Effect of information feedback on training standing up following stroke: a pilot feasibility study

Abstract

Background and objective: The ability to stand up is reduced following stroke. Traditional biofeedback is effective in improving the performance of lower limb activities. The aim of this study was to investigate the feasibility of and potential for information feedback from a simple inexpensive device to improve the ability to stand up from a chair in people following stroke.

Methods: A single-group study with pre–post measures design was used. Twenty people with hemiplegic stroke in inpatient rehabilitation received 10 sessions over 2 weeks of information feedback about foot placement during training of standing up. Progression involved increasing repetitions, increasing difficulty and fading feedback. Feasibility was determined by adherence, time taken, acceptability and safety. Clinical outcomes were the time taken to stand up, quality and foot position measured using the 5-Times-Sit-To-Stand-Test and carryover into daily activities measured by covert observation.

Results: The study was feasible with 97% of sessions completed, taking 19 (SD 6) to 25 (SD 10) minutes. Participants understood (4.6/5), found useful (4.6/5), challenging (4.4/5) and would recommend (4.7/5) the training. The time to stand up 5 times decreased by 24 (95% CI -48 to -1) s, and the quality of standing improved by 1.0/10.0 (95% CI 0.2 to 1.8). Carryover of the correct foot placement occurred to real life, with the beginning foot position correct 2.1/3.0 (95% CI 1.6 to 2.6) and end foot position correct 1.8/3.0 (95% CI 1.2 to 2.4) occasions.

Conclusions: The training is feasible and has the potential to improve the ability to stand up.

Keywords:

• Feedback
• Stroke
• Rehabilitation
• Standing up
• Physical therapy

Acknowledgements

The authors would like to thank the participants, assessors and staff who assisted in this study — specifically Robert Cargill, Jacqueline Taylor, Allyson Flynn, Christine O’Brien, Jasmin Jamieson, Megan Sullivan, Micarla Sexton and Laura-Jayne Van Alphen.

Conflict of Interest

The authors declare that there is no conflict of interest.

Ethical Considerations

This study was conducted in accordance with the Health Service Human Research Ethics Committee, ETHLR.12.239 approved on 17 October 2012.

Clinical Trial Registration

ANZCTR12613000620729