Article

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.

Langue : ANGLAIS