Page 227 - Hospital Authority Convention 2017
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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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