplished with ambulance straps (typically 3 is

sufficient). To achieve this, do not perform step 14 (taping the 2 boxes). Bring the child into his bolster

seat and make sure they are secure before taking the second box and sliding it behind them. Take the

ambulance straps and secure them to the outside of the 2 boxes. When activity time in the box is finished,

unfasten the straps and allow the child out.

Handlebars: If a child has difficulty standing up, slanting the front of the box and adding PVC pipes

allows the child to pull themselves up to standing. This can be accomplished by purchasing thick

cardboard for the top, 3 feet of PVC pipe, 2 90 degree corner joints and 2 3-way corner joints for PVC.

First, place the cardboard on top of the box (see step 14) and trace the PVC pipe circumference on top of

this additional layer (if your child needs it for standing up, place the circles between halfway and the

bolster end of the box; if your child needs it for support when standing, place the circles halfway). The

distance between circles should be your child’s chest width. Next, cut the holes on the top (extra)

cardboard, and cut a rectangle as wide as the 3-way PVC joint on the STS box (see image to left). Tape

the extra cardboard down. Next, size the PVC pipe to go through the 2 holes (this should be long enough

to go 4-6” above the top layer, or enough for the child to grip the bars). Size the remaining PVC pipe to

connect the 2 corner joints without overshooting where the holes are. Finally, connect the 2 smaller pipes

to their respective 3-way joints and place both through the holes, connect the long PVC pipe to the 2 90-

degree corner joints, and connect this to the smaller pipes to create sturdy handlebars (see image).

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Making your own Foot Straps:

Supplies needed to make two foot straps:

o Velcro sensitive neoprene – 10 inches by 10 inch square

(Neoprene can be ordered from Benik Corporation, 1-800-442-8910, $9.75 per square ft.)

o 1-inch wide hook Velcro – 24 inches

o Heavy duty sewing machine or needle and thread

Pattern: **Adjust longer or shorter depending on your child’s foot size. The directions will fit most

children in the 3 to 8-year range. If your child wears ankle foot orthotics (AFOs) you will need to make

the straps a bit longer to accommodate the increased size.**

1. Cut 2 large rectangles of neoprene – 3.5 inches

by 10 inches.

2. Cut 2 strips of neoprene 1-inch wide by 8

inches long.

3. Cut 8 pieces of Velcro 2 inches long.

4. Cut 2 pieces of Velcro 4 inches long.

5. On one end of large rectangle make a cut 3.5

inches down the middle creating 2 ends.

6. Sew a piece of Velcro to each of these end pieces.

7. Sew Velcro to both ends of the 1 inch wide strips.

8. Place the strap on the cardboard surface and attach it with the 4 inch piece

of Velcro.

9. Put the split end on the inside and pull one end up on the either side of

where the foot will go.

10. Place your child’s foot onto the strap and pull the neoprene up over the

instep attaching the Velcro to hold the foot snugly in place on the pedal.

11. Now take the one inch strip and attach it to the neoprene on the inside of your

child’s foot, wrap it around the heel of the shoe and attach it to neoprene on

the outside of your child’s foot (this will keep the heel from sliding

backwards).

12. NEVER strap your child’s feet in and walk away, they cannot get off the box

if their feet are attached. They could potentially fall over and take the STS

box with them if they try to get off with their feet attached.

13. Use the straps for a brief training session when you have time to help them,

then remove the straps and let them play and experiment without them.

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Cardboard

and PVC

Sit-to-Stand

Box

Instructions created by: Brian Huynh and Kevin Dellavecchia

Edited by: Jason Hubeny

Based off design by: Dr. Sandra Saavedra, Dr. Donna Snowdon, and Brian Huynh

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Description of Measurements:










Leg length: 5

Thigh length: 6

Lower leg length: 7

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• 1/2" width PVC piping = approximately 30-

35ft of pipe needed (cut into 5 ft. pieces for

convenience)

• PVC cutter tool = 1x

• PVC joints: (see schematic for clarification

on J1-15)

o J1 = "T" joint - 24x

o J2 = 3-way corner joint = 4x

o J3 = 4-way corner joint - 4x

o J4 = 45-degree joint = 4x

o J5 = 90-degree elbow joint - 6x

• Cardboard moving box = 1x (should be slightly smaller than the child's armpit height in sitting)

• 3-foot black foam roller or bolster = 1x (this is

what the child will be sitting on, and will extend

through the frame and into the box

• Contact paper = 1 roll (to cover up the outside

of the cardboard box for aesthetic and easy clean-up)

• Duct tape = 1-2 rolls (to cover up the edges of the box and close up the box once the frame is

inside)

• Tape measure = 1x

• PVC glue = 1x (to secure the PVC once the frame has been built to ensure integrity/safety of the

device)

• Scrap cardboard = for stabilizing the frame in the box

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Please refer to the Sit-to-Stand Box Schematic when building the PVC frame for the box. Instructions are

as follows:

1. Start by making the back, middle, front, and side supports - refer to figures E, F, G, and H on the

schematic. The squares in the center of the back (E) and middle (F) supports will later house the

bolster. The squares will be standard for a "foam roller bolster" and should measure 14cm x

14cm for a snug fit. The bottom of the support to the top of the square should be equal to 120%

(or higher) of the child's Lower Leg Length. The distance from the top of the square to the top of

the support should be equal to (or slightly lower than) the child's armpit height.

2. Assemble figures C and D, which will later become the bottom part of the frame. The length of

component C should be slightly larger than the child's thigh length, and the width of component

C should be slightly larger than the child's pelvis and chest widths. The length and width of

component D should be slightly smaller than the cardboard box - as this part of the frame will be

inside of the box for stability.

3. Next, assemble figures A and B, which will later become the top part of the frame. The length

and width of component A should be exactly equal to the length and width of component C. The

length and width of component B should be exactly equal to the length and width of component

D.

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4. Glue each figure separately. You can connect, but DO NOT GLUE component A to B or

component C to D yet. This will be done AFTER the frame is inside of the cardboard box.

5. Connect the bottom portion of figure E to the green joints (J1) of figure C at 90-degree angles.

6. Connect the bottom portion of figure H to the orange joints (J1) of figure C at 90-degree angles.

7. Connect the bottom portion of figure F to the black joints (J3) of figure D at 90-degree angles.

8. Connect the bottom portion of figure G to the purple joints (J2) of figure D at 90-degree angles.

9. Connect the top portion of figure E to the green joint (J1) of figure A at 90-degree angles.

10. Connect the top portion of figure H to the orange joints (J1) of figure A at 90-degree angles.

11. Connect the top portion of figure F to the black joints (J3) of figure B at 90-degree angles.

12. Connect the top portion of figure G to the purple joints (J2) of figure B at 90-degree angles.

13. Separate figure A from figure B, and separate figure C from figure D. Figure A should still be

attached to figure C, and figure B should still be attached to figure D.

14 cm 14 cm 14 cm

14 cm

14 cm 14 cm

14 cm

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14. Place figure B and D into the

box (figure D down) and pull

it so that it is in contact with

the side surface of the box.

Cut holes in the box

corresponding to the position

of the open joints from

figures B and D (the joints

that will connect to A and C).

15. Make a hole in the center of

the same side of the

cardboard box corresponding

to the position of the middle

square of figure F that will

house the bolster, Use the

bolster as a reference for size

of the hole.

16. Confirm that the bolster fits

through the frame and the

cardboard box.

17. Re-attach and glue figure A to B, and re-attach and glue figure C to D.

18. If not already there, place the bolster through the center squares of figure E, through the box, and

through figure F.

19. Slide the frame forward or backward in the box to meet the positional needs of the child

20. Assemble and glue the handlebars together (refer to figure I). Cut holes in the top of the box and

attach and glue the handlebars above the red joints of figure B.

21. To reinforce the top surface of the box, place cardboard in between the top of the frame and the

surface of the box. Push down on the top of the box to assess stability. Add more cardboard as

needed. Use cardboard on the sides and on the back of the frame within the box to increase the

stability of the frame as needed.

22. Seal the box with duct tape

Optional for cosmetics: Use contact paper to cover the outside

of the cardboard box. This will make the box look nicer and

makes it easier to clean the box. Use duct tape around the edges

and corners to hold the contact paper and create a uniform finish.

To decrease the relative seat height and decrease hip-knee

angle: Create cardboard supports that are 1-2 inches in height, and the width of the bottom portion of the

frame so that the supports fit snuggly. Cover with duct tape for improved sanitation and grip. Velcro foot

straps may be needed to secure the feet. This height change will challenge the child's strength and balance

more as they gain trunk control and gross motor ability.

Note: Keep in mind that increasing the seat height in this manner will DECREASE the relative height of

the armpit support

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Using the Sit-to-Stand Box:

Be sure your measurements are correct

(Child on left has a box too small)

Engage your child’s arms, head, and eyes

with toys and activities while in the box

Documents

How to Build a Sit-to-Stand Box