Sit to Stand Training in Stroke

PatientsAndre Ishmael

University of Central FloridaDoctor of Physical Therapy Class of 2014

Hemiparesis

• According to the National Stroke Association, Hemiparesis is the one sided weakness of the body.

• Different causes include stroke, cerebral palsy, brain tumors, multiple sclerosis, or traumatic brain injuries.

Affects of Hemiparesis on Stroke Survivors

• People with hemiparesis after a stroke generally may have problems moving the arm, leg, trunk and facial muscles.

• These weaknesses may decrease their ability to complete functional task or activities of daily living.

Sit to Stand Transfer• One of the most instrumental functional

task to increase independence with activities of daily living.

• Individuals with hemiparesis present with a weight bearing asymmetry when they rise from a chair spontaneously, placing more weight on the unaffected lower limb than on the affected on.

• A study looking at increased sit to stand practice in the hospital with stroke patients showed a decrease in asymmetry of weight bearing.

Sit to Stand Transfer

• http://youtu.be/n62y1OoG1JE• http://youtu.be/ZI1wtAyPz0k

Effects of foot position during sit-to-stand

• Study looking at symmetrical foot position (affected foot alongside unaffected side) vs. asymmetrical foot position (affect foot behind unaffected foot)

• Randomized control trial

• 40 participants• >40 years old• ≥21 mini mental

score• Excluded if with

unstable medical condition, severe aphasia

• Baseline measurements taken prior to intervention and posttest measurements taken at the end of week 4.• STS Performance• Berg Balance Scale (BBS)• Timed up-and-go test (TUG)

Training Program

• 20 day repetitive STS training with different foot positions• Group A – Affected foot positioned behind normal foot

(Asymmetrical foot position)• Group B – Affected foot positioned alongside normal foot

(Symmetrical foot position)

• Both groups received exercise program included stretching exercises, strengthening of the lower extremities and upper extremities , balance training, and gait training 20 days.

Results• Both groups with similar

baseline measurements• Both groups showed

improvement in each outcome measure

• Group A greater improvements in outcome measurements in every category.

Resources• Britton E, Harris N, Turton A. An exploratory randomized controlled trial of assisted

practice for improving sit-to-stand in stroke patients in the hospital setting. Clinical Rehabilitation [serial online]. May 2008;22(5):458-468. Available from: CINAHL Plus with Full Text, Ipswich, MA. Accessed February 1, 2014.

• Camargos A, Rodrigues-de-Paula-Goulart F, Teixeira-Salmela L. The effects of foot position on the performance of the sit-to-stand movement with chronic stroke subjects. Archives Of Physical Medicine & Rehabilitation [serial online]. February 2009;90(2):314-319. Available from: CINAHL Plus with Full Text, Ipswich, MA. Accessed February 1, 2014.

• Farqalit R, Shahnawaz A. Effect of foot position during sit-to-stand training on balance and upright mobility in patients with chronic stroke. Hong Kong Physiotherapy Journal [serial online]. December 2013;31(2):75-80. Available from: CINAHL Plus with Full Text, Ipswich, MA. Accessed February 1, 2014.

Thank You