Abstract
Question
Does
intensive sit-to-stand training in addition to usual care improve
sit-to-stand ability in people who are unable to stand up independently
after stroke?
Design
A multi-centre randomised controlled trial with concealed allocation, assessor blinding and intention-to-treat analysis.
Participants
Thirty
patients from two Sydney hospitals, < 3 months after stroke, with a
mean Modified Rankin Scale score of 4 points (SD 0.5).
Intervention
All
participants received usual care. Participants in the experimental
group attended two additional sessions of physiotherapy per day for 2
weeks. These sessions were individualised to the needs of each
participant in order to increase the amount and intensity of
sit-to-stand training.
Outcome measures
Outcome
measures were taken at baseline and at 2 weeks. The primary outcome was
clinicians’ impressions of sit-to-stand change, measured using videos
and a 15-point Global Impressions of Change Scale. Secondary outcomes
were sit-to-stand ability, composite strength of key muscles of the
affected lower limb, gross lower limb extension strength, the Goal
Attainment Scale, and ranking of change in ability to move from sitting
to standing.
Results
All
participants completed the trial. The mean between-group difference for
clinicians’ impressions of sit-to-stand change was 1.57/15 points (95%
CI 0.02 to 3.11). The secondary outcomes that indicated a treatment
effect were gross lower limb extension strength and ranking of change in
ability to move from sitting to standing, with mean between-group
differences of 6.2 deg (95% CI 0.5 to 11.8) and −7 (95% CI −1 to −13),
respectively.
Conclusion
Two
weeks of intensive sit-to-stand training in addition to usual care
improves sit-to-stand ability in people who are unable to stand up
independently after stroke.
Trial registration
ANZCTR 12616001288415.
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