Balance outcomes after additional sit-to-stand training in subjects with stroke: a randomized controlled trial

Abstract

Objective: To determine the effectiveness of sit-to-stand training in individuals with stroke. Design: Randomized controlled trial. Setting: Rehabilitation medical centre. Participants: Thirty-two subjects with stroke were randomly assigned to the control and experimental groups (n = 16 for each group). Interventions: Subjects in both groups received 30 minutes of general physical therapy three times a week for four weeks. Subjects in the experimental group received additional sit-to-stand training for 15 minutes each time. The total amount of therapy received was 45 minutes in the experimental group and 30 minutes in the control group each time. Main outcome measures: The weight-bearing distribution during quiet standing, the directional control and maximal excursion during limits of stability test, the scores of Berg Balance Scale and the extensor muscle strength of lower extremity were assessed before and after completing the 12 treatment sessions. Results: Our data showed significant improvements in directional control anteriorly in the experimental group (from 47.4 (36.6)% to 62.6 (26.1)%) compared with the control group (from 68.7 (16.7)% to 62.8 (29.7)%) (P = 0.028). A significant improvement in affected hip extensor strength was noted in the experimental group (from 19.3 (9.8)% to 22.6 (8.4)%) compared with the control group (from 24.4 (9.0)% to 22.8 (7.2)%) (P = 0.006). Significant improvements were noted only in the experimental group after treatment, including bilateral extensors, except the affected plantar flexors, the weight distribution in standing, the maximal excursion (Panterior = 0.049; Paffected = 0.023) and the directional control (Paffected = 0.013; Pnon-affected = 0.025). Conclusions: Additional sit-to-stand training is encouraged due to effects on dynamic balance and extensor muscles strength in subjects with stroke.