Perception of Weight-Bearing and Effort Distribution during Sit-to-Stand in Individuals Post-Stroke

Abstract

The objectives were to assess whether individuals who are poststroke can rate their perceived knee effort distribution during sit-to-stand tasks in various foot positions, to quantify their errors of perception and to compare these to their errors in weight-bearing perception. Weight-bearing distribution was assessed in hemiparetic participants (N = 19) using a force platform. Electromyographic (EMG) data normalized to maximal EMG values were used to quantify knee effort distribution. The difference between participants' real weight bearing and knee effort and the perceived values rated on a visual analog scale defined their errors of weight-bearing and effort perception. The perception of effort and weight bearing, and the errors therein, were compared among the four foot positions. Participants perceived only the changes induced by the different foot positions on their weightbearing distribution, not on their knee effort distribution, and they made greater perception errors with the knee effort distribution than with the weight-bearing distribution.

Determinants of sit-to-stand tasks in individuals with hemiparesis post stroke: A review

“…However, the study by Briè re et al [43] has revealed that patients are better at perceiving their WB than their knee efforts. Thus, the focus should be on asking the patients to increase the weight under the affected foot and not to increase their effort [43].…”

“…However, the study by Briè re et al [43] has revealed that patients are better at perceiving their WB than their knee efforts. Thus, the focus should be on asking the patients to increase the weight under the affected foot and not to increase their effort [43]. Placing the affected foot posterior to the unaffected foot will help increase the weight taken by the affected limb [9,18,24].…”

“…For those who had mild and moderate knee strength impairment, knee efforts and WB were similar [42] revealing that the strategy adopted by the participants depended on the level of strength deficit. However, the same authors demonstrated that the intraclass correlation coefficient (ICC) between real distribution and perception scores was greater for WB than for level of effort, 0.358 and 0.061 respectively [43] revealing that participants poststroke were not able to judge their perception of effort at the knees.…”

Effects of foot pressure using the elastic band with rings during sit-to-stand in persons with stroke

“…According to Brière et al [2], it is better to perceive the affected side than to increase the knee effort. When patients first attempt to stand from a sitting position following a stroke, they tend to load their weight on the less-affected side due to non-use syndrome [29,30].…”

“…There is also a tendency toward asymmetric weight-bearing during STS because patients usually support themselves with the non-paretic foot [2]. Engardt and Olsson [3] reported that, following stroke, patients performed more asymmetric weight-bearing with the less-affected leg.…”