The purchase of the horizontal rack stand was to allow me diversity in my therapy room with the clients I would be working with. For some reason, I felt compelled to refer to my setup as "Leroy, the LED Light Box", hence my illuminated assistant, Leroy. This stand will allow me to expand the length of the treatment area as my light practice grows. Though I look forward to also expanding to the motorized horizontal stand, this manual one is not horrible to adjust. I have a hydraulic table so I can keep the manual stand at an established height for most sessions. I used my table to help me attach my lightbox to my stand when I set it up and that proved to be a very smart decision. When I have needed to raise or lower it, it does need a firm hold (that lightbox is not light), but it is manageable. The ability to change the way the lightbox is facing is far less of a challenge, so on the whole, it's not bad if you have good strength. I would recommend using 2 people to adjust the height if you are not very strong or have poor motor skills.