Page 227 - Hospital Authority Convention 2017

Service Enhancement Presentations

F7.5 Committed and Happy Staff 13:15 Room 421

Can Mechanical Device Replace Manual Handling in Re-learning the Sit-to-stand of Stroke Patient? A Single-
blinded Randomised Controlled Trial
Ng CM, Woo KH, Lo TM, Lau FO HOSPITAL AUTHORITY CONVENTION 2017
Physiotherapy Department, Tai Po Hospital, Hong Kong

Introduction
In Hong Kong, stroke is one of the commonest causes of hospital admissions with the largest number of bed days. It usually
affects the patient’s functional mobility especially sit-to-stand, which is the most important prerequisite for independent
living. In the past, lifting up the patient by physiotherapist is a common method to regain this ability, in which repetition is
key to success. In a growing demand of this population, there will be a higher chance of staff injury. Hence, a new regimen
focusing on the training by assistive device may be a better way to achieve the goal.

Objective
To investigate whether the 10-session of mechanical device is as effective as manual sit-to-stand training to improve the
independence of standing up.

Methodology
The study was an assessor-blinded, randomised controlled trial. All selected patients should be on first episode of stroke,
with good mental status and were unable to stand up independently. They were randomly assigned to control or intervention
group that training was provided by physiotherapist and mechanical device respectively. The mechanical device was
equipped with a weight stack and a pulley locking system to provide graduated support of standing up and sitting motion.
By using a counter-weight mechanism, only minimal manual guidance was needed. All subjects should wear safety harness
to prevent fall. Both groups of patients had no lesser than 100 repetitions or 10 minutes/day and five days/week of training
sessions. The outcome measures were Sit-to-Stand Test (SST) from the Balance Master® and the success of standing up,
which was defined as the patient could complete the SST from the Balance Master®, were assessed after 10 sessions.

Result and Conclusion
From January 2015 to March 2017, 38 stroke patients had completed the study (intervention: 18, control: 20; mean age
69.4 years). 12 out of 18 patients (66.7%) in intervention group and seven out of 20 patients (35.0%) in control group could
complete the SST (p=0.05). This test also reflected that the subjects in intervention group were capable of standing up in a
more efficient way, by faster forward weight shift and lesser muscle strength. The results confirmed that this new training
method is as effective as the traditional one to regain the independence in sit-to-stand of stroke patients. It may minimise
staff injury when encountering the challenging growing demand. Wednesday, 17 May

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