Comparative kinematic and electromyographic assessment of clinician- and device-assisted sit-to-stand transfers in patients with stroke

Phys Ther. 2013 Oct;93(10):1331-41. doi: 10.2522/ptj.20120500. Epub 2013 May 2.

Abstract

Background: Workplace injuries from patient handling are prevalent. With the adoption of no-lift policies, sit-to-stand transfer devices have emerged as one tool to combat injuries. However, the therapeutic value associated with sit-to-stand transfers with the use of an assistive apparatus cannot be determined due to a lack of evidence-based data.

Objective: The aim of this study was to compare clinician-assisted, device-assisted, and the combination of clinician- and device-assisted sit-to-stand transfers in individuals who recently had a stroke.

Design: This cross-sectional, controlled laboratory study used a repeated-measures design.

Methods: The duration, joint kinematics, and muscle activity of 4 sit-to-stand transfer conditions were compared for 10 patients with stroke. Each patient performed 4 randomized sit-to-stand transfer conditions: clinician-assisted, device-assisted with no patient effort, device-assisted with the patient's best effort, and device- and clinician-assisted.

Results: Device-assisted transfers took nearly twice as long as clinician-assisted transfers. Hip and knee joint movement patterns were similar across all conditions. Forward trunk flexion was lacking and ankle motion was restrained during device-assisted transfers. Encouragement and guidance from the clinician during device-assisted transfers led to increased lower extremity muscle activation levels.

Limitations: One lifting device and one clinician were evaluated. Clinician effort could not be controlled.

Conclusions: Lack of forward trunk flexion and restrained ankle movement during device-assisted transfers may dissuade clinicians from selecting this device for use as a dedicated rehabilitation tool. However, with clinician encouragement, muscle activation increased, which suggests that it is possible to safely practice transfers while challenging key leg muscles essential for standing. Future sit-to-stand devices should promote safety for the patient and clinician and encourage a movement pattern that more closely mimics normal sit-to-stand biomechanics.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Ankle Joint / physiology
  • Biomechanical Phenomena
  • Cross-Sectional Studies
  • Electromyography
  • Female
  • Hip Joint / physiology
  • Humans
  • Knee Joint / physiology
  • Lower Extremity / physiology
  • Male
  • Middle Aged
  • Movement / physiology
  • Moving and Lifting Patients*
  • Muscle, Skeletal / physiology
  • Paresis / etiology
  • Self-Help Devices*
  • Stroke / complications*
  • Torso / physiology