The 7 Essential Tilt Table Uses for Physiotherapy: Key Benefits for Recovery and Rehabilitation
If you or someone you care for is recovering from a stroke, spinal injury, or dealing with mobility impairments, you know how critical it is to find effective rehabilitation tools. Tilt tables are powerful devices that not only aid recovery but also enhance circulation, maintain bone density, and promote early mobilization, giving patients the independence they deserve.
In this blog, we’ll explore 7 essential uses of tilt tables, showing you how they can significantly improve rehabilitation outcomes, whether in a clinical setting or at home. Whether you're a physiotherapist, a caregiver, or a patient looking for long-term solutions, this guide will help you understand how tilt tables can play a vital role in recovery.
Ready to discover how tilt tables can help your recovery journey? Continue reading to learn more, and don't forget to check out our tilt table collection here for a range of high-quality options tailored to meet your needs!
What is a Tilt Table?
Definition and Description:
A tilt table is a rehabilitation device that gradually tilts a patient from a lying position to an upright stance. It has an adjustable platform, safety straps, and footplates to support the patient during the process.
How It’s Used:
In clinics, physiotherapists use tilt tables to help patients adjust to standing after a stroke, spinal cord injury, or other mobility challenges.
At home, tilt tables help individuals with long-term disabilities (like paraplegia or MS) practice standing and weight-bearing exercises safely.
Healthtec Sliding Top Tilt table (Clear Span) w/ Split Foot Plate and Hoist Access is shown for demonstration, and it is one of the most popular tilt tables on the market.
The Top 7 Uses and Benefits of Tilt Tables in Physiotherapy & Rehab
1) Early Mobilization After Stroke
After a stroke, patients often experience difficulty standing or sitting upright due to muscle weakness, paralysis, or coordination problems. Tilt tables are ideal for helping these patients gradually reintroduce upright posture, as they provide a safe and controlled environment for weight-bearing without the risk of falling.
How the Tilt Table is Used:
The patient is positioned on the tilt table in a supine (lying) position, secured with safety straps at the chest, hips, and knees. The table is then slowly tilted upwards, typically starting at 30° to 45°, and gradually increased to higher angles as the patient tolerates it. Sessions usually last 10–20 minutes, with the tilt angle adjusted based on the patient’s tolerance.
Benefits and Goals:
The primary goals of using a tilt table for stroke patients are to improve circulation, restore upright tolerance, and prevent complications like pressure sores and blood clots. It also helps maintain muscle strength and flexibility, aiding in overall recovery.
Evidence or Expert Insights:
Studies have shown that early upright positioning with tilt tables improves post-stroke rehabilitation outcomes, including faster recovery and better cardiovascular health. Clinical practice recommends incorporating tilt table use early in stroke recovery to prevent complications and improve long-term functional mobility (Baltz et al., 2013).
2) Spinal Cord Injury Rehabilitation
For individuals with spinal cord injuries (SCI), particularly those with paralysis or severe leg weakness, tilt tables are essential for helping them achieve supported standing. SCI patients often face challenges like orthostatic hypotension, muscle spasticity, and reduced circulation, which tilt tables help address by gradually transitioning them from a lying to an upright position.
How the Tilt Table is Used:
The patient is transferred onto the tilt table and secured with harness straps. The table is slowly raised, typically starting at 60° to 80°, with sessions lasting 10–15 minutes daily, gradually increasing in duration. As the patient adapts, standing sessions can extend up to 30 minutes or more, depending on tolerance. Therapists monitor vitals closely to ensure safe transitions, and compression garments are often used to assist circulation.
Benefits and Goals:
Tilt-table standing improves circulation, reduces spasticity, and enhances bone health by promoting weight-bearing. It also helps prevent contractures and promotes functional independence, improving bowel and bladder function. Psychological benefits include a boost in mood and confidence from being upright, while physical benefits include reducing the frequency of muscle spasms and maintaining bone density.
Evidence or Expert Insights:
Studies show that early standing with tilt tables reduces orthostatic hypotension and increases activity tolerance, promoting faster recovery. The research also indicates that pairing tilt-table standing with Functional Electrical Stimulation (FES) helps slow bone loss (Cowhig & Farrell, 2019).
Additionally, regular tilt-table standing leads to improved bowel regularity, reduced muscle spasms, and better blood pressure control over time. For patients with incomplete SCI, tilt tables are used for pre-gait training, such as weight shifting and assisted stepping, to prepare for future walking.
3) Traumatic Brain Injury (TBI) and Disorders of Consciousness
Patients with severe traumatic brain injury (TBI) or those in minimally conscious states benefit from tilt table therapy to increase arousal and promote neural recovery. Tilt tables help provide vestibular stimulation (inner ear balance organs sense the change in head position) and improve blood circulation, essential for patients with severely impaired consciousness or those who cannot actively engage in therapy.
How the Tilt Table is Used:
The patient, often with limited consciousness, is placed on the tilt table and gradually tilted to an upright position. The table is typically tilted to 30° to 45° initially, and sessions last about 15–30 minutes depending on the patient's tolerance. This positioning helps stimulate neural pathways and can be paired with other therapies like cognitive stimulation or sensory input to further enhance recovery.
Benefits and Goals:
The main goal is to increase arousal and improve consciousness by stimulating the brain’s vestibular system through upright positioning. Tilt table use also enhances circulatory function, helping with organ perfusion and respiratory function, while improving gastrointestinal motility and bladder drainage. These benefits contribute to overall recovery and prevent complications like bedsores and deep vein thrombosis.
Evidence or Expert Insights:
Research indicates that tilt table therapy can improve consciousness levels in TBI patients. A study published in the Journal of Rehabilitation Research and Development showed that upright positioning significantly enhanced neurological recovery and alertness in patients with severe brain injuries (Kumar et al., 2020).
Clinicians report that regular tilt-table standing can help activate the brain's reticular activating system, improving consciousness scores over time. Additionally, tilt table sessions have been shown to improve respiratory function and reduce complications associated with prolonged bed rest (Jang et al., 2019).
4) Orthostatic Hypotension Training and Autonomic Conditioning
Orthostatic hypotension (OH) causes dizziness or fainting when moving from a lying to an upright position, common in conditions like spinal cord injury (SCI) or prolonged bed rest. Tilt tables are critical for autonomic conditioning, helping patients gradually adjust to standing while monitoring blood pressure to avoid fainting.
How the Tilt Table is Used:
The patient is positioned on the tilt table and slowly raised from a lying to an upright position, typically starting at 30° to 45°. Tilt sessions usually last 5–10 minutes initially, gradually increasing to 20–30 minutes as the patient tolerates it. Blood pressure is monitored during each session to ensure the patient’s safety, and compression stockings or abdominal binders may be used to assist circulation.
Benefits and Goals:
The primary goal is to improve orthostatic tolerance by gradually training the autonomic nervous system to handle changes in posture. Tilt table therapy enhances circulatory function and helps reduce the symptoms of orthostatic hypotension, such as dizziness and fainting (Baltz et al., 2013). Long-term use can improve vascular health, prevent complications like deep vein thrombosis, and prepare the patient for more active rehabilitation.
Evidence or Expert Insights:
Studies indicate that regular tilt-table sessions help restore autonomic function in patients with orthostatic hypotension. Research shows that standing training with tilt tables improves blood pressure regulation and reduces symptoms of fainting and dizziness over time. Clinical guidelines recommend using tilt tables for daily sessions to condition the cardiovascular system in patients with SCI and other conditions prone to OH (Cowhig & Farrell, 2019).
5) Bone Health and Preventing Osteoporosis
In patients with prolonged immobility, such as those with spinal cord injuries (SCI), stroke, or long-term bed rest, bone mineral density can decrease rapidly, leading to conditions like osteoporosis. Tilt tables are used to help patients regain weight-bearing capacity in a controlled manner, which is essential for preventing bone loss and improving bone health.
How the Tilt Table is Used:
The patient is secured on the tilt table and gradually tilted from a horizontal to an upright position, typically to an angle of 60° to 80°. Sessions generally last 10–30 minutes and can be performed daily or several times a week, depending on the patient's tolerance and rehabilitation plan. When combined with therapies like Functional Electrical Stimulation (FES), the tilt table can further support bone health by engaging muscles during weight-bearing.
Benefits and Goals:
The primary goal of tilt table therapy for bone health is to provide weight-bearing stimulation to the bones, which helps prevent osteoporosis and supports bone density. Regular standing can help maintain muscle strength and improve overall circulatory function, reducing the risk of complications such as fractures.
Evidence or Expert Insights:
Research supports that regular tilt-table standing can help maintain bone mineral density, especially when combined with FES. A study found that passive standing can help reduce bone loss by providing mild mechanical load to bones, a process essential for preserving bone strength. Early and consistent use of tilt tables is recommended in SCI rehabilitation to slow bone mineral loss (Cowhig & Farrell, 2019).
6) Spasticity Management and Muscle Tone Regulation
For patients with neurological conditions such as stroke, cerebral palsy, or multiple sclerosis (MS), managing muscle spasticity is a critical component of rehabilitation. Tilt tables help provide sustained stretching to spastic muscles, reducing tone and improving overall mobility.
How the Tilt Table is Used:
The patient is securely positioned on the tilt table, typically in a supine position, with straps to hold them in place. The table is then tilted to an angle, often 60° to 80°, and held for 15–30 minutes, depending on tolerance. The tilt helps stretch tight muscles like the calves and hamstrings, which are commonly affected by spasticity. The table may be used alongside other treatments like botulinum toxin injections or manual stretching to provide a comprehensive approach.
Benefits and Goals:
The key goals are to reduce spasticity and improve muscle tone regulation. By positioning the patient upright, the tilt table can help relax spastic muscles, reduce pain from muscle stiffness, and improve range of motion. This aids in gait training and functional mobility, as well as decreasing the need for medications to manage spasticity.
Evidence or Expert Insights:
Studies show that tilt table therapy is an effective short-term treatment for reducing muscle tone in patients with spasticity, particularly in SCI and stroke patients. One study found that tilt-table standing helped reduce ankle plantarflexor spasticity in stroke patients, improving mobility and caregiving ease. Experts recommend tilt-table standing as part of a multidisciplinary approach to spasticity management (Cowhig & Farrell, 2019).
7) Preventing Contractures and Improving Range of Motion
Patients with limited mobility due to SCI, stroke, or TBI are at risk of developing joint contractures. Tilt tables help prevent these contractures by ensuring weight-bearing and providing full extension of joints, particularly the ankles, knees, and hips.
How the Tilt Table is Used:
The patient is placed on the tilt table and secured with straps. The table is tilted from horizontal to an angle that promotes muscle elongation, such as 60° to 80°. Sessions usually last 20–30 minutes to allow for sustained joint positioning and muscle stretching. Tilt table therapy may be combined with other interventions like passive range-of-motion exercises.
Benefits and Goals:
Tilt table use prevents muscle shortening and joint stiffness, reducing the risk of contractures. By maintaining normal postural alignment, it helps preserve joint function and range of motion, which is essential for mobility training and preventing deformities in long-term rehabilitation.
Evidence or Expert Insights:
Studies support tilt-table standing as an effective way to maintain joint flexibility in non-ambulatory patients. Research indicates that prolonged static positioning on a tilt table helps stretch tight muscles and maintains range of motion in patients with long-term immobilization. Clinicians emphasize that tilt tables should be used regularly in rehabilitation programs to prevent ankle contractures and improve leg function (Cowhig & Farrell, 2019).
Additional Tilt Table Uses: Honourable Mentions
Sports Rehabilitation: Gradual Weight-Bearing After Injury
Tilt tables are valuable in sports rehab for athletes recovering from serious injuries or surgeries, especially for weight-bearing exercises. By gradually allowing the athlete to stand and bear weight, tilt tables help with bone health and muscle activation, preparing them for more dynamic exercises like walking or light running.
NDIS Home Rehabilitation: Empowering Independence
For NDIS recipients, tilt tables offer a safe and controlled way to practice standing and weight-bearing exercises at home. They support patients with long-term disabilities, such as paraplegia, in maintaining mobility, circulation, and muscle function, helping them live with more independence.
You can find more information on how to receive a quote or invoice for tilt tables through NDIS on our NDIS page, where you can fill out a form to get personalised assistance.
Tilt Table Test: Diagnosing Orthostatic Hypotension
The Tilt Table Test is a diagnostic procedure used to evaluate orthostatic hypotension by monitoring a patient's blood pressure and heart rate as they are tilted from lying to standing. It helps identify fainting or dizziness caused by autonomic dysfunction, aiding in the diagnosis of conditions like POTS and vasovagal syncope.
Conclusion
Tilt tables are indispensable in physiotherapy and rehabilitation, offering significant benefits in recovery for patients with a variety of conditions. From stroke and spinal cord injuries to spasticity and orthostatic hypotension, tilt tables help promote early mobilization, improve circulation, and enhance overall well-being.
If you're looking for the right tilt table for your needs, whether for clinical use or home rehabilitation, view our tilt table collection to find the perfect solution for your rehabilitation goals. Don’t hesitate to reach out for personalized assistance and guidance!
Disclaimer:
The information in this article is for general educational purposes only and does not constitute medical advice. Please consult a qualified healthcare professional before making decisions about your health or rehabilitation needs.
References:
- Baltz, M. J., Lietz, H. L., Sausser, I. T., Kalpakjian, C., & Brown, D. (2013). Tolerance of a standing tilt table protocol by patients an inpatient stroke unit setting: a pilot study. Journal of Neurologic Physical Therapy: JNPT, 37(1), 9–13. https://doi.org/10.1097/NPT.0b013e318282a1f0
- Cowhig, J., & Farrell, C. (2019, January 11). Standing Up to the Challenge of SCI. Rehab Management. https://rehabpub.com/gait-balance/standing-challenge-sci/
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Kumar, S., Yadav, R., & Aafreen. (2020). Comparison between Erigo tilt-table exercise and conventional physiotherapy exercises in acute stroke patients: a randomized trial. Archives of Physiotherapy, 10, 3. https://doi.org/10.1186/s40945-020-0075-2
- Jang, M. H., Shin, M. J., & Shin, Y. B. (2019). Pulmonary and Physical Rehabilitation in Critically Ill Patients. Acute and Critical Care, 34(1), 1–13. https://doi.org/10.4266/acc.2019.00444
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