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 using 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 experienced a stroke.
Design Cross-sectional, controlled laboratory study that used a repeated measures design.
Methods The duration, joint kinematics and muscle activity of four sit-to-stand transfer conditions were compared for 10 stroke patients. Each patient performed four randomized sit-to-stand transfer conditions: clinician-assisted (CA), device-assisted with no patient effort (D-NE), device-assisted with patient's best effort (D-BE), and device- and clinician-assisted (D-CA).
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.
Limitations 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, suggesting that it is possible to safely practice transfers while challenging key leg muscles essential for standing. Future sit-to-stand devices should not only promote safety for the patient and clinician, but also encourage a movement pattern that more closely mimics normal sit-to-stand biomechanics.
- Received December 12, 2012.
- Accepted April 25, 2013.
- © 2013 American Physical Therapy Association