The effect of supported standing in adults with upper motor neurone disorders: a systematic review

Clin Rehabil. 2012 Dec;26(12):1059-77. doi: 10.1177/0269215512443373. Epub 2012 May 29.

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.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Activities of Daily Living
  • Adult
  • Bone Density
  • Humans
  • Leg / physiopathology*
  • Motor Neuron Disease / rehabilitation*
  • Muscular Atrophy / prevention & control*
  • Osteoporosis / prevention & control*
  • Range of Motion, Articular
  • Self-Help Devices*