A randomized controlled trial of the effects of intensive sit-to-stand training after recent traumatic brain injury on sit-to-stand performance

Objective: To examine the effectiveness of intensive practice of sit-to-stand on motor performance, exercise capacity and exercise efficiency in traumatic brain-injured patients during early inpatient rehabilitation. Design: Single-blind randomized controlled pilot study. Setting: Brain injury rehabilitation unit. Subjects: Twenty-four subjects who had recently sustained a severe traumatic brain injury (TBI) were randomized into an experimental (n = 13) and a control (n = 11) group. Interventions: In addition to their usual rehabilitation programme, subjects in the experimental group participated in four weeks of intensive training of sit-to-stand and step-up exercises with the aim of improving performance of sit-to-stand. The control group did no additional sit-to-stand or step-up training. Main outcome measures: Total number of sit-to-stands in 3 min as a measure of motor performance; peak oxygen consumption during a maximal 3-min sit-to-stand test (VO2peak) as a measure of exercise capacity; oxygen consumption during a 3-min equivalent workload sit-to-stand test (VO2equiv) as a measure of exercise efficiency. Pre- and post-training measurements were made. Results: The exercise programme resulted in a 62% improvement in motor performance (number of repetitions of sit-to-stand in 3 min) for the experimental group compared with the control group's 18% improvement (p < 0.05). There was no significant difference between groups for changes in exercise capacity or efficiency. In the experimental group, the increase in VO2peak from pre-test to post-test correlated with the increase in sit-to-stand repetitions (p < 0.05). Conclusions: Intensive task-specific training is recommended as an important component of rehabilitation early following severe traumatic brain injury.