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Orthostatic tolerance training of stroke patients in general medical wards: an experimental study
Asberg KH
Scandinavian Journal of Rehabilitation Medicine 1989;21(4):179-185
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

In order to initiate early activation and counteract the negative effects of bed rest, 71 patients acutely admitted to hospital with a confirmed stroke were randomized to either training or control wards. Sixty-three persons participated in a first orthostatic tolerance test on days 5 to 7 after admission, which was replicated on days 10 to 12. A third test was performed three months later. Regular stand-ups were initiated on days 1 to 2 after admission to hospital and were continued for 1 to 2 weeks. The trained group had a lower increase in heart rate during tilting and a lower proportion of severely disabled patients on days 5 to 7 compared with the control group. This difference was statistically significant but cannot be proved to be a result from the regular stand-ups. Still, this minimum type of early activation can be recommended for acute stroke patients, mainly those with a cerebral infarction, who are able to cooperate with the nursing staff.

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