Instrumented Analysis of the Sit-to-Stand Movement for Geriatric Screening: A Systematic Review

Abstract

The Sit-to-Stand (STS) is a widely used test of physical function to screen older people at risk of falls and frailty and is also one of the most important components of standard screening for sarcopenia. There have been many recent studies in which instrumented versions of the STS (iSTS) have been developed to provide additional parameters that could improve the accuracy of the STS test. This systematic review aimed to identify whether an iSTS is a viable alternative to a standard STS to identify older people at risk of falling, frailty, and sarcopenia. A total of 856 articles were found using the search strategy developed, with 12 articles retained in the review after screening based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Six studies evaluated the iSTS in fallers, five studies in frailty and only one study in both fallers and frailty. The results showed that power and velocity parameters extracted from an iSTS have the potential to improve the accuracy of screening when compared to a standard STS. Future work should focus on standardizing the segmentation of the STS into phases to enable comparison between studies and to develop devices integrated into the chair used for the test to improve usability.

Comparison of Human Interpretation and a Rule-Based Algorithm for Instrumented Sit-to-Stand Test

“…Previous studies have attempted to capture the dynamics of 5STS using different sensors such as accelerometers, motion capture devices, force plates, depth cameras, and RGB cameras. [18][19][20][26][27][28][29] Shukla et al 19) showed that a force plate or loadcell-embedded seat could more accurately capture 5STS than depth or RGB cameras, with a smaller mean error size compared to a human expert examiner. In the study, 19) the results of the phase-determination rule-based algorithm interpreting the time-weight curve of a loadcell-embedded chair were generally similar, although researchers adopted a percent cut-off value to define phases rather than the absolute weight value as used in the present study.…”

“…Among the various tools used to assess the physical performance of lower extremities, the five times sit-to-stand test (5STS) is one of the most commonly used tests owing to its advantages in clinical implementation. 18 ) The test can be performed in clinical environments with restricted time and space. 19 ) 5STS is included in the consensus definition for sarcopenia, either as a separate test (≥12 seconds for impaired physical performance) or as a component of the Short Physical Performance Battery (SPPB) score (with scores ≤9 indicating impaired physical performance).…”

“… 2 ) While most studies have adopted 5STS using a simple chair and stopwatch, researchers have also developed instrumented approaches using sensors of varying modalities to automatically or semi-automatically acquire 5STS measurements to minimize inter-rater variability and collect additional information during test protocols. 18 - 21 )…”

“…ies have adopted 5STS using a simple chair and stopwatch, researchers have also developed instrumented approaches using sensors of varying modalities to automatically or semi-automatically acquire 5STS measurements to minimize inter-rater variability and collect additional information during test protocols. [18][19][20][21] We previously developed a multi-sensor kiosk to semi-automatically perform SPPB using light detection and ranging (LiDAR) and loadcells to facilitate physical performance assessments in both clinical and research settings. 21) Electronic SPPB (eSPPB) was comparable to SPPB performed manually by a single experienced examiner.…”

An Embodied Sonification Model for Sit-to-Stand Transfers

“…Several linear kinematic parameters have been found to differentiate pathological and non-pathological STS, such as vertical, mediolaterial and anteroposterior acceleration, anteroposterior jerk, and vertical linear velocity (Millor et al, 2014 ). Velocity and acceleration measures during STS have shown potential in geriatric screening as well (Shukla et al, 2020 ). There are also some clinically relevant angular kinematic parameters such as knee extensor velocity and trunk tilt (Millor et al, 2014 ).…”