Sit to Stand Training in Stroke Patients

1. Sit to Stand Training in Stroke Patients Andre Ishmael University of Central Florida Doctor of Physical Therapy Class of 2014

2. 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.

3. 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.

4. 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.

5. Sit to Stand Transfer • http://youtu.be/n62y1OoG1JE • http://youtu.be/ZI1wtAyPz0k

6. 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)

7. Randomized control trial • 40 participants • >40 years old • ≥21 mini mental score • Excluded if with unstable medical condition, severe aphasia

8. 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)

9. 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.

10. 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.

11. 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.

12. Thank You