title: Comparative kinematic and electromyographic assessment of clinician- and device-assisted sit-to-stand transfers in patients with stroke.
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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors: J.M. Burnfield, PT, PhD, Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospital, 5401 South St, Lincoln, NE 68506 (USA).
authors: Judith M
authors: JM
authors: Burnfield
authors: Bernadette
authors: B
authors: McCrory
authors: Yu
authors: Y
authors: Shu
authors: Thad W
authors: TW
authors: Buster
authors: Adam P
authors: AP
authors: Taylor
authors: Amy J
authors: AJ
authors: Goldman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000843:Ankle Joint / Q000502:physiology; D001696:Biomechanical Phenomena; D003430:Cross-Sectional Studies; D004576:Electromyography; D005260:Female; D006621:Hip Joint / Q000502:physiology; D006801:Humans; D007719:Knee Joint / Q000502:physiology; D035002:Lower Extremity / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology; D055805:Moving and Lifting Patients; D018482:Muscle, Skeletal / Q000502:physiology; D010291:Paresis / Q000209:etiology; D012656:Self-Help Devices; D020521:Stroke / Q000150:complications*; D060726:Torso / Q000502:physiology