Effects of modified sit-to-stand training on load asymmetry in patients with hip fracture: a pilot quasi-randomized controlled trial

Load asymmetry in the lower limbs of patients with hip fracture is associated with decreased gait ability, impaired balance, and increased risk of fall. The modified sit-to-stand (STS), which combines positioning the foot behind with chair seat elevation, facilitates loading on the affected limb. This study aimed to investigate lower limb load asymmetry during STS and walking in patients with hip fracture after modified STS training. This quasi-randomized pilot trial assigned patients with hip fractures to modified or normal STS (feet together) groups, matched by age and stratified (mean age, 81.9±5.5 years vs. 82.7±6.8 years). Twelve and ten participants in the modified and normal STS groups, respectively, were included in the analysis. The intervention lasted for 15 min/day for 2 weeks in both groups. The amount of load on the affected and unaffected limbs during STS and the amount of load and stance time during walking were measured before and after the intervention. Other physical functional outcomes included lower limb strength, balance, and gait speed. The amount of load on the affected limb, stance time of the affected limb, knee extension strength of the affected limb, and Berg Balance Scale score showed a group and time interaction, and were significantly greater in the modified STS group after than before the intervention. Modified STS training in patients with hip fracture improves the load on the affected limb during STS, stance time of the affected limb during walking, knee extensor strength in the affected limb, and balance function.