Stand and deliver: using rota stands to aid stroke recovery

Louise Norman unpicks the pros and cons of using rota stands with people who have had a stroke.

Rarely does a piece of equipment cause so much consternation. Is it a turntable? Is it a rota stand? I have heard it called the ‘sturn’ (presumably a description of its function ‘standing turn’) and the ‘spinning wheel’ (patient suggestions are always the best). Call it what you will, the suitability of using it with patients following a stroke seems no less contentious. 
Anecdotal evidence can be confusing. I have worked alongside therapists who will not use a rota stand with patients with acute stroke in any circumstances whatsoever, through to those who advocate using any equipment necessary to assist the patient into a standing position. I suspect many stroke therapists are in the ‘middle’ of these two opinions, assessing each patient on an individual basis. After all, each patient is different from the patient before, but often the patient is different to how they were a short time ago – 24 hours can be a long time on a stroke unit. 
Therapists who baulk at the idea of using a rota stand in stroke care highlight the lack of ‘normal’ movement in the transfer. If we tell people to ‘push’ rather than ‘pull’ up to stand, why would we undermine this by encouraging pulling up on a rota stand? Further, hemiparetic limbs are vulnerable. The shoulder may be subluxed, or painful. Patients might overuse their ‘good’ side, which is ill-advised when a vulnerable central nervous system is trying to reorganise synaptically after injury. 
Therapists who use rota stands with patients who have had strokes cite the benefits of weight bearing, particularly through ‘active’ standing. Therapeutic handling can prevent joints adopting undesirable positions, supporting the upper limb throughout the transfer can maintain a satisfactory position of the shoulder. Then there is the psychological benefit to the patient. Some patients are so desperate to stand they will readily try any piece of equipment available – whether you have suggested it or not. Patient-centred care and patient choice is at the heart of everything we do – if a patient asks to try a rota stand, are we in a position to stop them? 
Louise Norman is a senior neurological physiotherapist at West Suffolk NHS Trust

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