Cluster-Randomized, Crossover Trial of Head Positioning in Acute Stroke

Craig S Anderson1, Hisatomi Arima1, Pablo Lavados1

  • 1From the George Institute for Global Health (C.S.A., H.A., L.B., M.L.H., P.M.V., K.R., J.Y.L., M.W.) and Faculty of Medicine (C.S.A., L.B., M.L.H., L.S., K.R., J.Y.L., M.W.), University of New South Wales, the Neurology Department, Royal Prince Alfred Hospital, Sydney Health Partners (C.S.A.), the Nursing Research Institute, St. Vincent's Health (S.M.), and Australian Catholic University (S.M., C.W.) - all in Sydney; the George Institute China at Peking University Health Science Center (C.S.A., L.S.) and the Department of Neurology, Peking Union Medical College Hospital (B.P., L.C.) Beijing, and the Department of Neurology, 85 Hospital of People's Liberation Army, Shanghai (L.S.) - all in China; the Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan (H.A.); the Department of Neurology and Psychiatry, Clínica Alemana de Santiago (P.L., V.V.O., P.M.V., A.B.), Facultad de Medicina, Clínica Alemana Universidad del Desarrollo (P.L.), and Departamento de Ciencias Neurológicas, Facultad de Medicina, Universidad de Chile (P.L.) - all in Santiago, Chile; the College of Health and Wellbeing, University of Central Lancashire, Preston (M.L.H., D.F., C.E.L., C.W.), the George Institute for Global Health, University of Oxford (M.W.), the Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh (G.E.M.), and the Department of Cardiovascular Sciences and NIHR Biomedical Research Unit, University of Leicester, Leicester (T.R.) - all in the United Kingdom; the Department of Epidemiology, Johns Hopkins University, Baltimore (M.W.); the Stroke Service-Neurology Division, Department of Neuroscience and Behavior, Ribeirão Preto School of Medicine, University of São Paulo, São Paulo (O.P.-N.); the Clinical Trials Unit, Department of Pharmacology, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka (H.A.D.S.); the Department of Neurology, Christian Medical College, Ludhiana, India (J.D.P.); and the Department of Neurology, Kaohsiung Medical University and Hospital, Kaohsiung (R.-T.L.), and the Stroke Center and Department of Neurology, Linkou Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taoyuan (T.-H.L.) - both in Taiwan.

Summary

Lying flat after acute stroke did not improve patient outcomes compared to sitting up. This study found no significant differences in disability or mortality between the two head positioning methods for stroke patients.