An exploratory randomized controlled trial of assisted practice for improving sit-to-stand in stroke patients in the hospital setting

Abstract

Objectives: To evaluate the amount of practice achieved and assess potential for effects on performance of 30 minutes of daily training in sit-to-stand. Design: Randomized controlled pilot study. Setting: Stroke rehabilitation unit, UK. Participants: Eighteen stroke patients needing `stand by' help to sit-to-stand. Interventions: In addition to usual rehabilitation the experimental group (n = 9) practised sit-to-stand and leg strengthening exercises for 30 minutes, on weekdays for two weeks, with a physiotherapy assistant. The control group received arm therapy. Main outcome measures: Frequency of sit-to-stands per day. Performance measures: rise time, weight taken through the affected foot at `thighs off', number of attempts needed to achieve three successful sit-to-stands and the number of sit-to-stands performed in 60 seconds. Outcome was measured one and two weeks after baseline assessment. Results: Sit-to-stand frequency averaged 18 per day. Thirty minutes of practice in sit-to-stand resulted in a mean of 50 (SD 17.2) extra stands per day. There was a significant mean difference of 10% body weight taken through the affected foot after one week of intervention: The control group had reduced weight through the affected leg while the training group increased weight (F1,16 = 11.1, P= 0.004, 95% confidence interval (CI) -16.61 to -3.72). No significant differences between groups were found on other measures. Results two weeks after baseline were inconclusive due to loss of five participants. Conclusions: Task-specific practice given for 30 minutes a day appears promising for patients learning to sit-to-stand.