Pilot randomized controlled trial to assess the impact of additional supported standing practice on functional ability post stroke

Objective: To investigate whether provision of additional standing practice increases motor recovery and mobility post stroke. Design: A pilot randomized controlled trial. Setting: A stroke rehabilitation unit in the UK. Participants: Seventeen participants, seven women and ten men, age range 51-92 admitted to the unit 6-58 days post stroke. Intervention: Each participant was randomly allocated into a control (conventional physiotherapy) or treatment (conventional therapy plus an additional session of standing practice) group. The period of intervention ranged from 14 to 28 days dependent upon length of stay on the unit. Outcome measures: The Gross Functional Too] Section of the Rivermead Motor Assessment, the Trunk Control Test and the Berg Balance Scale were used on admission to the study, at weekly intervals during the intervention, and at 12 weeks (after discharge). Results: Of the 17 participants recruited, three withdrew from the additional intervention group citing fatigue as a barrier and 15 completed the study. Participants completing additional standing practice demonstrated higher scores in all motor measures at week 12, but this difference was not statistically significant. There was a statistically significant difference (P<0.05) in the changes in Berg Balance score when comparing week 1 with week 12, in support of the group receiving extra standing practice. Conclusions: A larger study is required to establish the value of additional standing practice after stroke. This pilot demonstrates that the Gross Functional Tool Section of the Rivermead Motor Assessment and the Berg Balance Scale would be useful in such a study. Fatigue may be a significant barrier to ability to participate in more intensive programmes so screening participants for severe fatigue may be useful.