Health Parameters in Standing and Nonstanding Nonambulatory Adults With Cerebral Palsy.
Kevin P Murphy, Laura Gueron, Catherine McMillin and 1 others
PMID 34179748WHAT IT FOUND
Bone density and health parameters showed no meaningful differences between 13 adults with cerebral palsy who stood and 5 who did not.
Only descriptive occurrences, such as stand pivot transfers, were noted in the standing group.
Key findings
01Bone density showed no appreciable differences between standers and nonstanders at any measured time, including baseline.
02No meaningful differences were identified for measured variables from baseline to any later point between standing and nonstanding groups.
03Functional head control for more than 30 seconds in the midline was documented only in the standing group, and no statistical testing was reported.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Only 20 adults were recruited and 18 were analysed, with 5 nonstanders analysed. The researchers did not report statistical tests because the sample was small. Follow-up was very limited: only 3 participants had DEXA scans from baseline to 24 months, and 2 nonstanders were excluded because transportation and staffing were difficult. Joint contractures often made it impossible to measure bone density at all planned sites or in all participants. Standing posture and standing table equipment varied between participants. Participants were embedded in a multidisciplinary care system with many concurrent services and treatments, so the contribution of standing alone cannot be separated. The groups were classified by existing standing status, not assigned by the study.
The easy way to misread this
Do not read the self-reported improvements or the occurrences of head control and stand pivot transfers as proof that standing works. The study had no statistical tests, only 3 participants had DEXA scans from baseline to 24 months, and no appreciable differences were found in bone density or other measured parameters.