Systematic review and clinical recommendations for dosage of supported home-based standing programs for adults with stroke, spinal cord injury and other neurological conditions

BMC Musculoskeletal Disorders, 2015 · DOI: 10.1186/s12891-015-0813-x · Published: November 12, 2015

Assistive Technology Neurology Rehabilitation

Simple Explanation

This systematic review examines the effectiveness of home-based standing programs for adults with neurological conditions such as stroke and spinal cord injury. The review analyzes 36 studies published between 1980 and September 2015 to determine the impact of standing interventions on body structure, function, activity, and participation outcomes. The goal is to establish evidence-based dosage recommendations for home-based standing programs to improve various outcomes for adults with neurological conditions.

Study Duration

Not specified

Participants

36 studies addressing impact of a standing intervention on adults with sub-acute or chronic neurological conditions

Evidence Level

Systematic Review

Key Findings

1
Home-based supported standing programs have a stronger impact on range of motion and activity for individuals with stroke or spinal cord injury.
2
There is mixed evidence regarding the impact of standing programs on bone mineral density.
3
Standing for 30 minutes, 5 times a week, shows a positive impact on most outcomes, while 60 minutes daily is suggested for mental function and bone mineral density.

Research Summary

This systematic review evaluated the effectiveness of home-based supported standing programs for adults with neurological conditions, focusing on outcomes related to body structure and function, activity, and participation. The review found stronger evidence supporting the impact of these programs on range of motion and activity, particularly for stroke and spinal cord injury patients, while evidence for bone mineral density was mixed. Dosage recommendations suggest 30 minutes of standing 5 times a week for most outcomes, and 60 minutes daily for mental function and bone mineral density.

Practical Implications

Clinical Practice

Therapists can recommend supported standing interventions with confidence to impact ROM and activity outcomes for stroke and SCI patients.

Dosage Guidelines

Standing for 30 minutes, 5 times a week can positively impact self-care, balance, ROM, cardio-respiratory function, strength, spasticity, pain, skin, and bladder/bowel function. 60 min, 4-6 times a week may be required for positive impact on BMD and mental function.

Further Research

More high-quality research is needed for body structure and function outcomes such as BMD, cardio-respiratory function, pain, skin, and bowel/bladder function, especially for sub-acute stroke patients.

Study Limitations

1
The review was limited by the complexities of the electronic search and potential exclusion of studies published in other languages or grey literature.
2
Some included studies lacked detail about the intervention, making it challenging to compare results across studies.
3
The bulk of studies identified achieved low-quality ratings and included low numbers of participants, resulting in low strength of recommendation.

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