HeadPoST Version 2.1
Research type
Research Study
Full title
HeadPoST: Head Position in Acute Stroke Trial
IRAS ID
150715
Contact name
Caroline Watkins
Contact email
Clinicaltrials.gov Identifier
Research summary
Nursing practice regarding head positioning in patients post-stroke differs substantially across the world. In Switzerland for instance, all patients are nursed lying flat for the first 72 hours post-stroke. In the United Kingdom we nurse most patients in the sitting up position, although in more mobile self-caring patients no position may be advocated with patients lying down or sitting up dependent on personal choice or time of day.
Currently there is insufficient evidence to support either head position in stroke patients, with guidelines being derived from studies in non-stroke patients.
Stroke is classified into two groups:
a. Ischaemic strokes resulting from a blockage in an artery that carries blood to the brain
b. Intracerebral hemorrhage strokes resulting when a blood vessel bursts and bleeds into the brain
HeadPoST is an international trial that aims to compare the effect of the lying flat (0º head) position with the sitting up (=30º head) position in the first 24 hours of hospital admission for patients with acute stroke on the outcome of death or disability in the first 90 days after stroke. It aims to answer:
1. Which position (lying flat or sitting up) is best for patients in the first 24 hours after a stroke?2. Do the different types of stroke benefit from the same or different position?
The design aims to include a seperate evaluation within a later cohort of sites, exploring challenges to implementation of both positions from the perspective of the clinical team, the fidelity to each position and the acceptability of both positions to patients, carers and staff. Informing an implementation package for final cohorts and contributing to future implementation.This will be the subject of a later apllication subject to funding .
This study will have a direct impact on patient care, providing robust evidence supporting evidence-based nursing policies on optimal head positioning, thereby contributing to better patient outcomes.REC name
Wales REC 5
REC reference
14/WA/1075
Date of REC Opinion
24 Jul 2014
REC opinion
Favourable Opinion