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

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

Author information

1
J.M. Burnfield, PT, PhD, Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospital, 5401 South St, Lincoln, NE 68506 (USA).

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.

PMID:
23641027
DOI:
10.2522/ptj.20120500
[Indexed for MEDLINE]
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