Introduction: As an essential pre-requisite to walking and independent living is the skill of Sit-to-Stand (STS). Following stroke, patients often adopt asymmetrical compensatory strategies to perform STS. Physiotherapists use a variety of techniques to teach patients to relearn symmetry in STS. We compared the effects of two common techniques, verbal facilitation and manual facilitation, on changes in STS symmetry among people with  stroke. 
 
Methods: A randomized outcome-blinded intervention trial was conducted in a subacute stroke rehabilitation unit with ten participants (< 3 months post stroke). Participants and  therapists were randomly assigned to either a manual facilitation or a verbal facilitation group, receiving 40 repetitions each day for ten days. Symmetry measures were collected using an instrumented Protokinetic, (Havertown, PA) along with lower limb mobility, balance and gait. 

Results:  There was no effect of either training method on STS symmetry however standing symmetry significantly improved pre/post in both groups but with no significant differences between groups (manual 21.76%, (17.53) to 8.66%, (18.71) and verbal group 21.96% (10.22) to 8.98% (14.08), TIME (F(1,8) 11.49), p=0.012, σ=0.83), TIME X Group (F(1,8) 0.00), p=0.99, σ= 0.05). Balance and lower limb mobility also significantly improved.

Conclusion: Both verbal and manual cueing led to improved standing symmetry however the movement of STS remained asymmetrical. Since balance and lower limb mobility improved, it is likely that despite cueing interventions, patients used compensatory strategies in order to improve function. Cueing methods used by physiotherapists are effective in facilitating functional recovery post stroke, but which method is the most effective still remains unknown.

COMPARING METHODS TO FACILITATE SIT TO STAND POST-STROKE