BackgroundCare-needing older adults and disabled individuals often require handrails for assistance of movements, such as sit-to-stand movements. Handrails must be set at the appropriate position; however, the effects of handrail height on joint movement and center-of-gravity movements during sit-to-stand movement remain unclear. In the present study, we sought to clarify the effects of handrail height on joint movement, center-of-gravity, and floor reaction force during sit-to-stand movement.MethodsSubjects included 16 healthy young adults and 25 older adults who require long-term care. Kinetic and kinematic measurements during sit-to-stand movement of young adults were conducted using a 3-D motion analyzer and a force plate. Trunk forward tilt angle during sit-to-stand movement of older adults was measured using a still image from a video recording.ResultsUsing low handrails, sit-to-stand movement resulted in an increased hip flexion angle, ankle dorsiflexion angle, and trunk forward tilt angle and a greater forward center-of-gravity shift than when not using handrails in young adults during seat-off. In contrast, using high handrails resulted in a smaller hip flexion angle and trunk forward tilt angle in young adults. The backward force on the floor was decreased in the low handrail condition, and was increased in the high handrail condition rather than that of sit-to-stand movement without handrails in young adults. The effect of handrail height on trunk forward tilt angle was the same in both healthy young adults and care-needing older adults during seat-off.ConclusionBecause handrail height affects joint movement and shift in the center-of-gravity during sit-to-stand movement, handrail position should be selected to match the status of older adults with functional impairment.
The `high and low' handrail position best facilitates STS movement in the elderly by reducing the time needed to perform STS movements and by reducing the torque and subsequent wear on the joints and muscles.
In this research, aiming to develop a walking assistance dolly which provides assistance in rising to stand, we analyzed the action of standing up and made an improved prototype walking dolly. For the analysis of the standing up action we measured the leg joints' torque of 20 healthy university students, who used two handrails at different heights in five patterns of standing up action, with a floor reaction force plate and a 3D motion analysis system. The leg joints' torque was highest without the handrails and decreased in the order of low handrails, changing grip from a low to a high handrail, high handrails and simultaneous grip of a low and a high handrail, and significant differences were found in one-way ANOVA. In comparison of the leg joints, the hip joint showed a significantly high torque value (p < 0.05). Elderly residents at a care facility who used the prototype walking dolly responded in interviews that, with the dolly, standing up was easy and that all kinds of standing up were possible.
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