Computational protocol: Effect of Handrail Height on Sit-To-Stand Movement

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Protocol publication

[…] Subjects were 16 healthy young adults aged 21–43 years (15 men and one woman; mean age, 23.2 ± 5.3 years; mean height, 172.6 ± 5.8 cm; mean weight, 65.2 ± 6.7 kg; mean ± standard deviation) and 25 care-needing older adults aged 65–93 years (three men and 22 women; mean age, 77.5 ± 8.4 years; mean height, 152.3 ± 8.0 cm; mean weight, 51.6 ± 7.3 kg). Healthy young adults were excluded if they had a history of a musculoskeletal or neurological disorder. Care-needing older adults included two people with cancer, six with Parkinson’s syndrome, five with diabetes mellitus, five with cerebrovascular diseases, two with cardiovascular diseases, two with respiratory diseases, one with visual impairment, and two with arteriosclerosis obliterans. Care-needing older adults used a handrail during STS movement as usual, and were excluded if they had dementia. All were physically capable of performing STS movement independently using a handrail. Comparison of the characteristics in the two groups revealed significant differences in height and weight (P < .001 for both; paired t-test). Written informed consent was obtained from all participants after explanation of the details of this study. The study protocol was approved by the Clinical Review Board of the Faculty of Medicine, Kagoshima University.A 3-D motion analyzer (VICON MX3; Oxford Metrics, Oxford, UK) comprising seven cameras and three force plates (OR6-7, BP400600; Advanced Mechanical Technology, MA, USA) were used to perform kinetic and kinematic measurements during STS movement by healthy young adults. We used three force plates, two of which were placed below the right and left feet respectively, and the third of which was placed under the chair. The sampling frequency was 100 Hz for the motion data and 1000 Hz for the FRF. A video camera (Sony DCR150; Sony Inc., Tokyo, Japan) was used to perform kinematic measurements on care-needing older adults, with a sampling frequency of 60 Hz.STS movement was compared for three conditions: no handrail (“Without”), high handrails (“High”), and low handrails (“Low”). Height-adjustable handrails were placed on either side of the participant. The subjects were instructed to grip the handrail in a way that facilitated the STS movement and to perform the STS movement at a spontaneous speed. Both arms were crossed above the chest during the Without condition.The height of the handrails was adjusted to the greater trochanter in the standing position (High) or the sitting position (Low), bilaterally. At the start, the participant was seated with their knee at 90 degrees degrees (). The order of conditions was randomized and measurements were taken after three practice trials. The average for the bilateral lower limb in three measurements was used for data analysis.Reflective markers were attached to landmarks on the healthy young adults prior to taking measurements. The Plug-in-Gait model was used for the marker set and analyzed with the 3-D motion analyzer and force plate []. For care-needing older adults, reflective markers were attached to the acromion, greater trochanter, lateral epicondyle of the femur, and ankle joint lateral malleolus.Seat-off is a key instance in STS movement when postural control is most difficult and there is a large load on the lower limb, and has been analyzed by Mark et al [] and Papa et al []. The seat-off event was decided by the FRF of the chair for young adults, and by visual observation for care-needing older adults. Therefore, we analyzed the kinetic and kinematic data at seat-off. Segments were defined and the forward tilt angle of the trunk, hip flexion angle, knee flexion angle, and ankle dorsiflexion angle when the gluteal region left the chair (“seat-off”), and COG during seat-off were measured on the sagittal plane. The forward tilt angle of the trunk was calculated as the angle between the trunk segment and vertical line; a positive value indicates the forward tilt. The vertical and forward/backward components of the FRF were normalized according to the participant’s weight. The instance position of the COG was calculated as the position relative to the ankle joint; positive values indicate a forward shift of the COG. ImageJ (National Institutes of Health; Bethesda, MD, USA) was used to analyze data from care-needing older adults. Positional information from the acromion and greater trochanter markers was used to calculate the trunk forward tilt angle at seat-off. Prior to this study, we tested the consistency between the trunk tilt angles during STS movement measured by the 3-D motion analysis and the video camera using the intraclass correlation coefficient (ICC). A high consistency was observed between those angles (ICC(2,1), 0.971; P < .001).One-way repeated measures analysis of variance (ANOVA) was performed with handrail height as a factor to test the effects of the handrail on the various indicators in healthy young adults. Two-way repeated measures ANOVA was performed to test the trunk forward tilt angle at seat-off with group (healthy young adults vs. care-needing older adults) and handrail height as factors. Prior to the repeated measures ANOVA, we tested the sphericity. If sphericity was not assumed, the Greenhouse–Geisser method was used for analysis. When a significant interaction was found, an unpaired t-test was used to examine the differences between groups, and one-way ANOVA was used to examine the effects of handrail height. The Bonferroni method was used for the post hoc test. All statistical analyses were performed with SPSS 20.0 (SPSS; Chicago, IL, USA), with a level of statistical significance of 5%. […]

Pipeline specifications

Software tools ImageJ, SPSS
Applications Miscellaneous, Microscopic phenotype analysis
Diseases Oculocerebrorenal Syndrome