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.
Footnotes
Dr Burnfield, Mr Buster, Mr Taylor, and Dr Goldman provided concept/idea/research design. All authors provided writing. Mr Buster, Mr Taylor, and Dr Goldman provided data collection. Dr Burnfield, Dr McCrory, Dr Shu, Mr Buster, and Mr Taylor provided data analysis. Dr Burnfield and Dr McCrory provided project management. Dr Burnfield provided fund procurement and facilities/equipment. Dr Shu provided consultation (including review of manuscript before submission).
This study was approved by the Madonna Rehabilitation Hospital Research Review Board.
This research was presented at the 33rd Annual Meeting of the American Society of Biomechanics; August 18–21, 2010; Providence, Rhode Island, and the 2011 International Stroke Conference; February 9–11, 2011; Los Angeles, California.
This research was supported, in part, by the Undergraduate Creative Activities and Research Experiences Program, Agricultural Research Division grants from the University of Nebraska-Lincoln, and the Donald and Pearl Winkler for Stroke Research Institute Endowment.
- Received December 12, 2012.
- Accepted April 25, 2013.
- © 2013 American Physical Therapy Association
Issue highlights
