Dataset Information

Association Between Free-Living Sit-to-Stand Transition Characteristics, and Lower-Extremity Performance, Fear of Falling, and Stair Negotiation Difficulties Among Community-Dwelling 75 to 85-Year-Old Adults.

ABSTRACT:

Background

Good sit-to-stand (STS) performance is an important factor in maintaining functional independence. This study investigated whether free-living STS transition volume and intensity, assessed by a thigh-worn accelerometer, is associated with characteristics related to functional independence.

Methods

Free-living thigh-worn accelerometry was recorded continuously for 3-7 days in a population-based sample of 75-, 80-, and 85-year-old community-dwelling people (479 participants; women n = 287, men n = 192). The records were used to evaluate the number and intensity (angular velocity of the STS phase) of STS transitions. Associations with short physical performance battery (SPPB), 5-times-sit-to-stand test (5×STS), isometric knee extension force, self-reported fear of falls, and self-reported difficulty in negotiating stairs were also assessed.

Results

The number of STS transitions, mean and maximal angular velocity were lower in older age groups (p < .05). All variables were higher in men than in women (p < .001) and were positively associated with SPPB total points, knee extension force (r ranged from 0.18 to 0.39, all p < .001) and negatively associated with 5×STS (r = -0.13 - -0.24, all p < .05), lower extremity functional limitations (p < .01), fear of falls (p < .01), and stair negotiation difficulties (p < .01).

Conclusions

Free-living STS characteristics were related to lower-extremity performance, lower extremity functional limitations, self-reported fear of falls, and stair negotiation difficulties, which can be a sensitive indicator of impending functional decline. Moreover, STS transitions may provide an indicator of adequacy of lower-limb muscle strength among older individuals.

SUBMITTER: Lopponen A

PROVIDER: S-EPMC9373963 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Association Between Free-Living Sit-to-Stand Transition Characteristics, and Lower-Extremity Performance, Fear of Falling, and Stair Negotiation Difficulties Among Community-Dwelling 75 to 85-Year-Old Adults.

Löppönen Antti A Karavirta Laura L Koivunen Kaisa K Portegijs Erja E Rantanen Taina T Finni Taija T Delecluse Christophe C Van Roie Evelien E Rantalainen Timo T

The journals of gerontology. Series A, Biological sciences and medical sciences 20220801 8

<h4>Background</h4>Good sit-to-stand (STS) performance is an important factor in maintaining functional independence. This study investigated whether free-living STS transition volume and intensity, assessed by a thigh-worn accelerometer, is associated with characteristics related to functional independence.<h4>Methods</h4>Free-living thigh-worn accelerometry was recorded continuously for 3-7 days in a population-based sample of 75-, 80-, and 85-year-old community-dwelling people (479 participan ...[more]

PMID: 35313347

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Project description:Interactive sonification of biomechanical quantities is gaining relevance as a motor learning aid in movement rehabilitation, as well as a monitoring tool. However, existing gaps in sonification research (issues related to meaning, aesthetics, and clinical effects) have prevented its widespread recognition and adoption in such applications. The incorporation of embodied principles and musical structures in sonification design has gradually become popular, particularly in applications related to human movement. In this study, we propose a general sonification model for the sit-to-stand (STS) transfer, an important activity of daily living. The model contains a fixed component independent of the use-case, which represents the rising motion of the body as an ascending melody using the physical model of a flute. In addition, a flexible component concurrently sonifies STS features of clinical interest in a particular rehabilitative/monitoring situation. Here, we chose to represent shank angular jerk and movement stoppages (freezes), through perceptually salient pitch modulations and bell sounds. We outline the details of our technical implementation of the model. We evaluated the model by means of a listening test experiment with 25 healthy participants, who were asked to identify six normal and simulated impaired STS patterns from sonified versions containing various combinations of the constituent mappings of the model. Overall, we found that the participants were able to classify the patterns accurately (86.67 ± 14.69% correct responses with the full model, 71.56% overall), confidently (64.95 ± 16.52% self-reported rating), and in a timely manner (response time: 4.28 ± 1.52 s). The amount of sonified kinematic information significantly impacted classification accuracy. The six STS patterns were also classified with significantly different accuracy depending on their kinematic characteristics. Learning effects were seen in the form of increased accuracy and confidence with repeated exposure to the sound sequences. We found no significant accuracy differences based on the participants' level of music training. Overall, we see our model as a concrete conceptual and technical starting point for STS sonification design catering to rehabilitative and clinical monitoring applications.

Project description:BackgroundAfter a neurological injury, mobility focused rehabilitation programs intensively train walking on treadmills or overground. However, after discharge, quite a few patients are not able to independently negotiate stairs, a real-world task with high physical and psychological demands and a high injury risk. To decrease fall risk and improve patients' capacity to navigate typical environments, early stair negotiation training can help restore competence and confidence in safe stair negotiation. One way to enable early training in a safe and permissive environment is to unload the patient with a body weight support system. We here investigated if unloaded stair negotiation complies with basic locomotor principles, in terms of enabling performance of a physiological movement pattern with minimal compensation.MethodsSeventeen able-bodied participants were unloaded with 0-50% bodyweight during self-paced ascent and descent of a 4-tread staircase. Spatio-temporal parameters, joint ranges of motion, ground reaction forces and myoelectric activity in the main lower limb muscles of participants were compared between unloading levels. Likelihood ratio tests of separated linear mixed models of the investigated outcomes assessed if unloading affects the parameters in general. Subsequent post-hoc testing revealed which levels of unloading differed from unsupported stair negotiation.ResultsUnloading affected walking velocity, joint ranges of motion, vertical ground reaction force parameters and myoelectric activity in all investigated muscles for stair ascent and descent while step width and single support duration were only affected during ascent. A reduction with increasing levels of body weight support was seen in walking velocity (0.07-0.12 m/s), ranges of motion of the knee and hip (2-10°), vertical ground reaction force peaks (10-70%) and myoelectric activity (17-70%). An increase with unloading was only seen during ascent for ankle range of motion and tibialis anterior activity at substantial unloading.ConclusionsBody weight support facilitates stair negotiation by providing safety and support against gravity. Although unloading effects are present in most parameters, up to 30% body weight support these changes are small, and no dysfunctional patterns are introduced. Body weight support therefore fulfills all the necessary requirements for early stair negotiation training.

Dataset Information

Association Between Free-Living Sit-to-Stand Transition Characteristics, and Lower-Extremity Performance, Fear of Falling, and Stair Negotiation Difficulties Among Community-Dwelling 75 to 85-Year-Old Adults.

Background

Methods

Results

Conclusions

Publications

Association Between Free-Living Sit-to-Stand Transition Characteristics, and Lower-Extremity Performance, Fear of Falling, and Stair Negotiation Difficulties Among Community-Dwelling 75 to 85-Year-Old Adults.

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