Relationship of Knee Extension Force to Independence in Sit-to-Stand Performance in Patients Receiving Acute Rehabilitation

Abstract

Background and Purpose. The ability to rise from a chair is important for independence in everyday life. This study was conducted to determine to what extent knee extension force (KEF) could explain independence in sit-to-stand (STS) performance from a standard chair. Subjects and Methods. This was a descriptive and correlational study of patients receiving acute rehabilitation (N=107). Measurements of KEF of both lower extremities were obtained using manual muscle testing (MMT) and hand-held dynamometers (HHDs). The HHD measurements were normalized based on body weight and age- and sex-specific reference values. Measurements of the ability to stand without using the upper extremities (STS [without hands]) and to stand using the upper extremities (STS [with hands]) were correlated with the force measurements. Results. The correlations (r) of the KEF measurements with STS success ranged from .652 to .708 for STS (without hands) and from .545 to .638 for STS (with hands). Body weight added to the explanation of STS (without hands) (R=.662) and STS (with hands) (R=.584) provided by KEF measured by HHD. The receiver operating characteristic curves showed that HHD (weight normalized) was the most sensitive and specific measure for explaining independence in STS. Discussion and Conclusion. Manual and dynamometric measurements of KEF are related to independence in STS. Measurements of KEF quantified with a dynamometer and normalized against body weight provided the most valid, specific, and sensitive cutoff point for explaining STS independence.

Objectively Measured Physical Activity and Its Association with Functional Independence, Quality of Life and In-Hospital Course of Recovery in Elderly Patients with Proximal Femur Fractures: A Prospective Cohort Study

“…Furthermore the participants' nutritional status was assessed with the questions: "Have you lost weight in the last 6 months" (current weight loss) and "Have you eaten less than usual in the past week" (eating reduction), which combined with the body mass index (BMI) and severity of the illness gives the Nutritional Risk Screening (NRS-2002) score [24,25]. As a proxy for prefall frailty, a retrospective one repetition Sit-to-Stand test (STS) [26,27] was acquired by asking the participants "Do you use your hands for support when you rise from a chair. " A preadmission mobility category (premobility) was assessed for each patient; no walking ability (bedridden) (corresponds to 1), need for aiding devices (corresponds to 2) or walking without help (corresponds to 3).…”

White Paper

“…Eriksrud and Bohannon found the minimum lower extremity strength necessary to rise from a chair without arm assistance is 40% to 47% of a person's body weight, equating to a 5/5 grade for the quadriceps on one side and 4+/5 grade on the other using the MMT scale. 25 If strength is graded as 4/5 and 5/5 or "within functional limits" without examining performance of functional activity, important impairments of muscle performance will not be identified.…”

Comparison of Older Adults Walking with An Anterior, Posterior and without A Wheeled Walker

“…Another reason for this difference in opinion could be the type of disability experienced by these two groups. Older adults have decreased balance, strength and range of motion due to aging 7,43,44 . Children with CP have an upper motor neuron disorder which causes spasticity and poor motor control 45,46 .…”