[논문]Standing Practice In Rehabilitation Early after Stroke (SPIRES): a functional standing frame programme (prolonged standing and repeated sit to stand) to improve function and quality of life and reduce neuromuscular impairment in people with severe sub-acute stroke—a protocol for a feasibility randomised controlled trial

Logan, Angie; Freeman, Jennifer; Kent, Bridie; Pooler, Jillian; Creanor, Siobhan; Vickery, Jane; Enki, Doyo; Barton, Andrew; Marsden, Jonathan

doi:10.1186/s40814-018-0254-z

Standing Practice In Rehabilitation Early after Stroke (SPIRES): a functional standing frame programme (prolonged standing and repeated sit to stand) to improve function and quality of life and reduce neuromuscular impairment in people with severe sub-acute stroke—a protocol for a feasibility randomised controlled trial 원문보기

Pilot and Feasibility Studies, v.4, 2018년, pp.66 -

Logan, Angie (Faculty of Health and Human Sciences, School of Health Professions, Peninsula Allied Health Centre, Plymouth University, Derriford Rd, Plymouth, PL6 8BH UK) , Freeman, Jennifer (Faculty of Health and Human Sciences, School of Health Professions, Peninsula Allied Health Centre, Plymouth University, Derriford Rd, Plymouth, PL6 8BH UK) , Kent, Bridie (School of Nursing and Midwifery, Plymouth University, Room 405, Rolle Building, Drake Circus, Plymouth, Devon PL4 8AA UK) , Pooler, Jillian (Peninsula Schools of Medicine and Dentistry, Rooms 14 & 15, ITTC Building Research Way, Plymouth, PL6 8BU UK) , Creanor, Siobhan (Peninsula Clinical Trials Unit (PenCTU), Plymouth University Peninsula Schools of Medicine and Dentistry, Room N16, Plymouth Science Park, Plymouth, PL6 8BX UK) , Vickery, Jane (Peninsula Clinical Trials Unit (PenCTU), Plymouth University Peninsula Schools of Medicine and Dentistry, Room N16, Plymouth Science Park, Plymouth, PL6 8BX UK) , Enki, Doyo (Medical Statistics, Peninsula Schools of Medicine and Dentistry, Room N15, Plymouth Science Park, Plymouth, PL6 8BX UK) , Barton, Andrew (Natio) , Marsden, Jonathan

Abstract ▼ AI-Helper

BackgroundThe most common physical deficit caused by a stroke is muscle weakness which limits a person’s mobility. Mobility encompasses activities necessary for daily functioning: getting in and out bed, on/off toilet, sitting, standing and walking. These activities are significantly affected in people with severe stroke who typically spend most of their time in bed or a chair and are immobile. Immobility is primarily caused by neurological damage but exacerbated by secondary changes in musculoskeletal and cardiorespiratory systems. These secondary changes can theoretically be prevented or minimised by early mobilisation, in this case standing up early post-stroke.Standing up early post-stroke has been identified as an important priority for people who have suffered a severe stroke. However, trials of prolonged passive standing have not demonstrated any functional improvements. Conversely, task-specific training such as repeated sit-to-stand has demonstrated positive functional benefits. This feasibility trial combines prolonged standing and task-specific strength training with the aim of determining whether this novel combination of physiotherapy interventions is feasible for people with severe stroke as well as the overall feasibility of delivering the trial.Methods/designThis is a pragmatic multi-centre parallel single-blinded two-armed feasibility randomised controlled trial. Fifty people with a diagnosis of severe stroke will be randomly allocated to either the functional standing frame programme or usual physiotherapy. All patient participants will be assessed at baseline and followed up at 3 weeks, then 3, 6 and 12 months post-randomisation. Trial objectives are to determine the feasibility according to the following indicators:: (i) Process: recruitment and retention rate, ability to consent, eligibility criteria, willingness/ability of physiotherapists to recruit, willingness of patients to be randomised, and acceptability of the intervention; (ii) Resource: burden and potential costs; (iii) Management: treatment fidelity, participant adherence, acceptability and completeness of outcome measures, impact and management or orthostatic hypotension; and (iv) Safety: number and nature of adverse and serious adverse events.DiscussionThe functional standing frame programme addresses a key concern for people who have suffered a severe stroke. However, several uncertainties exist which need to be understood prior to progressing to a full-scale trial, including acceptability and tolerance of the functional standing frame programme intervention and practicality of the trial procedures. This feasibility trial will provide important insights to resolve these uncertainties.Trial registrationInternational Standard Randomised Controlled Trial Number ISRCTN15412695. Registration on 19 December 2016.Electronic supplementary materialThe online version of this article (10.1186/s40814-018-0254-z) contains supplementary material, which is available to authorized users.

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