Hendrie W A, Watson M J, McArthur M A
MS Centre, Iceni Court , Norwich , UK and.
Disabil Rehabil. 2015;37(13):1178-85. doi: 10.3109/09638288.2014.957790. Epub 2014 Sep 10.
People with multiple sclerosis (MS) commonly experience muscle weakness which limits their ability to stand. Supported standing may minimise the secondary complications of prolonged sitting but evidence for this is scarce. This study investigated the effects of regular standing in an Oswestry frame on some secondary complications of immobility and explored the lived experience of standing.
Nine people with MS participated in a mixed-methods study over 48 weeks. Single-case experiments were used. Outcomes included: Amended Motor Club Assessment, Canadian Occupational Performance Measure, Penn Spasm Scale, bowel frequency and a numerical pain-scale. The qualitative strand used a case-study approach with a phenomenological perspective.
Significant improvements (p < 0.05) were demonstrated for individuals in strength, ADL and spasms but not in bowel frequency or pain. Subjective improvements occurred in continence, clonus and fall-rate. Being upright or strengthened by standing enabled participants to re-engage with activities and re-establish themselves within relationship roles. This engendered a sense of achievement and increased optimism.
This study provides preliminary evidence of the effectiveness of regular frame-standing in improving strength, function, spasms, continence and fall-rate in people with severe MS. Standing reinstated a sense of belonging and optimism by restoring important life-roles and feelings of normality as participants regained previously valued activities. Implications for Rehabilitation Regular standing in an Oswestry frame may improve functional ability in people with severe MS. Regular frame standing may have a positive psychological effect on people with severe MS. Self-management of a standing regime may be feasible.
多发性硬化症（MS）患者常出现肌肉无力，这限制了他们站立的能力。支撑站立可能会将长时间坐着的继发并发症降至最低，但这方面的证据很少。本研究调查了在奥斯韦斯特里框架中定期站立对一些不动继发并发症的影响，并探讨了站立的实际体验。
9名MS患者参与了一项为期48周的混合方法研究。采用单病例实验。结果包括：改良运动俱乐部评估、加拿大职业表现测量、宾夕法尼亚痉挛量表、排便频率和数字疼痛量表。定性部分采用具有现象学视角的案例研究方法。
个体在力量、日常生活活动能力（ADL）和痉挛方面有显著改善（p<0.05），但在排便频率或疼痛方面没有改善。在尿失禁、阵挛和跌倒率方面有主观改善。站立使身体挺直或增强力量，使参与者能够重新参与活动，并在人际关系角色中重新确立自己的位置。这带来了成就感并增强了乐观情绪。
本研究提供了初步证据，表明在严重MS患者中定期在框架中站立对改善力量、功能、痉挛、尿失禁和跌倒率有效。站立通过恢复重要的生活角色和正常感，重新建立了归属感和乐观情绪，因为参与者重新获得了以前重视的活动。康复意义在奥斯韦斯特里框架中定期站立可能会改善严重MS患者的功能能力。定期在框架中站立可能会对严重MS患者产生积极的心理影响。站立方案的自我管理可能是可行的。
