title: Sit-to-stand biomechanics of individuals with multiple sclerosis.
abstract: BACKGROUND
  It is unclear how people with multiple sclerosis, who often have compromised strength and balance, compare to healthy controls during sit-to-stand movements. The purpose of this study was to compare sit-to-stand biomechanics among three groups: people with multiple sclerosis who exhibit leg weakness, people with multiple sclerosis who have comparable strength to controls, and healthy controls.
  
  
  METHODS
  Twenty-one individuals with multiple sclerosis (n=10 exhibiting leg weakness: n=11 exhibiting comparable strength to controls), and 12 controls performed five sit-to-stand trials while kinematic data and ground reaction forces were captured. ANOVAs followed by Tukey's post-hoc tests (α=0.05) were used to determine group and limb differences for leg strength, movement time, and sagittal-plane joint kinematics and kinetics.
  
  
  RESULTS
  Persons with multiple sclerosis exhibiting leg weakness displayed decreased leg strength, greater trunk flexion, faster trunk flexion velocity and decreased knee extensor power compared to the other two groups (p<0.05; d≥0.87), and slower rise times compared to controls(p<0.03; d≥1.17). No differences were found between controls and the multiple sclerosis-comparable strength group. Across all 3 groups, leg strength was moderately correlated with trunk kinematics and knee extensor velocities, moments and powers of the sit-to-stand (p≤0.05).
  
  
  CONCLUSIONS
  Participants with multiple sclerosis exhibiting leg weakness took longer to stand and appeared to use a trunk-flexion movement strategy when performing the sit-to-stand. The majority of group differences appear to be a result of leg extension weakness. Treatment that includes leg strengthening may be necessary to improve sit-to-stand performance for people with multiple sclerosis.
authors.affiliation: Department of Health and Nutritional Sciences, South Dakota State University, Brookings, SD, USA. Electronic address: bradley.bowser@sdstate.edu.
authors.forename: Bradley
authors.initials: B
authors.lastname: Bowser
authors.affiliation: Columbia University, New York, NY, USA.
authors.forename: Sean
authors.initials: S
authors.lastname: O'Rourke
authors.affiliation: Department of Kinesiology, University of Georgia, Athens, GA, USA. Electronic address: browncn@uga.edu.
authors.forename: Cathleen N
authors.initials: CN
authors.lastname: Brown
authors.affiliation: Department of Kinesiology, University of Georgia, Athens, GA, USA. Electronic address: ljwhite@uga.edu.
authors.forename: Lesley
authors.initials: L
authors.lastname: White
authors.affiliation: Department of Kinesiology, University of Georgia, Athens, GA, USA. Electronic address: kjsimpsonuga@gmail.com.
authors.forename: Kathy J
authors.initials: KJ
authors.lastname: Simpson
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D016022:Case-Control Studies; D005260:Female; D006615:Hip / Q000502:physiology / Q000503:physiopathology; D006801:Humans; D007717:Knee / Q000502:physiology / Q000503:physiopathology; D007719:Knee Joint; D007866:Leg / Q000502:physiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009068:Movement; D009103:Multiple Sclerosis / Q000503:physiopathology*; D053580:Muscle Strength; D010291:Paresis; D011187:Posture; D016059:Range of Motion, Articular; D060726:Torso
keywords: Disability; Ground reaction forces; Joint kinetics; Lower extremity strength; Standing up; Trunk kinematics