The online version of this article (doi:10.1186/s12891-015-0813-x) contains supplementary material, which is available to authorized users.
Author 1 has worked as an educational consultant for various manufacturers and suppliers of standing devices. Funding from these sources did not influence or bias the content of this work.
Author 2 declares no conflict of interest.
GP conceived the study, but both authors designed and carried out the review, wrote and refined the article for publication. Both authors read and approved the final manuscript.
Sitting for more than 8 h a day has been shown to negatively impact health and mortality while standing is the recommended healthier alternative. Home-based standing programs are commonly recommended for adults who cannot stand and/or walk independently. The aim of this systematic review is to review effectiveness of home-based standing programs for adults with neurological conditions including stroke and spinal cord injury; and to provide dosage guidelines to address body structure and function, activity and participation outcomes.
Eight electronic databases were searched, including Cochrane Library databases, MEDLINE, CINAHL and EMBASE. From 376 articles, 36 studies addressing impact of a standing intervention on adults with sub-acute or chronic neurological conditions and published between 1980 and September 2015 were included. Two reviewers independently screened titles, reviewed abstracts, evaluated full-text articles and rated quality and strength of evidence. Evidence level was rated using Oxford Centre for Evidence Based Medicine Levels and quality evaluated using a domain-based risk-of-bias rating. Outcomes were divided according to ICF components, diagnoses and dosage amounts from individual studies. GRADE and the Evidence-Alert Traffic-Lighting system were used to determine strength of recommendation and adjusted in accordance with risk-of-bias rating.
Stronger evidence supports the impact of home-based supported standing programs on range of motion and activity, primarily for individuals with stroke or spinal cord injury while mixed evidence supports impact on bone mineral density. Evidence for other outcomes and populations is weak or very weak.
Standing should occur 30 min 5 times a week for a positive impact on most outcomes while 60 min daily is suggested for mental function and bone mineral density.
Additional file 1: Search strategy. (DOCX 90 kb)12891_2015_813_MOESM1_ESM.docx
Additional file 2: Domain based risk of bias for included primary studies. (DOCX 134 kb)12891_2015_813_MOESM2_ESM.docx
Additional file 3: Details of excluded studies with reasons. (DOCX 88 kb)12891_2015_813_MOESM3_ESM.docx
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- Systematic review and clinical recommendations for dosage of supported home-based standing programs for adults with stroke, spinal cord injury and other neurological conditions
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