Introduction

Recovering from stroke often requires relearning fundamental everyday movements such as standing up from a chair, sitting down safely, and transferring between surfaces. These tasks are essential for independence — sit-to-stand (STS), standing balance, and transfer training form the backbone of functional rehabilitation.

💺 Sit-to-Stand Training

Why it matters

Standing up from a chair is a complex, coordinated task that needs adequate muscle strength, postural control and symmetrical weight-bearing. After stroke, deficits in any of these components can make STS unsafe or impossible without assistance.

Goals of Sit-to-Stand Training

• Promote symmetrical weight-bearing between limbs
• Improve coordination and muscle control
• Encourage smooth, timely transitions without dominant arm push-off

Training Steps

🧍 Standing Balance & Posture Training

Early Standing — Modified Plantigrade

Modified plantigrade is a safe starting position: patient places hands on a high stable surface, keeps the affected arm straight and allows the affected leg to accept weight. This encourages out-of-synergy patterns and functional alignment.

Progression

• Hold static standing for stability
• Weight-shift: side-to-side, forward–backward, diagonally
• Add reaching tasks to challenge balance
• Reduce hand support progressively: both hands → one hand → no hands

🔁 Transfer Training

Training transfers prepares patients to move safely between surfaces (bed ↔ wheelchair ↔ toilet ↔ car). Emphasize safety, technique, independence, and practice across multiple surfaces.

Early Stage

• Provide maximum assistance initially and adjust seat heights to reduce effort
• Avoid habitual transfers to the strong side only — train weaker side to reduce long-term dependency

Therapist Techniques

• Support affected arm in prayer position or with therapist hands
• Stabilize weak knee with therapist’s knee to prevent buckling
• Provide manual guidance at trunk/pelvis for safe movement

Practice Surfaces

• Wheelchair
• Bed
• Toilet / tub seat
• Car seat

🧘 Advanced Functional Training

When basic transfers and standing are safe, progress to more challenging postures and functional tasks:

• Quadruped (hands and knees)
• Side-sitting
• Kneeling / half-kneeling
• Prone on elbows (if safe re: shoulder integrity)

Practice getting down to and up from the floor — a key safety skill after a fall.

🌟 Key Takeaways

Final Words

Stroke rehabilitation is rebuilding independence one movement at a time. Each successful sit-to-stand or transfer raises confidence and functional ability. With consistent practice, clear cues, and progressively challenging tasks, patients can regain meaningful independence in daily life.