A randomized trial evaluation of the Oswestry Standing Frame for patients after stroke

Abstract

Background: Standing is believed to have benefits in addressing motor and sensory impairments after stroke. One device to facilitate standing for severely disabled patients is the Oswestry Standing Frame. Objective: To evaluate the effectiveness of the Oswestry Standing Frame for severely disabled stroke patients. Design: A single centre, randomized controlled trial. Setting: An inpatient stroke rehabilitation unit. Subjects: Patients were recruited if they had a clinical diagnosis of stroke, were medically stable and unable to achieve any score on the Trunk Control Test or unable to stand in mid-line without the assistance of two therapists. Intervention: The intervention (n=71) and control (n=69) groups both received usual stroke unit care but the intervention group also received a minimum of 14 consecutive days' treatment using the standing frame. Main outcome measures: The primary outcome measure was the Rivermead Mobility Index (RMI). Secondary measures included the Barthel Index; the Rivermead Motor Assessment; the balanced sitting and sitting to standing components of the Motor Assessment Scale; the Trunk Control Test and the Hospital Anxiety and Depression Scale. Blind assessment was undertaken at baseline, six weeks, 12 weeks and six months post stroke. Information on resource use was also collected. Results: There was no statistically significant difference between groups in any of the outcome measures or for resource use. Mann-Whitney U-tests for the RMI change from baseline scores to six weeks, 12 weeks and six months post stroke were p=0.310; p=0.970 and p=0.282, respectively. Conclusion: Use of the Oswestry Standing Frame did not improve clinical outcome or provide resource savings for this severely disabled patient group.