S-Press leg strengthening device in community inpatient wards: patient suitability, sit-to-stand ability, and patient-rated comfort outcomes

BackgroundLeg muscle deconditioning due to hospitalisation results in loss of muscle strength, physical immobility, and decreased ability to carry out activities of daily living. This causes delayed discharges, more nursing, carer, or social service support following discharge, possible discharge to care home rather than the patients own home, and increased risk of readmissions. Leg muscle deconditioning is associated with increased mortality, infections, and depression. Enhancing leg muscle strength should form part of in-patients rehabilitation plans. Progressive resistance training (PRE) offers a cost-effective way of preserving and improving muscle strength and function; however, it is not typically carried out in hospital. ObjectiveTo examine patient suitability, sit-to-stand ability, and patient-rated comfort outcomes of a leg strength training device (S-Press) in five community inpatient wards in Englands National Health Service (NHS). MethodsDesign: an open-label patient cohort design with no control group. Collection of the following data: reason for admission, number of times S-Press was used, number of repetitions, set up position used in, resistance levels used, increase in resistance level over use, time for five-times sit-to-stand, and patient reported comfort rating. Measures of sit-to-stand were conducted before use of S-Press and before discharge. ResultsAn extensive range of admission reasons were recorded for 45 patients who used S-Press, indicating widespread suitability. Forty patients had information on set up position used in: 25 (62.5%) in chair, 13 (32.5%) on bed, and 2 (5%) in wheelchair. Out of 28 people who used S-Press more than once, the average number of S-Press sessions was 5.2, with 57% increasing resistance level and number of repetitions. Five-times sit-to-stand data collected for 16 participants showed all had a reduced length of time taken to sit-to-stand. There was an average reduction in five-times sit-to-stand of 17.4 seconds. Thirty-seven patients rated comfort out of 10, the most frequent rating was 10 out of 10 (15 out of the 37); average rating was 8.73. ConclusionThe S-Press is beneficial for patients rehabilitation by offering PRE that is simple and easy to use and can be integrated as part of their rehabilitation plans. Patients with a wide variety of reasons for admission can use S-Press to strengthen their legs, either in a chair, wheelchair or bed as required. The majority of patients increased resistance and repetitions that they could do, indicating increased leg strength. Most patients find S-Press to be very comfortable to use. Five-times sit-to-stand improvements were seen for all those measured; speeding up this essential functional process is linked to increased mobility and ability to carry out activities of daily living. S-Press could be introduced to the most hospital wards.