Interventions for improving sit‐to‐stand ability following stroke

Background Standing up from a seated position is one of the most frequently performed functional tasks, is an essential pre‐requisite to walking and is important for independent living and preventing falls. Following stroke, patients can experience a number of problems relating to the ability to sit‐to‐stand independently. Objectives To review the evidence of effectiveness of interventions aimed at improving sit‐to‐stand ability after stroke. The primary objectives were to determine (1) the effect of interventions that alter the starting posture (including chair height, foot position, hand rests) on ability to sit‐to‐stand independently; and (2) the effect of rehabilitation interventions (such as repetitive practice and exercise programmes) on ability to sit‐to‐stand independently. The secondary objectives were to determine the effects of interventions aimed at improving ability to sit‐to‐stand on: (1) time taken to sit‐to‐stand; (2) symmetry of weight distribution during sit‐to‐stand; (3) peak vertical ground reaction forces during sit‐to‐stand; (4) lateral movement of centre of pressure during sit‐to‐stand; and (5) incidence of falls. Search methods We searched the Cochrane Stroke Group Trials Register (June 2013), CENTRAL (2013, Issue 5), MEDLINE (1950 to June 2013), EMBASE (1980 to June 2013), CINAHL (1982 to June 2013), AMED (1985 to June 2013) and six additional databases. We also searched reference lists and trials registers and contacted experts. Selection criteria Randomised trials in adults after stroke where: the intervention aimed to affect the ability to sit‐to‐stand by altering the posture of the patient, or the design of the chair; stated that the aim of the intervention was to improve the ability to sit‐to‐stand; or the intervention involved exercises that included repeated practice of the movement of sit‐to‐stand (task‐specific practice of rising to stand). The primary outcome of interest was the ability to sit‐to‐stand independently. Secondary outcomes included time taken to sit‐to‐stand, measures of lateral symmetry during sit‐to‐stand, incidence of falls and general functional ability scores. Data collection and analysis Two review authors independently screened s, extracted data and appraised trials. We undertook an assessment of methodological quality for random sequence generation, allocation concealment, blinding of outcome assessors and method of dealing with missing data. Main results Thirteen studies (603 participants) met the in