Heel-Elevation Effects on Sit-to-Stand Movement in Patients with Parkinson's Disease—A Randomized Crossover Study

ObjectiveTo examine the effect of heel elevation using a tilting plate on sit-to-stand performance in Parkinson's disease (PD) patients, evaluate the influence of different tilt angles, and identify clinical factors associated with this effect.MethodsThirty-six PD patients participated in a randomized crossover trial. Half started in a flat position, and half in a heel-elevated position, using three tilting angles. The time to complete five times sit-to-stand tests (FTSST) was measured under flat and heel-elevated conditions.ResultsThe fastest FTSST in the heel-elevated condition was reduced by a median decrease of 2.3 s and a median reduction of 14.0% when compared to the flat condition. Neither tilt angle nor ankle dorsiflexion range of motion was not associated with the reduction in FTSST duration. Multivariable regression analyses revealed that the time of FTSST under the flat condition and the standing subscale in the Unified Parkinson's Disease Rating Scale Part III exhibited significant positive associations with the observed shortening effects of FTSST induced by heel elevation.ConclusionsThe use of a heel-elevation intervention reduces the duration of transitioning from a seated to a standing position among patients with PD, particularly among those with a more pronounced disability. (UMIN000048428, https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000055160).