Knee efforts and weight-bearing asymmetry during sit-to-stand tasks in individuals with hemiparesis and healthy controls

Abstract

The asymmetrical weight-bearing distribution of individuals with hemiparesis rising from a chair might be used to produce similar muscular efforts at the lower limbs. The aim of this study was to determine if individuals with hemiparesis have symmetrical levels of effort at the knee during spontaneous sit-to-stand transfers. Nineteen subjects with hemiparesis and 16 healthy controls participated. Their weight-bearing (WB) distribution during sit-to-stand was assessed with a force platform setup while the knee effort distribution was quantified using electromyographic (EMG) data normalized to maximal EMG values then expressed relative to the sum of the bilateral efforts. The healthy individuals presented symmetrical weight-bearing and knee effort distributions during the sit-to-stand transfer. The participants with hemiparesis, classified in three subgroups based on knee extensors' strength asymmetries (mild, moderate and severe), yielded different results. The mild group (n = 6) behaved like the controls, with almost symmetrical WB and knee efforts. The moderate group (n = 7) had similar WB and effort asymmetries while the severe group (n = 6) exhibited a WB distribution difference between sides but had almost symmetrical knee effort. These results for the severe group suggest that a control is exerted on the levels of effort when rising from a chair, which might be required when a certain threshold of effort is reached on the nonparetic side.