Sitting, standing and walking

Rehabilitation of movement addresses limitations of specific physical activities:

• Sitting balance difficulties are common after stroke, and sitting balance is a predictor of recovery. Sitting training interventions have included lateral weight transfer training, trunk exercises, body vibration, and practice of reaching beyond arm's length while sitting.
• Standing up from sitting (and then transfer to walking) is an important aspect of functioning after a stroke. Therapy generally includes practice standing up, along with other interventions (e.g. strength training). Practising standing up can be done to combine strength training for leg muscles along with functional practice. Other interventions such as biofeedback can be used to enhance training and improve standing up.
• Standing is an important determinant of performance of activities of daily living, which is a strong predictor of functional recovery and walking capacity and an important risk factor for falls. Often after stroke, people regain their ability to stand however not always to full capacity, and with ongoing deficits in postural sway, weight transference, and maintaining their balance when influenced by external forces. These limitations can then impact on a person's ability to reach their goals in other areas of their physical rehabilitation.
• Walking difficulty is common after stroke, with 56% of patients reported as unable to mobilise independently on admission to hospital. Systematic reviews tend to focus on specific interventions such as task-specific overground training, cueing of cadence, joint position feedback, electrical stimulation, virtual training, mental practice and use of an orthosis. Alternatively, reviews focus on ways to deliver the interventions, such as circuit class training, treadmill training, electromechanically assisted training, and community-based ambulation training.
   

This topic is also linked to Weakness, Cardiorespiratory fitness, Spasticity and Contracture.

For current research and evidence-based recommendations see our Clinical Guidelines.