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Tolerance of a Standing Tilt Table Protocol by Patients an Inpatient Stroke Unit Setting: A Pilot Study

Baltz, Mathew J. PT, DPT; Lietz, Hendrika L. PT, DPT, NCS; Sausser, Ida Trott PT, DPT; Kalpakjian, Claire PhD; Brown, Devin MD

Journal of Neurologic Physical Therapy: March 2013 - Volume 37 - Issue 1 - p 9–13
doi: 10.1097/NPT.0b013e318282a1f0
Research Articles
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Background and Purpose: To describe and examine physiologic and self-reported indices of tolerance to a standing tilt table protocol (STTP) among patients following an acute stroke.

Methods: We undertook a prospective, observational pilot study of patients admitted to a stroke unit of a single academic medical center. A clinical protocol for the use of the tilt table was developed and applied to subjects in the acute phase following a stroke. The protocol involved a stepwise process to gradually raise the subject into a standing position on the tilt table platform, at 10° intervals from 60° to 90°. Tolerance of the STTP was operationally defined as the ability to sustain 60° or greater of tilt table inclination for a minimum of 5 minutes, without signs or symptoms of intolerance. Specific measures recorded were frequencies of the highest angle achieved, the duration of standing time tolerated, and physiologic response.

Results: Thirty-six patients with ischemic or hemorrhagic stroke (22 women and 14 men) aged 24 to 87 (mean age = 62, SD = 16) years participated in a single trial of the STTP. Fifty-three percent of subjects (N = 19) attained 60° or higher on the tilt table, with a mean total standing time of approximately 9 minutes.

Discussion and Conclusions: This pilot study suggests that the use of a tilt table is well tolerated among patients in the acute stroke phase and may be an effective tool for introducing early upright mobilization to a medically fragile patient population.

Video Abstract available (see Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A35) for more insights from the authors.

University of Michigan Health System, Ann Arbor.

Correspondence: Mathew J. Baltz, PT, DPT, University of Michigan Health System, 1500 E Medical Center Dr, Ann Arbor, MI 48109 (mathewj@med.umich.edu).

This study was funded by a grant from the University of Michigan Practice-Oriented Research Training (PORT) Program and the Department of Physical Medicine and Rehabilitation. The PORT Program is supported by a grant from the National Institutes of Health Clinical and Translations Sciences Award (UL1RR024986).

A poster presentation of this work was presented at the James Rae Scientific Day for residents of Physical Medicine and Rehabilitation at the University of Michigan Hospital in May 2011.

A poster presentation of this work has been accepted to the APTA Combined Sections Symposium scheduled for February 2012. A poster presentation has been accepted by the American Heart Association International Stroke Conference 2012.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jnpt.org).

The authors declare no conflicts of interest.

© 2013 Neurology Section, APTA