Side difference in the hip and knee joint moments during sit-to-stand and stand-to-sit tasks in individuals with hemiparesis.

BACKGROUND No study has reported the differences between sides in the net muscular moment of lower limbs of subjects with hemiparesis during sit-to-stand and stand-to-sit tasks in various foot positions. Moreover, the asymmetry of lower-joint moments has not yet been related to muscular weakness of the lower limbs in this population. METHODS A convenience sample of 12 individuals (mean age (standard deviation): 49.7 (9.0) years) with chronic hemiparesis due to stroke were asked to stand up and sit down at their natural speed in four foot positions. The joint moments at the hip and knee on both sides during the tasks were estimated with an inverse dynamic approach while the dynamic concentric strength in extension at the hip and knee was assessed with a Biodex dynamometric system. Statistical analyses (paired t-tests and ANOVAs) were used to assess the effects of sides and foot position factor on the asymmetry in the hip and knee joint moments. The level of association between muscle weakness and the asymmetry in the joint moments was quantified with Pearson correlation coefficients (r). FINDINGS At the knee, the extensor moments were significantly lower on the affected side (P<0.05) and were affected by the foot position. At the hip, the moments were not significantly different between sides and were slightly modified by the foot positions. There were also strong correlations (0.70<r<0.89; P<0.05, for symmetrical foot position) between the asymmetry in knee extensor moments and the asymmetry in strength. No relation was established at the hip. INTERPRETATION The sit-to-stand and stand-to-sit tasks are characterized by a marked asymmetry in the knee extensor moments, which is associated with knee extensor weakness.

[1]  P. Desjardins,et al.  A chair with a platform setup to measure the forces under each thigh when sitting, rising from a chair and sitting down , 2008, Medical & Biological Engineering & Computing.

[2]  P. Cheng,et al.  Comparison of balance responses and motor patterns during sit-to-stand task with functional mobility in stroke patients. , 1997, American journal of physical medicine & rehabilitation.

[3]  Richard W. Bohannon,et al.  Relationship of knee extension force to independence in sit-to-stand performance in patients receiving acute rehabilitation. , 2003, Physical therapy.

[4]  Janice J Eng,et al.  Muscle strength and weight-bearing symmetry relate to sit-to-stand performance in individuals with stroke. , 2005, Gait & posture.

[5]  M. Engardt,et al.  Long-term effects of auditory feedback training on relearned symmetrical body weight distribution in stroke patients. A follow-up study. , 1994, Scandinavian journal of rehabilitation medicine.

[6]  T. Kotake,et al.  An analysis of sit-to-stand movements. , 1993, Archives of physical medicine and rehabilitation.

[7]  S. Nadeau,et al.  Muscular utilization of the plantarflexors, hip flexors and extensors in persons with hemiparesis walking at self-selected and maximal speeds. , 2007, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[8]  E. Chosa,et al.  Biomechanical analysis of effects of foot placement with varying chair height on the motion of standing up , 2000, Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association.

[9]  R. L. Kirby,et al.  Effect of limited knee-flexion range on peak hip moments of force while transferring from sitting to standing. , 1988, Journal of biomechanics.

[10]  S. Olney,et al.  Hemiparetic gait following stroke. Part I: Characteristics , 1996 .

[11]  G. Salem,et al.  Knee strength and lower- and higher-intensity functional performance in older adults. , 2000, Medicine and science in sports and exercise.

[12]  Julien Doyon,et al.  Training Mobility Tasks after Stroke with Combined Mental and Physical Practice: A Feasibility Study , 2004, Neurorehabilitation and neural repair.

[13]  S. Lord,et al.  Sit-to-stand performance depends on sensation, speed, balance, and psychological status in addition to strength in older people. , 2002, The journals of gerontology. Series A, Biological sciences and medical sciences.

[14]  Alice M. K. Wong,et al.  Postural Control During Sit-to Stand and Gait in Stroke Patients , 2003, American journal of physical medicine & rehabilitation.

[15]  Tim Kauffman ASSOCIATION BETWEEN HIP EXTENSION STRENGTH AND STAND-UP ABILITY IN GERIATRIC PATIENTS , 1982 .

[16]  Characterization of contralateral torques during static hip efforts in healthy subjects and subjects with hemiparesis. , 1992, Brain : a journal of neurology.

[17]  C. Richards,et al.  Responsiveness and predictability of gait speed and other disability measures in acute stroke. , 2001, Archives of physical medicine and rehabilitation.

[18]  R. Brand,et al.  The biomechanics and motor control of human gait: Normal, elderly, and pathological , 1992 .

[19]  S. Gandevia,et al.  The distribution of muscle weakness in upper motoneuron lesions affecting the lower limb. , 1990, Brain : a journal of neurology.

[20]  A. Hof,et al.  An explicit expression for the moment in multibody systems. , 1992, Journal of biomechanics.

[21]  M. Maležič,et al.  Quantitative analysis of rising from a chair in healthy and hemiparetic subjects. , 1994, Scandinavian journal of rehabilitation medicine.

[22]  M. Levin,et al.  Relief of hemiparetic spasticity by TENS is associated with improvement in reflex and voluntary motor functions. , 1992, Electroencephalography and clinical neurophysiology.

[23]  E. Olsson,et al.  Body weight-bearing while rising and sitting down in patients with stroke. , 2020, Scandinavian journal of rehabilitation medicine.

[24]  H Iwakura,et al.  Motion analysis in the movements of standing up from and sitting down on a chair. A comparison of normal and hemiparetic subjects and the differences of sex and age among the normals. , 1983, Scandinavian journal of rehabilitation medicine.

[25]  P. Stratford,et al.  Measuring Physical Impairment and Disability With the Chedoke‐McMaster Stroke Assessment , 1993, Stroke.

[26]  G. Pyka,et al.  Effect of muscle strength and movement speed on the biomechanics of rising from a chair in healthy elderly and young women. , 1998, Gait & posture.

[27]  B. E. Maki,et al.  Measuring balance in the elderly: validation of an instrument. , 1992, Canadian journal of public health = Revue canadienne de sante publique.

[28]  M. Y. Lee,et al.  The sit-to-stand movement in stroke patients and its correlation with falling. , 1998, Archives of physical medicine and rehabilitation.

[29]  Diane Podsiadlo,et al.  The Timed “Up & Go”: A Test of Basic Functional Mobility for Frail Elderly Persons , 1991, Journal of the American Geriatrics Society.

[30]  Denis Gravel,et al.  The effect of foot position and chair height on the asymmetry of vertical forces during sit-to-stand and stand-to-sit tasks in individuals with hemiparesis. , 2006, Clinical biomechanics.

[31]  D Gravel,et al.  Influence of contractile tension development on dynamic strength measurements of the plantarflexors in man. , 1988, Journal of biomechanics.

[32]  J. Eng,et al.  Reliability and comparison of weight-bearing ability during standing tasks for individuals with chronic stroke. , 2002, Archives of physical medicine and rehabilitation.