Evaluation of a home-based exercise and training programme to improve sit-to-stand in patients with chronic stroke

Objective: To investigate the feasibility and efficacy of a task-specific homebased exercise protocol for improving sit-to-stand (STS), with additional exercises to strengthen lower limb extensor muscles in patients with chronic stroke. Design: A pre-test, post-test design was used. Subjects: Six subjects at least one year post stroke and discharged from all rehabilitation services for at least six months participated in the study. Outcome measures: Functional performance of sit-to-stand was evaluated using the Standing Up item of the Motor Assessment Scale (MAS). Peak vertical ground reaction force, walking speed over 10 m and grip strength were also measured. Results: Group MAS score was significantly higher at post-test than at pretest with two subjects reaching the highest point on the scale and three subjects reaching the second highest point. Time-to-peak vertical ground reaction force occurred significantly closer to thighs-off, the critical time when the body mass is propelled into standing. Walking speed increased significantly over 10 m from a mean of 0.86 m/s to 1.10 m/s. Grip strength, which was not trained, did not change. Conclusions: This study demonstrates that a home-based task-specific exercise and training protocol for STS can induce improved performance of STS and increase walking speed more than one year after stroke.