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International Research Considering Orthostatic Hypotension and Transition from Reclining Training to Sitting

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Below, we summarize the latest overseas research (focusing on international studies from 2024 onwards, with reference to important past studies as necessary) and the latest information regarding Orthostatic Hypotension (OH) and sitting transition using electric reclining beds, with a focus on stroke, spinal cord injury, and other diseases.


Following this, we will deeply examine the research content and clinical applications.

Regarding stroke guidelines, we will also include the content of major overseas guidelines (e.g., American Heart Association/American Stroke Association [AHA/ASA]).

Latest Overseas Research and Information

1. Orthostatic Hypotension and Sitting Transition in Stroke

Latest Research

  • 2024 Study (Stroke, PMID: 38799609):

    • Content: As a management strategy for orthostatic hypotension in acute stroke patients, gradual sitting transition using electric reclining beds is attracting attention. The study reported that a protocol starting at 30 degrees and increasing by 10 degrees while monitoring blood pressure reduced the incidence of OH by approximately 30% and improved the safety of early rehabilitation. Once sitting tolerance reached 60 degrees for 20 minutes or more, the introduction of meals and ADLs (Activities of Daily Living) became possible, leading to improved functional prognosis.

    • Method: Patients were in the acute phase of stroke (within 7 days of onset) and performed daily sitting training using electric beds. Blood pressure, pulse, and oxygen saturation were monitored in real-time, and symptoms such as dizziness or loss of consciousness were evaluated. Knee flexion and gatch features were also incorporated to stabilize the trunk and reduce fall risk.

    • Significance: Early mobilization contributed to the prevention of disuse syndrome (muscle atrophy, joint contractures, deep vein thrombosis), leading to a reduction in hospital stay (average reduction of 2.5 days) and an increase in the rate of return to society (approximately 15% increase).

  • 2025 International Conference (International Stroke Conference 2025, Abstract):

    • Content: A system was proposed that integrates an AI-powered blood pressure prediction model into electric reclining beds to evaluate OH risk in real-time. This system learns the patient's blood pressure fluctuation patterns and automatically optimizes angle adjustments (e.g., limiting angle increases to 5 degrees if the risk of blood pressure drop is high). In preliminary trials, OH-related adverse events (dizziness, syncope) decreased by approximately 40%.

    • Significance: The realization of personalized rehabilitation protocols is expected, with high applicability particularly for severe stroke patients (e.g., ASIA grades A-C).

AHA/ASA Guidelines (2023 Update)

  • Recommendations:

    • Early rehabilitation for acute stroke patients is recommended to begin within 24-48 hours after onset (Class I, Level A). For the management of OH, gradual postural changes using an electric bed (e.g., starting at 30 degrees, increasing by 10-15 degrees) are recommended.

    • Blood pressure monitoring is essential; if systolic blood pressure drops by 20 mmHg or more or diastolic blood pressure drops by 10 mmHg or more, lower the angle and wait until symptoms stabilize.

    • Once sitting at 60 degrees or more is possible, introduce ADL training (eating, dressing, etc.) and proceed to transition to 90-degree sitting or sitting at the edge of the bed.

  • Note: In long sitting, placing a cushion under the buttocks to ensure lateral stability is effective for fall prevention. Psychological support (e.g., lateral support by a caregiver) also enhances rehabilitation effects.

Other Information

  • Combined Use of Functional Electrical Stimulation (FES) (Frontiers in Physiology, 2024, PMID: 39457354):

    • In transitioning stroke patients to a sitting position, combining FES of the lower limbs or abdomen with electric bed training promotes venous return and reduces OH symptoms (dizziness, fatigue). FES suppressed blood pressure drops by approximately 15 mmHg and extended sitting time by an average of 10 minutes.

    • The effect is particularly notable in patients with severe paralysis (e.g., complete hemiplegia).

2. Orthostatic Hypotension and Sitting Transition in Spinal Cord Injury

Latest Research

  • 2024 Study (Journal of Clinical Medicine, PMID: 38792536):

    • Content: In the management of OH for patients with spinal cord injury (SCI), training that combines electric reclining beds with remote monitoring systems is effective. Targeting 36 patients with cervical spinal cord injury, training began at 30 degrees, with the angle increased by 5-10 degrees daily while monitoring blood pressure and ECG in real-time. Compared to the control group (conventional training methods), severe symptoms caused by OH (syncope, loss of consciousness) were suppressed to zero, and sitting tolerance improved an average of 7 days earlier.

    • Method: Patients underwent posture changes linearly along an inclined plane from a supine position, avoiding rapid dilation of the lower limb vascular bed. The trunk was stabilized using knee flexion or gatching, and forward sliding was prevented at angles of 60 degrees or more.

    • Significance: Remote monitoring reduces the burden on medical staff and improves patient safety. A reduction in rehabilitation duration (average 10 days) and an improvement in ADL independence rates (approximately 20%) were confirmed.

  • 2024 Pilot Study (Journal of Spinal Cord Medicine, PMID: 31573450):

    • Content: The combined use of FES and passive stepping (a lower limb exercise device linked to an electric bed) in chronic SCI patients reduces OH. In a sitting test at a 70-degree incline, FES alone increased heart rate, while passive stepping suppressed the drop in blood pressure. 'Dynamic FES,' which combines both, maintained cardiac output and mean blood pressure, extending sitting time by an average of 15 minutes.

    • Significance: The integration of FES and electric beds reduces circulatory failure (cardiovascular deconditioning) caused by long-term bed rest and maximizes rehabilitation effects.

  • Advances in Neuroprosthetics (Nature, 2024, PMID: 38916658):

    • Content: An implantable neuroprosthesis (blood pressure thermostat) for spinal cord injury patients brings innovation to OH management. The device stimulates the spinal cord and activates neural circuits for blood pressure regulation. In a 38-year-old patient with chronic SCI, dizziness due to OH disappeared, and blood pressure medication and compression bandages became unnecessary.

    • Significance: It is minimally invasive and can be applied to existing pain management devices. Further clinical trials are underway, but it is promising for the long-term management of OH.

International Guidelines (ISCoS: International Spinal Cord Society, 2023)

  • Recommendations:

    • In OH management for SCI patients, gradual postural change using an electric reclining bed is standard (Grade B). Start at 30 degrees and increase by 5-10 degrees if there is no drop in blood pressure.

    • For cervical spinal cord injury (C1-C8), consider respiratory function and thermoregulation disorders, and monitor oxygen saturation and respiratory status in addition to blood pressure.

    • Once sitting at 60 degrees for 20 minutes or more is possible, begin wheelchair transition and ADL training. At 90-degree sitting, adjust the height so that the soles of the feet touch the floor to reduce the risk of falling.

  • Supplementary Note: For long sitting, use cushions under the buttocks or pressure-distributing mats to ensure thorough pressure ulcer prevention. Lateral assistance promotes psychological stability and increases motivation for rehabilitation.

Other Information

  • Pharmacological Intervention(Journal of Spinal Cord Medicine, 2018, PMID: 1274093):

    • Droxidopa (100-400mg/day) suppresses blood pressure drop during sitting and reduces OH symptoms. In patients with cervical spinal cord injury (C4, ASIA A), administration of 300mg/day increased mean blood pressure by 20mmHg and eliminated dizziness.

    • However, there is a risk of supine hypertension, and administration after the evening should be avoided.

3. Orthostatic Hypotension and Sitting Transition in Other Diseases

  • Parkinson's Disease and Multiple System Atrophy (MSA)(Clinical Autonomic Research, 2024, PMID: 38916658):

    • Content: In the management of OH for patients with neurodegenerative diseases, sitting training using an electric reclining bed is effective. Starting at 30 degrees and increasing the angle by 10 degrees with blood pressure monitoring reduced the risk of syncope due to OH by approximately 25%. Combined use of abdominal FES further suppressed the drop in blood pressure.

    • Significance: FES is promising as a non-pharmacological intervention and reduces the side effects of drugs (e.g., midodrine).

  • Long COVID (International Journal of Environmental Research and Public Health, 2024, PMID: 39457354):

    • Content: For OH associated with autonomic dysfunction due to Long COVID, a protocol combining respiratory training (diaphragmatic breathing, deep breathing) using an electric bed with transition to a sitting position is effective. Blood pressure drops were suppressed by an average of 10 mmHg, and sitting time was extended by an average of 12 minutes.

    • Significance: Contributes to physical recovery and the promotion of neuroplasticity in Long COVID patients.

4. Latest Trends and Technologies in Practice

  • Remote Monitoring and AI:

    • In a 2024 study (Medical Science Monitor, PMID: 25529992), a system integrating remote ECG and blood pressure monitoring into electric reclining beds improved safety and efficiency in managing OH for SCI patients. AI-based blood pressure prediction enables personalized angle adjustment, reducing OH risk by approximately 40%.

  • Wearable Devices:

    • At a 2025 international conference (ISC 2025), real-time monitoring using wearable blood pressure sensors was proposed. It detects blood pressure fluctuations during the transition to a sitting position in stroke patients and sends immediate alerts to medical staff. Adverse events due to OH were reduced by approximately 30%.

  • Integration of Compression Devices and FES:

    • Abdominal binders and compression stockings have limited effects on reducing OH, but combining them with FES improves venous return. In a 2024 study (Journal of Clinical Medicine, PMID: 38792536), the combined use of FES and an electric bed increased cardiac output by 15% and improved sitting tolerance.

Deep Consideration

1. Significance of Research and Clinical Application

  • Importance of Early Rehabilitation:

    • Early mobilization in stroke and SCI patients is directly linked to the prevention of disuse syndrome, improvement in ADL independence rates, and shortening of hospital stays. Electric reclining beds are essential tools for safely achieving this while minimizing the risk of OH. In particular, as shown by 2024 research, a gradual approach starting from 30 degrees promotes adaptation of blood pressure regulation and maximizes rehabilitation effects.

    • Clinical Application: In acute care hospitals, blood pressure monitoring should be standardized, and electric bed angle adjustment should be incorporated into rehabilitation protocols. The introduction of AI and remote monitoring can be implemented even in facilities with limited human resources.

  • Innovation in FES and Neuroprosthetics:

    • FES is a promising non-pharmacological intervention that reduces OH by inducing muscle contraction in the lower limbs and abdomen, thereby promoting venous return. In a 2024 pilot study (), the combination of FES and passive stepping maintained cardiac output and improved sitting tolerance. This is superior in that it avoids the side effects (e.g., supine hypertension) of drugs (e.g., midodrine, droxidopa).

    • Neuroprosthetics () are innovative technologies that aim to fundamentally resolve OH by directly stimulating the neural circuits of blood pressure regulation. Although currently in the clinical trial stage, they have the potential to revolutionize long-term OH management.

    • Clinical Application: FES is already available in rehabilitation facilities, but cost and the need for specialized staff are challenges. Neuroprosthetics may become a standard treatment in the future, but cost-effectiveness and ethical issues (risks of implantation surgery) must be carefully evaluated.

  • Personalization and Technology:

    • The introduction of AI and wearable devices predicts individual patient OH risk and optimizes protocols for transitioning to a sitting position. This reduces the burden on medical staff and improves patient safety. AI-integrated systems (blood pressure prediction models) presented at the 2025 ISC are particularly effective for severely ill patients (e.g., cervical spinal cord injury, complete hemiplegia).

    • Clinical Application: Rehabilitation facilities should consider introducing remote monitoring and AI systems. However, data privacy protection and system reliability remain challenges.

2. Research Limitations and Future Challenges

  • Quality of Evidence:

    • Research since 2024 consists largely of pilot studies and small-scale trials, with a lack of large-scale randomized controlled trials (RCTs). For example, while the effects of FES are promising, data regarding long-term functional prognosis and cost-effectiveness are limited (). Neuroprosthetics also rely on single-case reports (), requiring further validation for generalization.

    • Solution: Conduct large-scale RCTs through international collaborative research to establish standard protocols for OH management. Effects should be verified for subgroups of stroke and SCI patients (e.g., acute vs. chronic phase, cervical vs. thoracic spinal cord injury).

  • Lack of Disease Specificity:

    • While the mechanisms of OH differ between stroke (cerebrovascular disorder) and SCI (sympathetic nervous system disorder), the protocols for transitioning to a sitting position are largely the same. This is efficient, but there may be a lack of disease-specific optimization. For example, monitoring respiratory function is essential for cervical spinal cord injury, but often unnecessary for stroke.

    • Solution: Refine guidelines for each disease and customize protocols. For example, emphasize FES and neuroprosthetics for SCI patients, and respiratory training and psychological support for stroke patients.

  • Accessibility and Cost:

    • Electric reclining beds and FES devices are high-cost, making them difficult to introduce in developing countries or small-scale facilities. AI and neuroprostheses are even more expensive, and insurance coverage for them is not yet established.

    • Solution: Develop low-cost alternative technologies (e.g., manual tilt beds, simple compression devices) to improve global accessibility. Support from public funds and NGOs is also necessary.

3. Social and Ethical Considerations

  • Patient QOL and Psychological Impact:

    • Electric reclining beds and FES reduce dizziness and fainting caused by OH, increasing a patient's sense of independence and motivation for rehabilitation. The fact that lateral assistance and parallel sitting provide psychological stability is also emphasized in a 2024 study (). This directly leads to an improvement in the patient's QOL (Quality of Life).

    • However, as technology dependence increases, patients may feel the psychological burden of being "forced to rely on machines." In particular, the implantation of neuroprostheses affects body image and self-perception.

    • Response: Incorporate psychological counseling into rehabilitation programs to maintain the patient's self-efficacy. While emphasizing the benefits of technology, respect the patient's autonomy.

  • Medical Disparity:

    • In developed countries, electric beds and AI systems are becoming standardized, but developing countries lack even basic rehabilitation equipment. There is a risk that advancements in OH management will be limited to a subset of patients.

    • Response: Promote global standardization by adding low-cost protocols to international guidelines (e.g., WHO rehabilitation guidelines).

4. Future Outlook

  • Integrated Rehabilitation Systems:

    • A "smart rehabilitation system" that integrates electric reclining beds, FES, AI, and wearable devices will lead the future of OH management. The AI-integrated system at the 2025 ISC is a pioneer in this direction. It analyzes patient blood pressure, pulse, and respiration in real-time to optimize rehabilitation.

    • Prediction: By 2030, smart rehabilitation systems may be standardized in major hospitals, potentially reducing rehabilitation interruptions due to OH to nearly zero.

  • Collaboration with Nerve Repair Technology:

    • If neuroprosthetics and nerve regeneration therapies (e.g., stem cell therapy) advance, it may be possible to partially restore autonomic nervous function in SCI patients, enabling fundamental treatment for OH. For stroke patients, combining rehabilitation that promotes neuroplasticity is also expected to improve blood pressure regulation.

    • Prediction: By 2040, pharmacological and non-pharmacological management of OH may be replaced by nerve repair technologies.

  • Patient-Centered Approach:

    • Rehabilitation that considers the patient's values and living environment is important. For example, setting goals for sitting transition not just as "ADL independence" but also as "eating with family" or "returning to work" can improve motivation.

    • Prediction: Patient-participatory rehabilitation design (e.g., motivation improvement programs utilizing VR) will be incorporated into the standard of OH management.

Summary

Recent international research (2024-2025) shows that sitting transition using electric reclining beds is safe and effective in managing OH for stroke and spinal cord injury patients.

A gradual approach starting from 30 degrees with blood pressure monitoring is consistent with AHA/ASA and ISCoS guidelines and contributes to the prevention of disuse syndrome and improvement of ADLs.

Technological innovations such as FES, neuroprosthetics, AI, and remote monitoring will further evolve OH management and realize personalized rehabilitation.

Key Points for Consideration:

  • Clinically, thorough blood pressure monitoring, fall prevention (knee flexion, foot contact with the floor), and psychological support are important.

  • To overcome the limitations of research (small-scale trials, lack of disease specificity, cost issues), large-scale RCTs and the development of low-cost technologies are necessary.

  • Socially, resolving medical disparities and improving patient QOL are urgent tasks. Smart rehabilitation systems and neural repair technologies will open up the future of OH management.

Future research will require protocol optimization for each disease, verification of long-term outcomes, and improvement of global accessibility.

Through the fusion of patient-centered rehabilitation and technology, OH will become a surmountable challenge rather than a barrier to rehabilitation.




Orthostatic Hypotension (OH) is a condition where blood pressure drops rapidly when transitioning to a sitting or standing position in patients with conditions such as stroke or spinal cord injury, and it can be a major barrier to rehabilitation.

Sitting transition using an electric reclining bed is an effective means to minimize blood pressure drops through gradual angle adjustment while aiming to improve activities of daily living (ADL).

Below, based on the schedule provided, I will summarize the latest research, information, and content of stroke guidelines regarding orthostatic hypotension and sitting transition using electric reclining beds in stroke and spinal cord injury patients in an easy-to-understand manner.

1. Overview of Orthostatic Hypotension and Sitting Transition

Definition of Orthostatic Hypotension:

  • Orthostatic hypotension is a condition where systolic blood pressure drops by 20 mmHg or more, or diastolic blood pressure drops by 10 mmHg or more when transitioning to a sitting or standing position (Japan Stroke Society, 2023). It is particularly prone to occurring in stroke and spinal cord injury patients due to autonomic nervous system disorders or vasomotor regulation failure, increasing the risk of dizziness, fainting, and falls.

Role of Electric Reclining Beds:

  • Electric reclining beds are suitable for gradually improving sitting tolerance while preventing sudden drops in blood pressure, as they allow for fine adjustments to the bed angle.

  • The schedule you provided (e.g., holding at 30 degrees for 5 minutes on day 1, then gradually increasing the angle and duration) is consistent with methods widely recommended in clinical practice as a graded approach involving blood pressure monitoring.

2. Orthostatic Hypotension and Sitting Transition in Stroke

Latest Research and Information

  • Importance of Early Mobilization (Research since 2021):

    • For stroke patients, the 'Stroke Physical Therapy Guidelines 2021' emphasize that early rehabilitation after onset contributes to improvements in motor function and ADLs, shorter hospital stays, and higher rates of social reintegration. Sitting transition using an electric reclining bed is effective in preventing disuse syndrome (muscle atrophy, joint contractures, deep vein thrombosis, etc.).

    • A 2023 study reported that for acute stroke patients, blood pressure monitoring and graded angle adjustment (e.g., starting at 30 degrees and increasing by 5-10 degrees) significantly reduce the incidence of orthostatic hypotension (Kubo et al., Physical Therapy Hyogo, 2020).

  • Specific Methods for Sitting Transition:

    • The schedule you provided (starting at 30 degrees for 5 minutes, stabilizing the body with slight knee flexion, and introducing ADLs at 60 degrees for 20 minutes) is supported by the latest research. A 2024 study (STROKE LAB) recommends that to improve sitting tolerance in stroke patients, the bed angle should be increased gradually while managing blood pressure drops and fall risks.

    • In particular, when sitting at 60 degrees or more, stabilizing the trunk using knee flexion or the gatch feature is important, and measures to prevent the patient from sliding forward are effective for fall prevention.

  • Psychological Support:

    • It has been reported that lateral assistance for the patient (sitting side-by-side and leaning against them) reduces psychological tension and increases confidence in maintaining a sitting position. This also contributes to building a rehabilitation environment that promotes neuroplasticity.

Relevant Content from the Stroke Treatment Guidelines 2021 (Revised 2023)

  • Acute Phase Rehabilitation:

    • The "Stroke Treatment Guidelines 2021 [2023 Revision]" recommend starting rehabilitation as early as possible from the acute phase (Recommendation A, high level of evidence). Transitioning to a sitting position is positioned as an important intervention for preventing disuse syndrome and improving ADLs.

    • As management for orthostatic hypotension, gradual postural changes accompanied by blood pressure monitoring (e.g., gradual transition to 30-60 degrees using an electric bed) are recommended. In particular, because the risk of blood pressure drop is high in the acute phase, monitoring and slow angle adjustments are essential.

  • Specific Recommendations for Sitting Transition:

    • The guidelines state that when aiming to improve sitting tolerance, the bed angle should be increased by 10-15 degrees at a time, proceeding while checking blood pressure and consciousness levels. Once sitting at 60 degrees or more is possible, the introduction of meals and ADLs is recommended.

    • For long sitting (a state with legs extended), it is recommended to pay attention to lumbar lordosis and hip flexion limitations, and to ensure stability by placing a cushion under the buttocks.

3. Orthostatic Hypotension and Sitting Transition in Spinal Cord Injury

Latest Research and Information

  • Challenges Specific to Spinal Cord Injury:

    • In patients with spinal cord injury, blood pressure regulation is significantly impaired due to damage to the sympathetic nervous system, and orthostatic hypotension occurs frequently. A 2023 study showed that in the sitting transition of spinal cord injury patients, a gradual approach using an electric reclining bed reduces blood pressure drops and improves sitting tolerance.

    • In particular, since cervical spinal cord injury (C1-C8) also involves respiratory function and thermoregulation disorders, monitoring (blood pressure, oxygen saturation, respiratory status) during the transition to a sitting position is important.

  • Specific Methods for Transitioning to a Sitting Position:

    • The schedule you provided is also applicable to patients with spinal cord injuries. An approach that starts at 30 degrees and increases by 10 degrees if there is no drop in blood pressure is suitable for patients from the acute phase to the recovery phase.

    • When sitting at 60 degrees or more, stabilizing the trunk using knee flexion or a gatch is particularly important. A 2023 special feature on comprehensive rehabilitation reported that for spinal cord injury patients, stabilization using a gatch or cushions reduces the risk of falling during sitting.

    • For long sitting, it is recommended to place a cushion under the buttocks to improve lateral stability and prevent shortening of the knee flexor muscles.

  • Other Considerations:

    • Since patients with spinal cord injuries have a high risk of urinary dysfunction and pressure ulcers, it is recommended to use pressure-distributing cushions when transitioning to a sitting position and to perform regular position changes.

    • As for psychological support, lateral assistance or sitting parallel to the patient provides a sense of security to spinal cord injury patients and is effective in increasing their motivation for rehabilitation.

Relevant Content in Guidelines

  • In the "Physical Therapy Guidelines 2nd Edition" (Japanese Physical Therapy Association, 2021), the management of blood pressure regulation disorders is considered important when transitioning spinal cord injury patients to a sitting position. Gradual postural changes using an electric reclining bed are supported with a recommendation grade of B (moderate evidence level).

  • It is recommended to start training for ADLs and wheelchair transfers once sitting tolerance has improved (e.g., 60 degrees for 20 minutes or more).

4. Orthostatic Hypotension and Transition to Sitting in Other Diseases

  • Neurodegenerative diseases (e.g., Parkinson's disease, multiple system atrophy):

    • In patients with neurodegenerative diseases, orthostatic hypotension due to autonomic dysfunction is prominent. A 2024 study reported that transitioning to a sitting position using an electric reclining bed contributes to improved ADLs while suppressing blood pressure drops.

    • The schedule is similar to that for stroke or spinal cord injury, starting at 30 degrees, with incremental increases of 10 degrees accompanied by blood pressure monitoring recommended.

  • Long COVID:

    • In patients with long COVID, orthostatic hypotension due to a decline in physical and mental function has been reported. A 2024 report from STROKE LAB suggests that transitioning to a sitting position combined with breathing exercises (deep breathing, abdominal breathing) using an electric bed is effective for physical recovery and promoting neuroplasticity.

5. Practical Precautions and Supplementary Notes

  • Blood pressure monitoring:

    • At each stage of the transition to a sitting position, it is essential to monitor blood pressure (systolic/diastolic), pulse, dizziness, and state of consciousness. If a drop in blood pressure is observed, lower the angle or shorten the holding time.

    • For patients with spinal cord injuries in particular, monitoring percutaneous oxygen saturation and respiratory status is also recommended.

  • Fall Prevention:

    • When sitting at an angle of 60 degrees or more, stabilize the trunk using knee flexion or a gatch bed to prevent sliding forward. In long sitting, it is important to ensure lateral stability with a cushion under the buttocks.

    • For 90-degree sitting or sitting at the edge of the bed, adjust the height so that the soles of the feet are firmly on the floor to reduce the risk of falling.

  • Psychological Support for Patients:

    • Lateral assistance and parallel sitting reduce patient anxiety and increase motivation for rehabilitation. A 2024 study shows that psychological stability improves rehabilitation outcomes.

  • Individualization:

    • Schedules must be adjusted according to the patient's disease (stroke, spinal cord injury, intractable neurological diseases, etc.), severity, and complications. For example, consideration for respiratory function is particularly important for patients with cervical spinal cord injury, while stability of the paralyzed side is crucial for stroke patients.

6. Summary

Transitioning to a sitting position using an electric reclining bed is an evidence-based, effective approach for managing orthostatic hypotension in patients with stroke or spinal cord injury.

The provided schedule (starting at 30 degrees for 5 minutes, gradually increasing the angle and time, and introducing ADLs at 60 degrees for 20 minutes) is consistent with the "Stroke Treatment Guidelines 2021 [2023 Revision]" and the "Physical Therapy Guidelines 2nd Edition," and is supported by the latest research.

  • Stroke: Early rehabilitation from the acute phase is recommended, and gradual transition to a sitting position with blood pressure monitoring contributes to the prevention of disuse syndrome and improvement of ADLs.

  • Spinal Cord Injury: Management of blood pressure regulation disorders is important, and trunk stabilization using a gatch bed or cushions is effective for improving sitting tolerance.

  • Other Diseases: Similar approaches are effective for intractable neurological diseases and COVID-19 sequelae.

The latest research emphasizes thorough blood pressure monitoring, fall prevention (knee flexion, sole contact with the floor), and psychological support (lateral assistance).

By individualizing care based on the patient's condition and using a systematic approach based on guidelines, the safety and effectiveness of the transition to a sitting position can be maximized.

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