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Training unsupported sitting does not improve ability to sit in people with recently acquired paraplegia: a randomised trial |
Harvey LA, Ristev D, Hossain MS, Hossain MA, Bowden JL, Boswell-Ruys CL, Hossain MM, Ben M |
Journal of Physiotherapy 2011;57(2):83-90 |
clinical trial |
8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
QUESTION: Do people with recently acquired paraplegia benefit from six-week motor retraining program aimed at improving their ability to sit unsupported? DESIGN: A randomised controlled trial with concealed allocation, assessor blinding, and intention-to-treat analysis. PARTICIPANTS: 32 people with recently acquired paraplegia and limited ability to sit unsupported. INTERVENTION: All participants undertook standard inpatient rehabilitation over a six-week period. Experimental participants received three additional 30-minute sessions per week of motor retraining directed at improving their ability to sit unsupported. OUTCOME MEASURES: the three primary outcomes were the Maximal Lean Test, Maximal Sideward Reach Test, and the Performance Item of the Canadian Occupational Performance measure (COPM). The secondary outcomes were the Satisfaction Item of the COPM, Participant's Impressions of Change, Clinicians' Impressions of Change, The T-shirt Test, and the Spinal Cord Injury Falls Concern Scale. RESULTS: The mean between-group differences for the Maximal Lean Test, Maximal Sideward Reach Test and the Performance Item of the COPM were -20 mm (95% CI -64 to 24), 5% arm length (95% CI -3 to 13) and 0.5 points (95% CI -0.5 to 1.5) respectively. The secondary outcomes did not differ significantly between groups. CONCLUSION: People with recently acquired paraplegia do not benefit from a six-week motor retraining program directly specifically at improving their ability to sit unsupported. Their ability to sit unsupported does, however, improve over time, suggesting that the practice of activities of daily living has important carry-over effects on unsupported sitting, rendering additional training redundant. TRIAL REGISTRATION: ACTRN12608000464369.
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