Tolerance of a standing tilt table protocol by patients an inpatient stroke unit setting: a pilot study

To describe and examine physiologic and self-reported indices of tolerance to a standing tilt table protocol (STTP) among patients following an acute stroke.

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.

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.

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.