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Updated: Oct 1, 2025
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Author Spotlight: Enhancing Upper Limb Rehabilitation in Stroke Patients Through Advanced Robotic and Neuromodulation Technologies
Published on: October 11, 2024
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Functional standing frame programme early after severe sub-acute stroke (SPIRES): a randomised controlled feasibility
Angela Logan1,2, Jennifer Freeman3, Bridie Kent3
1Faculty of Health, School of Health Professions, University of Plymouth, Plymouth, UK. angie.logan@nhs.net.
Pilot and Feasibility Studies
|March 4, 2022
Summary
This feasibility study found that while a functional standing frame program showed promise for severe stroke patients, low adherence necessitates design improvements before a definitive randomized controlled trial (RCT). Further research is needed to optimize early mobilization strategies.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Clinical Trials
Background:
- Early mobilization (>24h post-stroke) is recommended, but evidence for severe stroke is limited.
- Prolonged standing and sit-to-stand training have been studied separately, not combined in severe sub-acute stroke.
- A functional standing frame program combines prolonged standing and sit-to-stand repetitions.
Purpose of the Study:
- To determine the feasibility of a randomized controlled trial (RCT) comparing a functional standing frame program with usual physiotherapy for severe sub-acute stroke.
- To assess feasibility indicators including process, resource, management, and safety.
- To evaluate adherence, fidelity, and acceptability of the trial and intervention.
Main Methods:
- Assessor-blinded feasibility RCT with a nested qualitative component (interviews, focus group) and process evaluation.
- Participants (≥18 years, mRS 4/5) randomized to: (1) functional standing frame (30 min standing + sit-to-stand) + 15 min usual physiotherapy, or (2) 45 min usual physiotherapy daily for 3 weeks.
- Feasibility assessed via adherence, fidelity, acceptability, safety, and patient outcomes (motor, activities, quality of life) at multiple time points.
Main Results:
- 45 participants randomized (22 to intervention); 60% followed up fully.
- 12 participants (27%) died during the trial, unrelated to the trial.
- Adherence was low: no participants completed all 21 sessions; 39% (intervention) and 51% (control) sessions completed.
Conclusions:
- Most progression criteria for the feasibility trial were met.
- Adherence to the interventions was unacceptably low and requires addressing before a definitive RCT.
- Solutions have been identified to improve adherence for future trials of this standing frame intervention.
