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 (email@example.com).
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.
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The authors declare no conflicts of interest.