Automated movement feedback for recovering independence in the sit-to-stand movement in an older population: a pilot randomised controlled trial of a novel system

Background: The sit-to-stand (StS) movement is a frequently performed task critical to independent living that is both difficult to perform and associated with falls in older populations. Consequently, the recovery of this movement through supervised practice is a priority during the rehabilitation of older people. Technology may enable self-practice, potentially improving rehabilitation outcomes. The purpose of this study was to evaluate the clinical feasibility and effectiveness of an automated movement feedback system for recovering the StS movement in an older population.Methods: This was a phase two pilot randomised controlled trial. Participants were in-patients on a geriatric rehabilitation unit with an impaired StS ability. Following baseline outcome measurements, including quantifying the number of StS executions 48 hours pre- and post- trial, participants were block randomised to either a control group receiving standard rehabilitation or an experimental group receiving standard rehabilitation augmented with a novel automated movement feedback system for the StS training sessions. The intervention aimed to last four weeks with outcome measures repeated following completion.Results: Eighteen participants (81.25+/- 7.31 years) were evenly distributed between the two groups and interventions were completed without incident. The novel feedback group provided positive feedback on their experience, reporting the system to be motivating and instructive. Differences between the groups were statistically significant (p<0.05) for change in clinical measures (Tinetti and Elderly Mobility Score) with greater improvement in the technology-based feedback group. Daily StS movements increased in the experimental group (5.75±1.97 to 29.5± 6.22) but decreased in the control group (17.00 ± 4.86 to 11.88 ± 3.37) a difference that was statistically significant (p=0.02).Conclusions: This randomised controlled trial evaluated a novel automated movement feedback system for recovering independence in the StS movement in an older population. The positive findings demonstrate the system to be suitable for use in a clinical environment and provide preliminary evidence of improved outcome in terms of StS capacity when compared to standard therapy.