Does self-initiated sit-to-stand training with an assistive device regain the independence of sit-to-stand in stroke patient? A single-blinded randomized controlled trial

Abstract

BackgroundIt is unknown whether self-initiated sit-to-stand training with an assistive device is effective to regain the independence of sit-to-stand in stroke survivors.ObjectiveTo compare the effectiveness of self-initiated sit-to-stand training with an assistive device with manual sit-to-stand training.DesignParallel randomized controlled, assessor-blinded trial between January 2015 and May 2018. Randomization was performed by drawing lots to allocate treatment groups.SettingA rehabilitation hospital in Hong Kong.Participants69 participants in medical wards with unilateral hemiparetic stroke. A total of 52 participants fulfilled the study requirements.InterventionTen sessions of intervention with conventional physiotherapy program followed, by self-initiated sit-to-stand training with an assistive device, or by manual sit-to-stand training.Main outcome measureNumber of participants regained the independence of sit-to-stand, sit-to-stand test from the Balance master® and Five-repetition sit-to-stand test.Results69 participants (intervention, n = 36; control, n = 33) were randomized (mean age, 69.8 years (SD: 10.6), mean post-stroke days 18.6 (SD: 16.0)). Seventeen participants had not completed 10 sessions of training, leaving 52 (n = 26; n = 26) participants for per protocol analysis. Eighteen participants in the intervention group and 10 participants in the control group had regained the independence of sit-to-stand (Phi and Cramer’s V: –0.31 and 0.31). The participants in the intervention group were faster to complete the Five-repetition sit-to-stand test than the control group (32.7 sec (SD: 1.93) versus 48.4 sec (SD, 6.8); 95% confidence interval, –30.8 to –0.7; p < 0.05). No adverse side effects occurred during and after the training across groups.ConclusionsSelf-initiated sit-to-stand training with an assistive device may have positive effects on speeding up regaining the independence of sit-to-stand on sub-acute stroke survivors.