Meredith Newman1, Karen Barker. 1. Physiotherapy Research Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, Oxford, UK. meredith.newman@ouh.nhs.uk
Abstract
OBJECTIVES: To evaluate whether supported standing can affect lower limb muscle length, spasticity, bone mineral density or the function of adults with upper motor neurone disorders. DATA SOURCES: A search was conducted of MEDLINE, EMBASE, AMED, CINAHL and Cochrane library electronic databases; clinical trial registers via www.controlled-trials.com and complemented with citation tracking. REVIEW METHODS: Two reviewers independently evaluated eligibility and methodological quality. Class I and II studies of assisted standing for adults with stroke, multiple sclerosis, traumatic brain injury or spinal cord injury were eligible. A domain-based risk of bias approach was used to assess quality. RESULTS: Seventeen studies were included: 11 class I and 6 class II studies involving 540 participants, of whom 73% were non-ambulant. Quality was generally low, with only two high quality trials identified. High-quality evidence suggested tilt-table standing has a small effect on preventing loss of ankle dorsiflexion. One high-quality study found a low-dose standing programme did not alter bone loss early after spinal injury. Class II low-quality evidence suggested long-term, higher dose programmes may slow bone loss. Limited evidence for the effectiveness of standing on spasticity and function was inconclusive. CONCLUSION: Supported standing can prevent small losses of ankle mobility but the clinical importance of these effects is uncertain. Low-dose standing is unlikely to protect bone health.
OBJECTIVES: To evaluate whether supported standing can affect lower limb muscle length, spasticity, bone mineral density or the function of adults with upper motor neurone disorders. DATA SOURCES: A search was conducted of MEDLINE, EMBASE, AMED, CINAHL and Cochrane library electronic databases; clinical trial registers via www.controlled-trials.com and complemented with citation tracking. REVIEW METHODS: Two reviewers independently evaluated eligibility and methodological quality. Class I and II studies of assisted standing for adults with stroke, multiple sclerosis, traumatic brain injury or spinal cord injury were eligible. A domain-based risk of bias approach was used to assess quality. RESULTS: Seventeen studies were included: 11 class I and 6 class II studies involving 540 participants, of whom 73% were non-ambulant. Quality was generally low, with only two high quality trials identified. High-quality evidence suggested tilt-table standing has a small effect on preventing loss of ankle dorsiflexion. One high-quality study found a low-dose standing programme did not alter bone loss early after spinal injury. Class II low-quality evidence suggested long-term, higher dose programmes may slow bone loss. Limited evidence for the effectiveness of standing on spasticity and function was inconclusive. CONCLUSION: Supported standing can prevent small losses of ankle mobility but the clinical importance of these effects is uncertain. Low-dose standing is unlikely to protect bone health.
Authors: J A Freeman; W Hendrie; S Creanor; L Jarrett; A Barton; C Green; J Marsden; E Rogers; J Zajicek Journal: BMC Neurol Date: 2016-05-05 Impact factor: 2.474
Authors: Angie Logan; Jennifer Freeman; Bridie Kent; Jillian Pooler; Siobhan Creanor; Jane Vickery; Doyo Enki; Andrew Barton; Jonathan Marsden Journal: Pilot Feasibility Stud Date: 2018-03-23