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.

BackgroundYoungsters with unilateral congenital below-elbow deficiency (UCBED) seem to function well with or without a prosthesis. Reasons for rejecting prostheses have been reported earlier, but unfortunately not those of the children themselves. Furthermore, reasons for acceptance are underexplored in the literature.ObjectivesTo investigate opinions of children and early and late adolescents with UCBED, and those of their parents and healthcare professionals, concerning (1) reasons to wear or not to wear prostheses and (2) about rehabilitation care.MethodsDuring one week of online focus group interviews, 42 children of 8–12 y/o, early and late adolescents of 13–16 and 17–20 y/o, 17 parents, and 19 healthcare professionals provided their opinions on various topics. This study addresses prosthetic use or non-use of prosthetics and rehabilitation care. Data were analyzed using the framework approach.ResultsCosmesis was considered to be the prime factor for choosing and wearing a prosthesis, since this was deemed especially useful in avoiding stares from others. Although participants functioned well without prostheses, they agreed that it was an adjuvant in daily-life activities and sports. Weight and limited functionality constituted rejection reasons for a prosthesis. Children and adolescents who had accepted that they were different no longer needed the prosthesis to avoid being stared at. The majority of participants highly valued the peer-to-peer contact provided by the healthcare professionals.ConclusionsFor children and adolescents with UCBED, prostheses appeared particularly important for social integration, but much less so for functionality. Peer-to-peer contact seemed to provide support during the process of achieving social integration and should be embedded in the healthcare process.

Accelerometry is frequently used in movement analysis to assess body postures and motions. Here, we assessed the validity of ambulatory accelerometric measurement of the sit-to-stand (STS) movement duration. We compared accelerometric and opto-electronic assessment of the STS movement duration under four conditions (comfortable, slow, fast movement and exaggerated trunk flexion) with six healthy subjects and six subjects with stroke who performed movements six times under each condition. Accelerometric and opto-electronic data of STS movement duration were strongly related (r = 0.98). Accelerometry showed a fixed bias of 0.07 s (95% CI 0.008, 0.141) in healthy subjects and 0.32 s (95% CI 0.223, 0.422) in stroke subjects. In healthy subjects, a significant negative proportional bias of 0.1 was detected (95% CI -0.160, -0.032). Accelerometry showed discriminative validity in comparing stroke subjects to healthy subjects, and in comparing speed conditions. Our results indicate that accelerometry can provide valid data on the STS movement duration, furthermore during its use additional information on the STS movement, such as balance control, can be recorded.

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Piezoresistive accelerometer signals are frequently used in movement analysis. However, their use and interpretation are complicated by the fact that the signal is composed of different acceleration components. The aim of the study was to obtain insight into the components of accelerometer signals from the trunk and thigh segments during four different sit-to-stand (STS) movements (self-selected, slow, fast and fullflexion). Nine subjects performed at least six trials of each type of STS movement. Accelerometer signals from the trunk and thigh in the sagittal direction were decomposed using kinematic data obtained from an opto-electronic device. Each acceleration signal was decomposed into gravitational and inertial components, and the inertial component of the trunk was subsequently decomposed into rotational and translational components. The accelerometer signals could be reliably reconstructed: mean normalised root mean square (RMS) trunk: 6.5% (range 3-12%), mean RMS thigh: 3% (range 2-5%). The accelerometric signals were highly characteristic and repeatable. The influence of the inertial component was significant, especially on the timing of the specific event of maximum trunk flexion in the accelerometer signal. The effect of inertia was larger in the trunk signal than in the thigh signal and increased with higher speeds. The study provides insight into the acceleration signal, its components and the influence of the type of STS movement and supports its use in STS movement analysis.

Objectives:To describe the course of walking behaviour over a period of 1 year after stroke, using accelerometry, and to compare 1-year data with those from a healthy group. Design: One-year follow-up cohort study. Subjects: Twenty-three stroke patients and 20 age-matched healthy subjects. Methods: Accelerometer assessments were made in the participants' daily environment for 8 h/day during the 1 st (T1), 12 th (T2) and 48 th (T3) weeks after stroke, and at one timepoint in healthy subjects. Primary outcomes were: percentage of time walking and upright (amount); mean duration and number of walking periods (distribution); step regularity and gait symmetry (quality); and walking speed. Step regularity, gait symmetry and gait speed showed a tendency to increase consistently from T1 to T3. At T3, amount and distribution variables reached the level of the healthy group, but significant differences remained (p < 0.02) in step regularity and gait speed. Conclusion: In this cohort, different outcomes of walking behaviour showed different patterns and levels of recovery, which supports the multi-dimensional character of gait.

STS-related functioning improved significantly in the first year after stroke, with the most improvement occurring during the first 12 weeks. After 12 weeks, rising speed, gait speed, and BI continue to improve.