Biomechanical analyses of rising from a chair

Quantification of the biomechanical factors that underlie the inability to rise from a chair can help explain why this disability occurs and can aid in the design of chairs and of therapeutic intervention programs. Experimental data collected earlier from 17 young adult and two groups of elderly subjects, 23 healthy and 11 impaired, rising from a standard chair under controlled conditions were analyzed using a planar biomechanical model. The joint torque strength requirements and the location of the floor reaction force at liftoff from the seat in the different groups and under several conditions were calculated. Analyses were also made of how body configurations and the use of hand force affect these joint torques and reaction locations.

In all three groups, the required torques at liftoff were modest compared to literature data on voluntary strengths. Among the three groups rising with the use of hands, at the time of liftoff from the seat, the impaired old subjects, on an average, placed the reaction force the most anterior, the healthy old subjects placed it intermediately and the young subjects placed it the least anterior, within the foot support area. Moreover, the results suggest that, at liftoff, all subjects placed more importance on locating the floor reaction force to achieve acceptable postural stability than on diminishing the magnitudes of the needed joint muscle strengths.     

Computation of the kinematics and the minimum peak joint moments of sit-to-stand movements

Background  

A sit-to-stand (STS) movement requires muscle strength higher than that of other daily activities. There are many elderly people, who experience difficulty when standing up from a chair. The muscle strength required (or the load on the joints) during a STS task is determined by the kinematics (movement pattern). The purpose of this study was to evaluate the kinematics and resultant joint moments of people standing up from a chair in order to determine the minimum peak joint moments required for a STS task.     

Not All Is Lost: Old Adults Retain Flexibility in Motor Behaviour during Sit-to-Stand

Sit-to-stand is a fundamental activity of daily living, which becomes increasingly difficult with advancing age. Due to severe loss of leg strength old adults are required to change the way they rise from a chair and maintain stability. Here we examine whether old compared to young adults differently prioritize task-important performance variables and whether there are age-related differences in the use of available motor flexibility. We applied the uncontrolled manifold analysis to decompose trial-to-trial variability in joint kinematics into variability that stabilizes and destabilizes task-important performance variables. Comparing the amount of variability stabilizing and destabilizing task-important variables enabled us to identify the variable of primary importance for the task. We measured maximal isometric voluntary force of three muscle groups in the right leg. Independent of age and muscle strength, old and young adults similarly prioritized stability of the ground reaction force vector during sit-to-stand. Old compared to young adults employed greater motor flexibility, stabilizing ground reaction forces during sit-to-sand. We concluded that freeing those degrees of freedom that stabilize task-important variables is a strategy used by the aging neuromuscular system to compensate for strength deficits.     

Biomechanical analysis of the relation between movement time and joint moment development during a sit-to-stand task

Background  

Slowness of movement is a factor that may cause a decrease of quality of daily life. Mobility in the elderly and people with movement impairments may be improved by increasing the quickness of fundamental locomotor tasks. Because it has not been revealed how much muscle strength is required to improve quickness, the purpose of this study was to reveal the relation between movement time and the required muscle strength in a sit to stand (STS) task. Previous research found that the sum of the peak hip and knee joint moments was relatively invariant throughout a range of movement patterns (Yoshioka et al., 2007, Biomedical Engineering Online 6:26). The sum of the peak hip and knee joint moment is an appropriate index to evaluate the muscle strength required for an STS task, since the effect of the movement pattern variation can be reduced, that is, the results can be evaluated purely from the viewpoint of the movement times. Therefore, the sum of the peak hip and knee joint moment was used as the index to indicate the required muscle strength.     

Power and work produced in different leg muscle groups when rising from a chair

The aim of this study was to determine the power output and work done by different muscle groups at the hip and knee joints during a rising movement, to be able to tell the degree of activation of the muscle groups and the relationship between concentric and eccentric work. Nine healthy male subjects rose from a chair with the seat at knee level. The moments of force about the hip and knee joints were calculated semidynamically. The power output (P) and work in the different muscle groups surrounding the joints was calculated as moment of force times joint angular velocity. Work was calculated as: work = f Pdt. The mean peak concentric power output was for the hip extensors 49.9 W, hip flexors 7.9 W and knee extensor 89.5 W. This power output corresponded to a net concentric work of 20.7 J, 1.0 J and 55.6 J, respectively. There was no concentric power output from the knee flexor muscles. Energy absorption through eccentric muscle action was produced by the hip extensors and hip flexors with a mean peak power output of 4.8 W and 7.4 W, respectively. It was concluded that during rising, the hip and knee muscles mainly worked concentrically and that the greatest power output and work were produced during concentric contraction of the knee and hip extensor muscles. There was however also a demand for eccentric work by the hip extensors as well as both concentric and eccentric work by the hip flexors. The knee flexor muscles were unloaded.     

Age-related changes in finger coordination in static prehension tasks.

We studied age-related changes in the performance of maximal and accurate submaximal force and moment production tasks. Elderly and young subjects pressed on six dimensional force sensors affixed to a handle with a T-shaped attachment. The weight of the whole system was counterbalanced with another load. During tasks that required the production of maximal force or maximal moment by all of the digits, young subjects were stronger than elderly. A greater age-related deficit was seen in the maximal moment production tests. During maximal force production tests, elderly subjects showed larger relative involvement of the index and middle fingers; they moved the point of thumb force application upward (toward the index and middle fingers), whereas the young subjects rolled the thumb downward. During accurate force/moment production trials, elderly persons were less accurate in the production of both total moment and total force. They produced higher antagonistic moments, i.e., moment by fingers that acted against the required direction of the total moment. Both young and elderly subjects showed negative covariation of finger forces across repetitions of a ramp force production task. In accurate moment production tasks, both groups showed negative covariation of two components of the total moment: those produced by the normal forces and those produced by the tangential forces. However, elderly persons showed lower values of the indexes of both finger force covariation and moment covariation. We conclude that age is associated with an impaired ability to produce both high moments and accurate time profiles of moments. This impairment goes beyond the well-documented deficits in finger and hand force production by elderly persons. It involves worse coordination of individual digit forces and of components of the total moment. Some atypical characteristics of finger forces may be viewed as adaptive to the increased variability in the force production with age.     

Dynamic optimization of the sit-to-stand movement

The purpose of this study was to clarify criteria that can predict trajectories during the sit-to-stand movement. In particular, the minimum jerk and minimum torque-change models were examined. Three patterns of sit-to-stand movement from a chair, i.e., upright, natural, and leaning forward, were measured in five young participants using a 3-D motion analysis device (200 Hz). The trajectory of the center of mass and its smoothness were examined, and the optimal trajectories predicted by both models were evaluated. Trajectories of the center of mass predicted by the minimum torque-change model, rather than the minimum jerk model, resembled the measured movements in all rising movement patterns. The upright pattern required greater extension torque of the knee and ankle joints at the instant of seat-off. The leaning-forward pattern required greater extension hip torque and higher movement cost than the natural and upright patterns. These results indicate that the natural sit-to-stand movement might be a result of dynamic optimization.     

Time-course of force production by fast isometric contraction of the knee extensor in young and elderly subjects

Rapid force production by isometric contraction of the knee extensor was examined in a wide range of force output for 12 healthy elderly (65-86 years) and 12 young (20-35 years) subjects. Time-course of tension development and duration of first burst EMG activities (AG-1) of the vastus medialis muscle were compared between both groups. Significant increase in the elderly as compared with the young was found in duration from the onset of the EMG to the rise of tension (TLT), but not in time from the rise to peak of force (FTmax), although FTmax tended to be longer in the elderly than the young at three different levels of force output. AG-1 duration was also prolonged in the elderly but the difference was not significant. The prolongation of TLT in the elderly suggests that spatio-temporal recruitments of the motor units and/or the percentage of fast twitch fibers decreases with aging.     

Does using an ejector chair affect muscle activation patterns in rheumatoid arthritic patients? A preliminary investigation.

The present study examined knee and arm extensor muscle activation patterns displayed by 12 elderly female rheumatoid arthritic patients (mean age = 65.5 +/- 8.6 yr) rising from an instrumented Eser ejector chair under four conditions: high seat (540 mm), low seat (450 mm), with and without ejector assistance. Electromyographic (EMG) signals were sampled (1000 Hz) for vastus lateralis (VL), vastus medialis (VM), rectus femoris (RF) and triceps brachii (TB) using a Noraxon Telemyo System (bandwidth 0-340 Hz). Muscle onset, offset and peak activity relative to loss of seat contact (SS), and integrated EMG, were calculated for each muscle burst before SS. A high seat significantly (p < or = 005) decreased VL and TB intensity but did not change muscle activation patterns compared with rising from a low seat. Ejector assistance significantly increased VM and RF burst duration and RF intensity but had no effect on vastii muscle intensity. It was concluded that concerns pertaining to muscle disuse when rising with ejector assistance were unfounded in the present study. However, further research is required to investigate the effects of habitual use of a mechanical ejector device on muscle activation patterns.     

Muscular strength and jumping performance relationships in young women athletes

The relationships between muscular strength and vertical jumping performance were examined in young women (14-19 years) track and field jumpers (n = 20) and volleyball players (n = 21). The knee extensor muscular strength measured at 9 knee angles was correlated with jumping height and peak power at the squat (SJ) and the countermovement (CMJ) vertical jump tests. Pearson product coefficient of correlation was used to test the significance of these relationships (p 0.80). Specifically, in the volleyball players, the strong relationships were noted for muscular strength at the knee angle range of 40 degrees to 90 degrees and CMJ jumping height as well as SJ peak power. Results indicate the dissimilarity in the relationships between the knee extensor muscular strength and jumping performance in the young female track and field jumpers and volleyball players. In addition, it appears that the measure selected to evaluate jumping performance alters the correlational results.     

Influence of patellar position on the knee extensor mechanism in normal and crouched walking

Patella alta is common in cerebral palsy, especially in patients with crouch gait. Correction of patella alta has been advocated in the treatment of crouch, however the appropriate degree of correction and the implications for knee extensor function remain unclear. Therefore, the goal of this study was to assess the impact of patellar position on quadriceps and patellar tendon forces during normal and crouch gait. To this end, a lower extremity musculoskeletal model with a novel 12 degree of freedom knee joint was used to simulate normal gait in a healthy child, as well as mild (23 deg min knee flexion in stance), moderate (41 deg), and severe (67 deg) crouch gait in three children with cerebral palsy. The simulations revealed that quadriceps and patellar tendon forces increase dramatically with crouch, and are modulated by patellar position. For example with a normal patellar tendon position, peak patellar tendon forces were 0.7 times body weight in normal walking, but reached 2.2, 3.2 and 5.4 times body weight in mild, moderate and severe crouch. Moderate patella alta acted to reduce quadriceps and patellar tendon loads in crouch gait, due to an enhancement of the patellar tendon moment arms with alta in a flexed knee. In contrast, patella baja reduced the patellar tendon moment arm in a flexed knee and thus induced an increase in the patellar tendon loads needed to walk in crouch. Functionally, these results suggest that patella baja could also compromise knee extensor function for other flexed knee activities such as chair rise and stair climbing. The findings are important to consider when using surgical approaches for correcting patella alta in children who exhibit crouch gait patterns.     

Increased hip adductor activation during sit-to-stand improves muscle activation timing and rising-up mechanics in individuals with hemiparesis

Long sit-to-stand (STS) time has been identified as a feature of impaired functional mobility. The changes in biomechanics of STS performance with simultaneous hip adductor contraction have not been studied, which may limit indications for use of hip adductor activation during STS training.Ten individuals with hemiplegia (mean age 61.8 years, injury time 29.8 ± 15.2 months) performed the STS with and without squeezing a ball between two legs. The joint moments, ground reaction force (GRF), chair reaction force and movement durations and temporal index of electromyography were calculated from the control condition for comparison with those from the ball squeezing condition.Under the squeeze condition, reduced peak vertical GRF during the ascension phase with increased loading rate was observed in the nonparetic limb, and the peak knee extensor moment occurred earlier in the paretic. Earlier activation of tibialis anterior and gluteus maximus, and gluteus medius were found in squeeze STS.Squeezing a ball between limbs during STS increased the contraction timing of tibialis anterior, gluteus maximus, gluteus medius, and soleus as well as a more symmetric rising mechanics encourage the use of squeezing a ball between limbs during STS for individuals with hemiparesis.     

External loading alters trunk kinematics and lower extremity muscle activity in a distribution-specific manner during sitting and rising from a chair

BackgroundExcess body mass alters gait biomechanics in a distribution-specific manner. The effects of adding mass centrally or peripherally on biomechanics during sitting and rising from a chair are unknown.MethodsMotion analysis and lower extremity EMG were measured for fifteen healthy, normal weight subjects during sit-to-stand (SitTS) and stand-to-sit (StandTS) from a chair under unloaded (UN), centrally loaded (CL), and peripherally loaded (PL) conditions.ResultsCompared to UN, PL significantly increased support width (SitTS and StandTS), increased peak trunk flexion velocity (SitTS), and trended to increase peak trunk flexion angle (SitTS). During StandTS, CL significantly reduced peak trunk flexion compared to UN and PL. EMG activity of the semitendinosus, vastus lateralis and/or medialis was significantly increased in CL compared to UN during SitTS and StandTS.ConclusionsAdding mass centrally or peripherally induces contrasting biomechanical strategies to successfully sit or rise from a chair. CL limits trunk flexion and increases knee extensor muscle activity whereas; PL increases support width and trunk flexion, thus preventing increased EMG activity.     

The demands of stair descent relative to maximum capacities in elderly and young adults.

In this study, we aimed to establish the joint moment and joint range of motion requirements of stair descent and the demands relative to maximal capacities in elderly and young adults. Participants descended a custom-built standard dimension four-step staircase, at their self-selected speed in a step-over manner. Kinetic data were acquired from force platforms embedded into each of the steps and into the floor at the base of the stairs. A motion analysis system was used to acquire kinematic data and joint moments were calculated using the kinematic and kinetic data. Maximum capacities (joint moment and joint range of motion) were assessed using a dynamometer. During stair descent the elderly generated lower absolute ankle joint moments than the young, which enabled them to operate at a similar relative proportion of their maximal capacity compared to young adults (75%). The knee joint moments during stair descent were similar between groups, but the elderly operated at a higher proportion of their maximal capacity (elderly: 42%; young: 30%). Ankle plantarflexion-dorsiflexion angle changes were similar between groups, which meant that the elderly operated at a higher proportion of their maximal assisted dorsiflexion angle. These results indicate that the elderly redistribute the joint moments in order to maintain the task demands within 'safe' limits.     

A Procedure for the Design of Novel Assisting Devices for the Sit-to-Stand

The Sit-to-Stand （STS） is an activity most people perform numerous times daily. Standing up deals with the transition from two stabilized postures, namely seated to standing, with movement of all body segments except the feet. During the STS the body＇s Center of Gravity （COG） is moved upward from a sitting position to a standing position without losing balance and requiring a good coordination of many muscles. Three main phases of the STS movement can be recognized. One begins to stand up by inclining the upper body forward, which moves body mass toward the feet in order to maintain balance after lift-off. Prior to leaving the chair, hip and knee extensor muscles are activated to provide antigravity support for these joints, this action is commonly referred to as ＂weight shift＂. Finally; after leaving the chair, the leg and trunk joints are straightened to achieve upright stance. The STS task can be considered of major importance for impaired and elderly people to achieve minimal mo- bility and independence. In this paper we detail a procedure for the design of assisting devices to be used for the STS. In par- ticular, an experimental procedure is described firstly to track and record point trajectories and the orientation of the trunk during the STS. This analysis is then used to get information for the design of assisting devices. A proposal and simulation results are presented for a novel mechatronic system. In particular, for the case under study experimental tests are used to drive the actua- tion system for the reported simulation. A functional mechatronic scheme is then proposed to control the device during its operation.     

Effect of squat depth and barbell load on relative muscular effort in squatting

ABSTRACT: Bryanton, MA, Kennedy, MD, Carey, JP, and Chiu, LZF. Effect of squat depth and barbell load on relative muscular effort in squatting. J Strength Cond Res 26(10): 2820-2828, 2012-Resistance training is used to develop muscular strength and hypertrophy. Large muscle forces, in relation to the muscle's maximum force-generating ability, are required to elicit these adaptations. Previous biomechanical analyses of multi-joint resistance exercises provide estimates of muscle force but not relative muscular effort (RME). The purpose of this investigation was to determine the RME during the squat exercise. Specifically, the effects of barbell load and squat depth on hip extensor, knee extensor, and ankle plantar flexor RME were examined. Ten strength-trained women performed squats (50-90% 1 repetition maximum) in a motion analysis laboratory to determine hip extensor, knee extensor, and ankle plantar flexor net joint moment (NJM). Maximum isometric strength in relation to joint angle for these muscle groups was also determined. Relative muscular effect was determined as the ratio of NJM to maximum voluntary torque matched for joint angle. Barbell load and squat depth had significant interaction effects on hip extensor, knee extensor, and ankle plantar flexor RME (p < 0.05). Knee extensor RME increased with greater squat depth but not barbell load, whereas the opposite was found for the ankle plantar flexors. Both greater squat depth and barbell load increased hip extensor RME. These data suggest that training for the knee extensors can be performed with low relative intensities but require a deep squat depth. Heavier barbell loads are required to train the hip extensors and ankle plantar flexors. In designing resistance training programs with multi-joint exercises, how external factors influence RME of different muscle groups should be considered to meet training objectives.     

Joint moments’ contributions to vertically accelerate the center of mass during stair ambulation in the elderly: An induced acceleration approach

Falls are a serious problem faced by the elderly. Older adults report mostly to fall while performing locomotor activities, especially the ones requiring stair negotiation. During these tasks, older adults, when compared with young adults, seem to redistribute their lower limb joint moments. This may indicate that older adults use a different strategy to accelerate the body upward during these tasks. The purposes of this study were to quantify the contributions of each lower limb joint moment to vertically accelerate the center of mass during stair ascent and descent, in a sample of community-dwelling older adults, and to verify if those contributions were correlated with age and functional fitness level. A joint moment induced acceleration analysis was performed in 29 older adults while ascending and descending stairs at their preferred speed. Agreeing with previous studies, during both tasks, the ankle plantarflexor and the knee extensor joint moments were the main contributors to support the body. Although having a smaller contribution to vertically accelerate the body, during stair descent, the hip joint moment contribution was related with the balance score. Further, older adults, when compared with the results reported previously for young adults, seem to use more their knee extensor moment than the ankle plantarflexor moment to support the body when the COM downward velocity is increasing. By contributing for a better understanding of stair negotiation in community dwelling older adults, this study may help to support the design of interventions aiming at fall prevention and/or mobility enhancement within this population.     

Functional evaluation of the TKA patient using the coordination and variability of rising.

A kinematic analysis of the knee function is important for the evaluation of total knee arthroplasties (TKA). We used the coordination and variability of rising from a chair as functional knee parameters. Twelve knee patients were measured prior to surgery (=pre-TKA group) and one year after surgery (=post-TKA group). A group of 15 healthy, age-matched subjects was selected as control group. The WOMAC questionnaire, frequently used by orthopaedic surgeons, was administered prior to the test. The test consisted of 10 times rising from a low chair and 10 times from a high chair. Knee and hip angles and angular velocities were measured with electrogoniometers. The relative phase (=MRP) between hip and knee was a measure for the coordination of rising and the standard deviation of the relative phase of the 10 trials (=SRP) was a measure for the variability. The coordination and variability of rising of the TKA patients were compared to the control group, and the relationship with the WOMAC questionnaire was calculated. The coordination of rising from a high chair and the variability of rising from both chair heights were significantly different for the pre-TKA group compared to the control group (p<0.05). The post-TKA group showed no significant differences with the control group, which indicates a functional recovery after TKA implantation. The functional parameters correlated adequately with the subjective WOMAC questionnaire. This study showed that our method is an objective measure of functionality and it will be worthwhile to use it as an additional evaluation tool.     

In vivo knee moments and shear after total knee arthroplasty

Tibiofemoral loading is very important in cartilage degeneration as well as in component survivorship after total knee arthroplasty. We have previously reported the axial knee forces in vivo. In this study, a second-generation force-sensing device that measured all six components of tibial forces was implanted in a 74-kg, 83-year-old male. Video motion analysis, ground reaction forces, and knee forces were measured during walking, stair climbing, chair-rise, and squat activities. Peak total force was 2.3 times body weight (BW) during walking, 2.5 x BW during chair rise, 3.0 x BW during stair climbing, and 2.1 x BW during squatting. Peak anterior shear force at the tibial tray was 0.30 x BW during walking, 0.17 x BW during chair rise, 0.26 x BW during stair climbing, and 0.15 x BW during squatting. Peak flexion moment at the tray was 1.9% BW x Ht (percentage of body weight multiplied by height) for chair-rise activity and 1.7% BW x Ht for squat activity. Peak adduction moment at the tray was -1.1% BW x Ht during chair-rise, -1.3% BW x Ht during squatting. External knee flexion and adduction moments were substantially greater than flexion and adduction moments at the tray. The axial component of forces predominated especially during the stance phase of walking. Shear forces and moments at the tray were very modest compared to total knee forces. These findings indicate that the soft tissues around the knee absorbed most of the external shear forces. Our results highlight the importance of direct measurements of knee forces.     

Walking on high heels changes muscle activity and the dynamics of human walking significantly

The aim of the study was to investigate the distribution of net joint moments in the lower extremities during walking on high-heeled shoes compared with barefooted walking at identical speed. Fourteen female subjects walked at 4 km/h across three force platforms while they were filmed by five digital video cameras operating at 50 frames/second. Both barefooted walking and walking on high-heeled shoes (heel height: 9 cm) were recorded. Net joint moments were calculated by 3D inverse dynamics. EMG was recorded from eight leg muscles. The knee extensor moment peak in the first half of the stance phase was doubled when walking on high heels. The knee joint angle showed that high-heeled walking caused the subjects to flex the knee joint significantly more in the first half of the stance phase. In the frontal plane a significant increase was observed in the knee joint abductor moment and the hip joint abductor moment. Several EMG parameters increased significantly when walking on high-heels. The results indicate a large increase in bone-on-bone forces in the knee joint directly caused by the increased knee joint extensor moment during high-heeled walking, which may explain the observed higher incidence of osteoarthritis in the knee joint in women as compared with men.