PTJ
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

PHYS THER
Vol. 82, No. 9, September 2002, pp. 866-879
This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Rapid Responses are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Janssen, W. G.
Right arrow Articles by Stam, H. J
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Janssen, W. G.
Right arrow Articles by Stam, H. J
Related Collections
Right arrow Gait and Locomotion Training
Right arrow Evidence-Based Practice
Social Bookmarking
Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?

Research Reports

Determinants of the Sit-to-Stand Movement: A Review

Wim GM Janssen, Hans BJ Bussmann and Henk J Stam

WGM Janssen, MD, is Rehabilitation Specialist, Department of Rehabilitation, University Hospital Rotterdam, Dr Molewaterplein 40, 3015 GD Rotterdam, the Netherlands (janssen{at}revd.azr.nl). Address all correspondence to Dr Janssen
HBJ Bussmann, PT, PhD, is Assistant Professor, Department of Rehabilitation, Erasmus University Rotterdam, Rotterdam, the Netherlands
HJ Stam, MD, PhD, is Rehabilitation Specialist, Professor and Head of the Department of Rehabilitation Medicine, University Hospital Rotterdam and Erasmus University Rotterdam


Submitted July 19, 2001; Accepted March 19, 2002


   Abstract
 
Background and Purpose. The sit-to-stand (STS) movement is a skill that helps determine the functional level of a person. Assessment of the STS movement has been done using quantitative and semiquantitative techniques. The purposes of this study were to identify the determinants of the STS movement and to describe their influence on the performance of the STS movement. Methods. A search was made using MEDLINE (1980–2001) and the Science Citation Index Expanded of the Institute for Scientific Information (1988–2001) using the key words "chair," "mobility," "rising," "sit-to-stand," and "standing." Relevant references such as textbooks, presentations, and reports also were included. Of the 160 identified studies, only those in which the determinants of STS movement performance were examined using an experimental setup (n=39) were included in this review. Results. The literature indicates that chair seat height, use of armrests, and foot position have a major influence on the ability to do an STS movement. Using a higher chair seat resulted in lower moments at knee level (up to 60%) and hip level (up to 50%); lowering the chair seat increased the need for momentum generation or repositioning of the feet to lower the needed moments. Using the armrests lowered the moments needed at the hip by 50%, probably without influencing the range of motion of the joints. Repositioning of feet influenced the strategy of the STS movement, enabling lower maximum mean extension moments at the hip (148.8 N·m versus 32.7 N·m when the foot position changed from anterior to posterior). Discussion and Conclusion. The ability to do an STS movement, according to the research reviewed, is strongly influenced by the height of the chair seat, use of armrests, and foot position. More study of the interaction among the different determinants is needed. Failing to account for these variables may lead to erroneous measurements of changes in STS performance.

Key Words: Chair • Determinants • Review • Sit-to-stand movement • Variables


   Introduction
Top
 Abstract
 Introduction
Methods
 STS Movement Determinants in...
 Discussion and Conclusions
 References
 
The sit-to-stand (STS) movement is one function people frequently use as they change from a sitting position to a standing position (and then often to walking). The ability to go from a sitting position to a standing position is an important skill; in elderly people, the inability to perform this basic skill can lead to institutionalization, impaired functioning and mobility in activities of daily living (ADL), and even death.1–3 Changes in ability to perform the STS movement are found in elderly people and people with disabling diseases and are related to the determinants of the STS movement.4–17 In a survey of independently living Dutch men and women aged 55 years and older, 25% of the men reported moderate disability and 5% of the men reported severe disability (as compared with 37.4% and 7.8% of the women, respectively) on the rising component of the Health Assessment Questionnaire.1

The manner in which the STS movement is defined depends to some extent on the aim of the study. Roebroeck et al,18 for example, defined the STS movement as moving the body's center of mass upward from a sitting position to a standing position without losing balance. Vander Linden et al19 defined the STS movement as a transitional movement to the upright posture requiring movement of the center of mass from a stable position to a less stable position over extended lower extremities. The STS movement also can be described using kinematic or kinetic variables, with definitions supplied for phases and events during this movement.20–22 A definition of these phases that is used frequently is the one provided by Schenkman et al21 and is marked by 4 events. Phase I (flexion-momentum phase) starts with initiation of the movement and ends just before the buttocks are lifted from the seat of the chair. Phase II (momentum-transfer phase) begins as the buttocks are lifted and ends when maximal ankle dorsiflexion is achieved. Phase III (extension phase) is initiated just after maximum ankle dorsiflexion and ends when the hips first cease to extend; including leg and trunk extension. Phase IV (stabilization phase) begins after hip extension is reached and ends when all motion associated with stabilization is completed.21

Studying the STS movement, in our opinion, requires a basic knowledge of the factors influencing how the movement is performed. The determinants, we believe, should be independent from the techniques used to study movement. The extent of these determinants' influence can be small and detected only when using specific measurement or research techniques (eg, moments assessed by force plates). Knowledge of the determinants, we contend, is necessary in order to conduct research on the STS movement or to interpret results of reported studies, because the results can be, in part, a function of a determinant.

The STS movement has been studied using standardized clinical tests, which are used in epidemiological studies and clinical testing.1–3,23–28 Measurements of aspects of the STS movement have been obtained using techniques such as use of force plates,20 video analysis,17,29–31 use of optoelectronic systems,13–15,32–35 goniometry,10,36 and accelerometry.37

Because the most recent review on the STS movement was published in 1991,38 we believed an update was necessary to gain insight into studies on the effects of variables on the STS movement, especially in view of the new technology available to study the movement. The aims of our article are to review research on STS movement determinants and to describe the type and magnitude of their influence on the STS movement. In addition, we aimed to expose gaps in the literature and make recommendations for future research.


   Methods
Top
 Abstract
 Introduction
 Methods
STS Movement Determinants in...
 Discussion and Conclusions
 References
 
A search was made using MEDLINE (1980–2001) and the Science Citation Index Expanded of the Institute for Scientific Information (1988–2001) using the key words "chair," "mobility," "rising," "sit-to-stand," and "standing." References such as textbooks, presentations, and reports also were included. After reading the articles or abstracts, studies were included only when quantitative instrumental analyzing techniques were used to study STS movement performance in the subjects (patients and people without known impairments). The studies in this review were included on the basis of their design (ie, the design had to be experimental and aimed at elucidating the effect of determinants on the STS movement by manipulating the variables). Thus, descriptive and comparative studies were excluded, but because we included textbooks, presentations, and similar materials, there was not a requirement that articles be peer reviewed.

The STS movement determinants are factors that influence how the movement is performed. We categorized the studied determinants as chair related (eg, seat height), subject related (eg, age, muscle force), or strategy related (eg, speed or light conditions) (Tab. 1). Strategy-related determinants are those that are related to the execution of the STS movement. Although subject-related determinants can be investigated only by means of comparative studies, which was beyond the scope of our study, the types of patients investigated are indicated in Table 2. We judged studies according to the techniques used (eg, use of force plates, optoelectronic devices, or goniometers), number of movements analyzed, the determinants studied (ie, chair related, subject related, or strategy related), and the dependent variables (Tab. 2).


View this table:
[in this window]
[in a new window] 		Table 1. Number of Experiments Performed in the 39 Reviewed Studies Investigating Determinants of the Sit-to-Stand Movementa

 

View this table:
[in this window]
[in a new window] 		Table 2. Details of the Experimental Studies That Addressed Determinants of the Sit-to-Stand (STS) Movementa

 

   STS Movement Determinants in the Reviewed Studies
Top
 Abstract
 Introduction
 Methods
 STS Movement Determinants in...
Discussion and Conclusions
 References
 
Of the 160 studies identified, we found 39 studies that addressed the effects of determinants on the STS movement using an experimental design (Tab. 2). We did not examine whether the results could be obtained consistently by multiple researchers (ie, we did not examine reliability of these judgments).

Chair-Related Determinants

The literature indicates that the chair has an influence on the performance of the STS movement (eg, the height of the seat can make an STS movement impossible).39 Most research has been focused on the height of the seat, and few studies tried to clarify the influence of the armrest position, use of armrests, or the type of chair on the STS movement.

Seat height.
Lowering the height of the seat makes the STS movement more demanding or even unsuccessful according to the literature we reviewed.10,14,30,39–43 The minimum height for successful rising for elderly people (community-dwelling and nursing home residents 64–105 years of age) with chair rise difficulties appears to be 120% of lower leg length.41 A lower seat apparently leads to increased angular velocity of the hip in order to stand14,30,39,42 and to more repositioning of the feet (also called the "stabilization strategy").14,39 In young subjects (25–36 years of age) without impairments, lowering the seat of the chair from 115% to 65% of knee height results in an increase in trunk flexion angular velocity of almost 100% in order to stand.14 A lower seat has been shown to increase trunk, knee, and ankle angular displacement.30,42,43 Changing the seat height affects the maximum moment needed at the hip and knee.15,42–44 Differences for hip and knee moments can be as large as 50% to 60%, with seat height having a greater influence on the moments needed at the knee than at the hip.15,42–44 The changes in seat height can result in changing biomechanical demands (eg, the need to move the body's center of mass over a larger distance) or in an altered strategy (eg, "stabilization strategy," due to the imposed biomechanical demands by a different foot, trunk, or arm position).

Armrests.
Issues related to the armrest use include positioning of the hands on the armrests, height of the armrests, and the moments exerted. There is no research on the relationship among the height of the armrests, seat height, hand positioning, and their cumulative effect on performance of the STS movement.

Using armrests, according to the articles we reviewed, results in lower moments at knee and hip; at the hip, a reduction of about 50% of the extension moment needed to perform the STS movement has been calculated.40,44,45 Burdett et al40 found no influence of the use of arms on joint angles in subjects without impairments (25–41 years of age). In a study by Alexander et al,46 young and old subjects without impairments used a hand bar positioned in front of them to perform the STS movement. They found no differences in body segment rotations in the young subjects (19–31 years of age). A difference in trunk rotation was observed in the old subjects (63–86 years of age), although this movement was analyzed only at the moment of maximum anterior head displacement.46

Chair type.
We found only 3 studies on the influence of specially designed chairs.30,40,47 Different types of chairs designed to "ease" the STS movement were studied.30,40,47 Wheeler et al47 suggested a negative influence of seat posterior slant because of tilting the body's center of mass farther backward. Use of an ejector mechanism lowered vertical impulses applied to the armrests by 47% in patients with arthritis, but no differences were found for knee and ankle moments.30

Backrests.
We found no experimental studies concerning the influence of backrests on STS movement. In only 8 studies30,39,41,42,45–48 was a chair with a backrest used. When a backrest was used, it was to standardize the STS movement starting position. The influence of trunk position has been studied; however, this influence cannot necessarily be related to backrest use or backrest position, because the trunk position studied was not comparable to the trunk position using a backrest.31

Strategy-Related Determinants

Speed.
Increasing speed of the STS movement increases the hip flexion, knee extension, and ankle dorsiflexion joint moments.13 To increase reproducibility and comparability of the results of their studies, some authors14,18,49 did not allow subjects to rise at their self-selected speeds. Subjects had to rise at a preset speed indicated by, for example, a metronome.18 Other researchers studied the influence of speed on strategy, peak joint moment, phase changes, and lateral displacement. Pai and colleagues33,34 reported that a faster STS movement influences the peak vertical momentum of the center of mass while the peak horizontal momentum remains relatively unchanged (data were given in graphs). A faster STS movement gave a shorter flexion and momentum-transfer phase.19,29 Vander Linden and colleagues19 reported no influence of speed on joint excursions. Gross et al50 and Papa and Cappozzo,51,52 however, described less hip flexion at the moment of seat-off in elderly subjects who stood rapidly. In several studies,48,50,53,54 elderly subjects (64–84 years of age) were less able to increase the speed of their STS movement.

Foot positioning.
Shepherd and colleagues17 studied the effect of foot position (posterior, preferred, and anterior positions) prior to the start of the STS movement, and they showed a shorter movement time with feet placed posterior. With the posterior placement of the feet, hip flexion and hip flexion speed were lowered, whereas anterior placement of the feet increased the pre-extension phase.17 Kawagoe et al55 also showed an influence of posterior foot placement. Positioning the feet more posteriorly enabled lower maximum mean extension moments at the hip (148.8 N·m versus 32.7 N·m) to be used for the STS movement.55 Hughes et al39 described repositioning of the feet as a movement strategy to lower moments used for the STS movement, which they called "stabilization strategy." Munton et al10 found no difference in electromyographic (EMG) activity of 6 large lower-extremity muscle groups with feet placed normal or posterior. Stevens et al56 studied the effect of the initial lower-extremity posture, including foot posture, on the STS movement and reported that the preferred lower-extremity position gives less head movement and lower ground reaction forces.

Trunk positioning/movement.
According to Shepherd and Gentile,31 changing the initial trunk position to have more flexion did not change the peak support moment, but the duration of maximum support moment did increase. The duration of the extension phase also became longer when the trunk initially was more flexed.31 Starting from a trunk position different from erect alters the kinematics and kinetics of the STS movement. For the condition "flexion of the trunk" (first flex the trunk toward the knees, before rising from the chair), Goulart and Valls-Sole37 described a longer movement time than for normal STS movement condition and delayed seat-off, without joint angular changes. This observation was supported by Schenkman et al,21 who described a momentum transfer strategy in which the momentum generated by the upper body is used during the extension phase.

Doorenbosch et al49 studied the effect of an STS strategy aimed at maximum flexion of the trunk during the STS movement. This strategy resulted in kinematic changes around the hip, but the range of motion of the knee and ankle did not change. Using the maximum flexion strategy, 27% lower (net) knee joint moments than in natural rising were found.49

Arm movement.
Study of the STS movement is often done with constraints on the use of the arms.57 In most studies, use of the arms during the STS movement was not allowed. Subjects were often instructed to stand up with their hands in their lap, folded, sideways, placed on the knees, or fixating an object. Some authors16,47 have reported that use of the arms during the STS movement is very common among elderly people and even among young people. Only Carr57 studied the effect of arm movement strategy on the body's center of mass. Arm position during the STS movement appears, based on the literature, to influence the position of the body's center of mass.57 The body's center of mass moves forward at the end of the STS movement when subjects point with their arms.57 Restricting the arms leads to a different pattern of ankle angular displacement, with a much higher mean standard deviation than occurs with the arms free. This finding suggests that more adjustment of the strategy of rising is needed, using ongoing adjustment at the ankle joint during restricted arm movement.57

Terminal constraint.
The terminal constraint is the required body position or activity at the end of the STS movement. The STS movement has been studied while the motion was aimed at standing quietly at the end of the movement. Pai and Lee35 conducted a study with a constraint to fall after the movement instead of standing quietly at the end. No study has quantitatively explored the sit-to-walk movement.

Dark versus light.
Visual control was manipulated while subjects performed the STS movement in light and darkness at 2 speeds.48,53 No effect on movement time was found in young (20–25 years of age) and elderly (71–82 years of age) people when visual control was varied.48,53 The speed of the center of mass, however, was lower in the blindfolded condition for the elderly subjects.53

Fixed joints.
Only one study58 concerned the influence of joint fixation on the level of control of STS movement performance using the so-called "uncontrolled manifold concept" (a cybernetic concept to describe results). This analysis showed that the position of the center of mass in the sagittal plane is controlled. No data on joint angle or angular velocity were given. Another study36 analyzed the relationship between the active limitation in range of motion of the knee following total knee arthroplasty and the height of the seat when rising from a seated position. The subjects with larger limitations in active knee flexion (<100° of knee flexion) required a higher angular velocity of the hip to lift the trunk forward than did those with less limitation of knee flexion (>100° of knee flexion).36

Knee position.
Positioning the knee in more extension than preferred prior to the STS movement appeared to lead to an increase of the hip joint angular displacement, with an increase of hip extension moments of 77%.59 This experimental setup is to some extent comparable to the foot-forward setup as used by Shepherd and Koh17 because foot forward will result in more knee extension.

Attention.
No experimental study addressing the influence of attention on the performance of the STS movement in subjects without impairments could be found.

Training.
Training can be a determinant in an experimental study. Hesse et al60 studied the influence of 4 weeks training (4-week inpatient rehabilitation program; the physical therapists trained the patients to distribute equal weight on both legs and to avoid lateral compensatory tilt of the trunk) on the temporal and spatial variables of the STS movement. Only in a subgroup of people with left hemiparetic strokes was a difference noted.


   Discussion and Conclusions
Top
 Abstract
 Introduction
 Methods
 STS Movement Determinants in...
 Discussion and Conclusions
References
 
Method

General.
In our review, we included only experimental studies. In an experimental study of the STS movement, the determinants are manipulated in order to explore their influence on performance. Not all of the studies reviewed, however, were completely experimental. Some articles included comparative or descriptive data. We believe that experimental studies are important because they provide the strongest evidence concerning the influence of the determinants. In these studies, only one determinant is usually manipulated while others are kept constant. In comparative studies, we believe conclusions are difficult to make because of the nonexperimental design. The relationship between subject-related determinants (eg, age, muscle force) and STS movement performance, in our view, is seldom unambiguous because subject-related determinants are generally examined in nonexperimental studies. For example, the influence of age on the ability to do an STS movement is often studied,46,48,51,53,61–63 with age accounting for small differences in STS movement performance and a decreased ability to decrease movement time. Whether these differences in the STS movement are the result of increased age or of covariates such as muscle force, balance disturbances, neuromusculoskeletal changes, or changed motor control is not clear. Another example concerns muscular force as a determinant of STS movement performance. Less quadriceps femoris muscle force will affect the performance of the STS movement, and the time to do the STS movement will increase.32,50,61,64 Related neuromusculoskeletal changes (eg, loss of trunk muscle force, loss of balance) may influence the performance of the STS movement to the same degree. When these related changes cannot be controlled for in a study, they can become confounding factors influencing the conclusions to be drawn from these studies.

Validity.
Our review of studies on the determinants of what makes the STS movement possible led us to believe that many studies have good internal validity, but we did not use evaluative criteria or examination by multiple authors. There is, in our view, also evidence for construct validity for the measures used, because clinical tests for STS movement performance appear to us to be highly correlated with physical functioning in elderly people.2,3 We question, however, whether the reviewed studies are externally valid for predicting changes in standing up. Standing up from a chair is almost never aimed at standing alone but is part of a goal-oriented behavior, such as going for a walk or picking up an object. Nevertheless, there are examples in which standing up is aimed at simple standing (eg, in church, watching sports).

Variability.
There is intrasubject and intersubject variability in the performance of the STS movement. Variability can be the result of problems in defining the STS movement events, technical problems, or analysis of a low number of STS movements, or it can be considered as a sign of flexibility of performance during the STS movement. To lower variability and to ease analysis of the determinants, many constraints were used in the STS movement studies that we reviewed (Tab. 2). We contend that only in clinical physical performance is testing of the natural STS movement imitated (with self-selected speed and strategy).9,23,24 Other explanations for variability may include a learning effect during performance of the STS movement, fatigue in repeating fast and frequent STS movements, and erroneous instructions leading to misinterpretation.

General Conclusions

In our review, we found that in most studies (27 of the 39 studies), a combination of force plate(s) and a motion analysis system (varying from video to a type of optoelectronic system) was used. Surface EMG analysis was used in 10 of the 39 studies. The number of analyzed STS movements per subject ranged from 1 to 15. In 7 of the 39 studies, only one trial was used for statistical analysis. The number of subjects studied ranged from 2 to 51. We believe, however, that general conclusions can be drawn. The height of the chair seat, the use of armrests, and foot positioning have a major influence on STS movement performance. A higher chair seat results in lower moments at hip and knee level (up to 60% and 50%, respectively).10,14,30,39,40,42–44 Lowering the chair seat will increase the need for generation of momentum or repositioning of the feet to lower the moments needed.14 Comparison of the results of the studies is difficult because of differences in study design and the fact that chair seat height is not always based on lower-extremity length. Using armrests will lower the moments needed at the knee by 50%, probably without influencing the range of motion of the joints.40,44,46 There were no reports on the interaction between the height of the armrests, chair seat height, or hand positioning and their cumulative effect on STS movement performance. Repositioning of feet appears to influence the STS movement strategy, enabling lower peak moments at the hip and knee.17,19,39,55,65 No experimental study was found that addressed the influence of the use of a backrest. The influence of trunk position has been studied; however, trunk position cannot be related to backrest position, because the studied trunk position is not comparable to the trunk position using a backrest.31

Clinical Significance

The ability to perform an STS movement is an important skill. In elderly people, the inability to perform this basic skill can lead to institutionalization, impaired ADL functioning, and impaired mobility.2,3 Consequently, this movement is frequently assessed in clinical practice. Knowledge of determinants of the STS movement, therefore, is important for clinicians interested in evaluating the ability to do an STS movement. For a proper evaluation of the STS movement in a clinical setting, we contend that standardization of the evaluation should be done in regard to type of chair, chair seat height, positioning of feet, and the use of armrests. Results of experimental studies show that these variables influence the performance of the STS movement. Neglecting these variables may result in an inability to measure actual changes in STS movement performance of a patient. Furthermore, problems in STS movement performance may be obscured without standardization. Another consequence may be that apparent changes or discrepancies may not actually be present. All of these factors can lead to suboptimal choices and decisions with respect to prognosis, planning, and therapy.

Recommendations

We believe that in both experimental and comparative STS movement studies, there needs to be control of variables that can influence STS movement performance. Some determinants (eg, chair seat height, speed, position of feet) have been studied extensively. Others (eg, the effects of footwear on STS movement performance) have not been well studied (although the footwear type does influence the performance of the Timed Up & Go Test66). The interaction among determinants has been studied to some extent.19,30,48,53,55 More research is needed, however, on the interaction of variables such as use of armrests, chair seat height, and foot positioning.

All of the studies we examined were directed at the level of impairment. Studying functional performance, in our opinion, should also include testing at the level of skills.67,68 To analyze the skill of a subject to perform the STS movement, it may be necessary to evaluate the abilities of that subject to cope with changing constraints (eg, STS movement at different speeds, at different chair seat heights, STS movement versus sit-to-walk movement, light versus darkness). To gain insight into the influence of the determinants on the STS movement may entail using other biomechanical models or paradigms.68,69 New techniques (eg, ambulatory techniques that register body posture and movements in the real-life environment of the subject) raise new research questions. To enhance the validity of data obtained in future studies and the generalizability of the results, new methods of research (which can be used outside the gait laboratory70), we believe, should be evaluated.


   Footnotes
 
All authors provided concept/idea/research design and writing. Dr Janssen provided data collection and analysis. Dr Stam provided project management, fund procurement, and facilities/equipment. Dr Bussmann and Dr Stam provided consultation (including review of manuscript before submission).

No grants were received for this study.


   References
Top
 Abstract
 Introduction
 Methods
 STS Movement Determinants in...
 Discussion and Conclusions
 References
 

  1. Odding E. Locomotor Disability in the Elderly: An Epidemiological Study of Its Occurrence and Determinants in a General Population of 55 Years and Over [thesis]. Rotterdam, the Netherlands: Erasmus University Rotterdam;1994 .
  2. Guralnik JM, Simonsick EM, Ferrucci L, et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol.1994; 49:M85–M94.
  3. Guralnik JM, Ferrucci L, Simonsick EM, et al. Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med.1995; 332:556–561.[Abstract/Free Full Text]
  4. Coghlin SS, McFadyen BJ. Transfer strategies used to rise from a chair in normal and low back pain subjects. Clin Biomech.1994; 9:85–92.
  5. Hesse S, Schauer M, Malezic M, et al. Quantitative analysis of rising from a chair in healthy and hemiparetic subjects. Scand J Rehabil Med.1994; 26:161–166.[Web of Science][Medline]
  6. Engardt M, Olsson E. Body weight-bearing while rising and sitting down in patients with stroke. Scand J Rehabil Med.1992; 24:67–74.[Web of Science][Medline]
  7. Yoshida K, Iwakura H, Inoue F. 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. Scand J Rehabil Med.1983; 15:133–140.[Web of Science][Medline]
  8. Ada L, Westwood P. A kinematic analysis of recovery of the ability to stand up following stroke. Australian Journal of Physiotherapy.1992; 38:135–142.
  9. Butler PB, Nene AV, Major RE. Biomechanics of transfer from sitting to the standing position in some neuromuscular diseases. Physiotherapy.1991; 77:81–88.
  10. Munton JS, Ellis MI, Wright V. Use of electromyography to study leg muscle activity in patients with arthritis and in normal subjects during rising from a chair. Ann Rheum Dis.1984; 43:63–65.[Abstract/Free Full Text]
  11. Ikeda ER, Schenkman ML, Riley PO, Hodge WA. Influence of age on dynamics of rising from a chair. Phys Ther.1991; 71:473–481.[Abstract/Free Full Text]
  12. Engardt M. Rising and sitting down in stroke patients: auditory feedback and dynamic strength training to enhance symmetrical body weight distribution. Scand J Rehabil Med Suppl.1994; 31:1–57.[Medline]
  13. Pai YC, Rogers MW. Speed variation and resultant joint torques during sit-to-stand. Arch Phys Med Rehabil.1991; 72:881–885.[Web of Science][Medline]
  14. Schenkman ML, Riley PO, Pieper C. Sit to stand from progressively lower seat heights: alterations in angular velocity. Clin Biomech.1996; 11:153–158.
  15. Hughes MA, Schenkman ML. Chair rise strategy in the functionally impaired elderly. J Rehabil Res Dev.1996; 33:409–412.[Web of Science][Medline]
  16. Durward BR. The Biomechanical Assessment of Stroke Patients in Rising to Stand and Sitting Down [thesis]. Glasgow, Scotland: Strathclyde University;1994 .
  17. Shepherd RB, Koh HP. Some biomechanical consequences of varying foot placement in sit-to-stand in young women. Scand J Rehabil Med.1996; 28:79–88.[Web of Science][Medline]
  18. Roebroeck ME, Doorenbosch CA, Harlaar J, et al. Biomechanics and muscular activity during sit-to-stand transfer. Clin Biomech.1994; 9:235–244.
  19. Vander Linden DW, Brunt D, McCulloch MU. Variant and invariant characteristics of the sit-to-stand task in healthy elderly adults. Arch Phys Med Rehabil.1994; 75:653–660.[Web of Science][Medline]
  20. Kralj A, Jaeger RJ, Munih M. Analysis of standing up and sitting down in humans: definitions and normative data presentation. J Biomech.1990; 23:1123–1138.[Web of Science][Medline]
  21. Schenkman ML, Berger RA, Riley PO, et al. Whole-body movements during rising to standing from sitting. Phys Ther.1990; 70:638–648; discussion: 648–651.[Abstract/Free Full Text]
  22. Kotake T, Dohi N, Kajiwara T, et al. An analysis of sit-to-stand movements. Arch Phys Med Rehabil.1993; 74:1095–1099.[Web of Science][Medline]
  23. Mathias S, Nayak US, Isaacs B. Balance in elderly patients: the "get-up and go" test. Arch Phys Med Rehabil.1986; 67:387–389.[Web of Science][Medline]
  24. Podsiadlo D, Richardson S. The timed "Up & Go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc.1991; 39:142–148.[Web of Science][Medline]
  25. Roorda LD, Roebroeck ME, Lankhorst GJ, et al. Measuring functional limitations in rising and sitting down: development of a questionnaire. Arch Phys Med Rehabil.1996; 77:663–669.[Web of Science][Medline]
  26. Thorbahn LD, Newton RA. Use of the Berg Balance Test to predict falls in elderly persons. Phys Ther.1996; 76:576–583; discussion: 584–575.[Abstract/Free Full Text]
  27. Seeman TE, Charpentier PA, Berkman LF, et al. Predicting changes in physical performance in a high-functioning elderly cohort: MacArthur studies of successful aging. J Gerontol.1994; 49:M97–M108.
  28. Berg K, Wood-Dauphinee S, Williams JI, Gayton D. Measuring balance in the elderly: preliminary development of an instrument. Physiotherapy Canada.1989; 41:304–311.
  29. Hanke TA, Pai YC, Rogers MW. Reliability of measurements of body center-of-mass momentum during sit-to-stand in healthy adults. Phys Ther.1995; 75:105–113; discussion: 113–108.[Abstract/Free Full Text]
  30. Munro BJ, Steele JR, Bashford GM, et al. A kinematic and kinetic analysis of the sit-to-stand transfer using an ejector chair: implications for elderly rheumatoid arthritic patients. J Biomech.1998; 31:263–271.[Web of Science][Medline]
  31. Shepherd RB, Gentile AW. Sit-to-stand: functional relationship between upper body and lower limb segments. Human Mov Sci.1994; 13:817–840.
  32. Hughes MA, Myers BS, Schenkman ML. The role of strength in rising from a chair in the functionally impaired elderly. J Biomech.1996; 29:1509–1513.[Web of Science][Medline]
  33. Pai YC, Naughton BJ, Chang RW, Rogers MW. Control of body centre of mass momentum during sit-to-stand among young and elderly adults. Gait Posture.1994; 2:109–116.
  34. Pai YC, Rogers MW. Control of body mass transfer as a function of speed of ascent in sit-to-stand. Med Sci Sports Exerc.1990; 22:378–384.[Web of Science][Medline]
  35. Pai YC, Lee WA. Effect of a terminal constraint on control of balance during sit-to-stand. J Mot Behav.1994; 26:247–256.[Web of Science][Medline]
  36. Itokazu M, Uemura S, Aoki T, Takatsu T. Analysis of rising from a chair after total knee arthroplasty. Bull Hosp Jt Dis.1998; 57:88–92.[Medline]
  37. Goulart FR, Valls-Sole J. Patterned electromyographic activity in the sit-to-stand movement. Clin Neurophysiol.1999; 110:1634–1640.[Web of Science][Medline]
  38. Kerr KM, White JA, Mollan RAB, Baird HE. Rising from a chair: a review of the literature. Physiotherapy.1991; 77:15–19.
  39. Hughes MA, Weiner DK, Schenkman ML, et al. Chair rise strategies in the elderly. Clin Biomech.1994; 9:187–192.
  40. Burdett RG, Habasevich R, Pisciotta J, Simon SR. Biomechanical comparison of rising from two types of chairs. Phys Ther.1985; 65:1177–1183.[Abstract/Free Full Text]
  41. Weiner DK, Long R, Hughes MA, et al. When older adults face the chair-rise challenge: a study of chair height availability and height-modified chair-rise performance in the elderly. J Am Geriatr Soc.1993; 41:6–10.[Web of Science][Medline]
  42. Rodosky MW, Andriacchi TP, Andersson GB. The influence of chair height on lower limb mechanics during rising. J Orthop Res.1989; 7:266–271.[Web of Science][Medline]
  43. Su FC, Lai KA, Hong WH. Rising from chair after total knee arthroplasty. Clin Biomech.1998; 13:176–181.
  44. Arborelius UP, Wretenberg P, Lindberg F. The effects of armrests and high seat heights on lower-limb joint load and muscular activity during sitting and rising. Ergonomics.1992; 35:1377–1391.[Medline]
  45. Seedhom BB, Terayama K. Knee forces during the activity of getting out of a chair with and without the aid of arms. Biomed Eng.1976; 11:278–282.[Web of Science][Medline]
  46. Alexander NB, Schultz AB, Warwick DN. Rising from a chair: effects of age and functional ability on performance biomechanics. J Gerontol.1991; 46:M91–M98.
  47. Wheeler J, Woodward C, Ucovich RL, et al. Rising from a chair: influence of age and chair design. Phys Ther.1985; 65:22–26.[Abstract/Free Full Text]
  48. Mourey F, Pozzo T, Rouhier-Marcer I, Didier JP. A kinematic comparison between elderly and young subjects standing up from and sitting down in a chair. Age Ageing.1998; 27:137–146.[Abstract/Free Full Text]
  49. Doorenbosch CA, Harlaar J, Roebroeck ME, Lankhorst GJ. Two strategies of transferring from sit-to-stand: the activation of monoarticular and biarticular muscles. J Biomech.1994; 27:1299–1307.[Web of Science][Medline]
  50. Gross MM, Stevenson PJ, Charette SL, et al. Effect of muscle strength and movement speed on the biomechanics of rising from a chair in healthy elderly and young women. Gait Posture.1998; 8:175–185.[Web of Science][Medline]
  51. Papa E, Cappozzo A. Sit-to-stand motor strategies investigated in able-bodied young and elderly subjects. J Biomech.2000; 33:1113–1122.[Web of Science][Medline]
  52. Papa E, Cappozzo A. A telescopic inverted-pendulum model of the musculo-skeletal system and its use for the analysis of the sit-to-stand motor task. J Biomech.1999; 32:1205–1212.[Web of Science][Medline]
  53. Mourey F, Grishin A, d'Athis P, et al. Standing up from a chair as a dynamic equilibrium task: a comparison between young and elderly subjects. J Gerontol A Biol Sci Med Sci.2000; 55:B425–B431.[Abstract/Free Full Text]
  54. Hesse S, Schauer M, Jahnke M. Standing-up in healthy subjects: symmetry of weight distribution and lateral displacement of the centre of mass as related to limb dominance. Gait Posture.1996; 4:287–292.
  55. Kawagoe S, Tajima N, Chosa E, et al. Biomechanical analysis of effects of foot placement with varying chair height on the motion of standing up. J Orthop Sci.2000; 5:124–133.[Medline]
  56. Stevens C, Bojsen-Moller F, Soames RW. The influence of initial posture on the sit-to-stand movement. Eur J Appl Physiol.1989; 58:687–692.[Web of Science]
  57. Carr JH. Balancing the centre of body mass during standing up. Physiotherapy Theory and Practice.1992; 8:159–164.
  58. Scholz JP, Schoner G. The uncontrolled manifold concept: identifying control variables for a functional task. Exp Brain Res.1999; 126:289–306.[Web of Science][Medline]
  59. Fleckenstein SJ, Kirby RL, MacLeod DA. Effect of limited knee-flexion range on peak hip moments of force while transferring from sitting to standing. J Biomech.1988; 21:915–918.[Web of Science][Medline]
  60. Hesse S, Schauer M, Petersen M, Jahnke M. Sit-to-stand manoeuvre in hemiparetic patients before and after a 4-week rehabilitation programme. Scand J Rehabil Med.1998; 30:81–86.[Web of Science][Medline]
  61. Alexander NB, Schultz AB, Ashton-Miller JA, et al. Muscle strength and rising from a chair in older adults. Muscle Nerve Suppl.1997; 5:S56–S59.[Medline]
  62. Baer GD, Ashburn AM. Trunk movements in older subjects during sit-to-stand. Arch Phys Med Rehabil.1995; 76:844–849.[Web of Science][Medline]
  63. Millington PJ, Myklebust BM, Shambes GM. Biomechanical analysis of the sit-to-stand motion in elderly persons. Arch Phys Med Rehabil.1992; 73:609–617.[Web of Science][Medline]
  64. Scarborough DM, Krebs DE, Harris BA. Quadriceps muscle strength and dynamic stability in elderly persons. Gait Posture.1999; 10:10–20.[Web of Science][Medline]
  65. Khemlani MM, Carr JH, Crosbie WJ. Muscle synergies and joint linkages in sit-to-stand under two initial foot positions. Clin Biomech.1999; 14:236–246.[Medline]
  66. Arnadottir SA, Mercer VS. Effects of footwear on measurements of balance and gait in women between the ages of 65 and 93 years. Phys Ther.2000; 80:17–27.[Abstract/Free Full Text]
  67. Rozendal RH. Clinical gait analysis: problems and solutions? Human Mov Sci.1991; 10:555–564.
  68. Mulder T, Nienhuis B, Pauwels J. Clinical gait analysis in a rehabilitation context: some controversial issues. Clin Rehabil.1998; 12:99–106.[Abstract/Free Full Text]
  69. Roberts PD, McCollum G. Dynamics of the sit-to-stand movement. Biol Cybern.1996; 74:147–157.[Web of Science][Medline]
  70. Bussmann HB, Reuvekamp PJ, Veltink PH, et al. Validity and reliability of measurements obtained with an "activity monitor" in people with and without a transtibial amputation. Phys Ther.1998; 78:989–998.[Abstract/Free Full Text]

Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?


This article has been cited by other articles:


Home page
 Human Factors: The Journal of the Human Factors and Ergonomics SocietyHome page
M. F. Story, A. C. Luce, A. Leung, E. M. Omiatek, M. R. Lemke, and D. M. Rempel
Accessibility of radiology equipment for patients with mobility disabilities.
Human Factors: The Journal of the Human Factors and Ergonomics Society, October 1, 2008; 50(5): 801 - 810.
[Abstract] [PDF]

Home page
 Clin RehabilHome page
E. Britton, N. Harris, and A. Turton
An exploratory randomized controlled trial of assisted practice for improving sit-to-stand in stroke patients in the hospital setting
Clinical Rehabilitation, May 1, 2008; 22(5): 458 - 468.
[Abstract] [PDF]

Home page
 ptjournalHome page
B. Etnyre and D. Q Thomas
Event Standardization of Sit-to-Stand Movements
Physical Therapy, December 1, 2007; 87(12): 1651 - 1666.
[Abstract] [Full Text] [PDF]

Home page
 ptjournalHome page
M. Schenkman, J. E Deutsch, and K. M Gill-Body
An Integrated Framework for Decision Making in Neurologic Physical Therapist Practice
Physical Therapy, December 1, 2006; 86(12): 1681 - 1702.
[Abstract] [Full Text] [PDF]

Home page
 Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
T. M. Manini, S. B. Cook, T. VanArnam, M. Marko, and L. Ploutz-Snyder
Evaluating task modification as an objective measure of functional limitation: repeatability and comparability.
J. Gerontol. A Biol. Sci. Med. Sci., July 1, 2006; 61(7): 718 - 725.
[Abstract] [Full Text] [PDF]

Home page
 Br. J. Sports. Med.Home page
J B Feland, R Hager, and R M Merrill
Sit to stand transfer: performance in rising power, transfer time and sway by age and sex in senior athletes
Br. J. Sports Med., November 1, 2005; 39(11): e39 - e39.
[Abstract] [Full Text] [PDF]

Home page
 ptjournalHome page
V. Dubost, O. Beauchet, P. Manckoundia, F. Herrmann, and F. Mourey
Decreased Trunk Angular Displacement During Sitting Down: An Early Feature of Aging
Physical Therapy, May 1, 2005; 85(5): 404 - 412.
[Abstract] [Full Text] [PDF]

This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Rapid Responses are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Janssen, W. G.
Right arrow Articles by Stam, H. J
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Janssen, W. G.
Right arrow Articles by Stam, H. J
Related Collections
Right arrow Gait and Locomotion Training
Right arrow Evidence-Based Practice
Social Bookmarking
Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2002 by the American Physical Therapy Association.