title: A pilot mixed methods investigation of the use of Oswestry standing frames in the homes of nine people with severe multiple sclerosis.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: MS Centre, Iceni Court , Norwich , UK and.
authors.forename: W A
authors.initials: WA
authors.lastname: Hendrie
authors.forename: M J
authors.initials: MJ
authors.lastname: Watson
authors.forename: M A
authors.initials: MA
authors.lastname: McArthur
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D002170:Canada; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D009103:Multiple Sclerosis / Q000534:rehabilitation*; D010865:Pilot Projects; D011187:Posture; D020127:Recovery of Function; D012648:Self Care; D012656:Self-Help Devices; D016896:Treatment Outcome
keywords: Activities of daily living; lived experience; motor function; single case studies; standing frame