脑卒中偏瘫患者坐-站转移生物力学分析研究进展

doi:10.3969/j.issn.1006-9771.2018.03.008

Abstract

Abstract: Hemiplegics after stroke are often disabled in sit-to-stand (STS). This article discussed the biomechanics of STS in the hemiplegic stroke patients, in terms of kinematics, kinetics and surface electromyography, and the rehabilitation for the stroke patients with STS dysfunction. It was found that the stability, duration, symmetry of support and degree and sequence of muscular activation were different when the patients finished the STS task in three foot positions of natural, symmetrical and unaffected foot behind. The early STS rehabilitation training or other rehabilitation may improve the function of the hemiplegic lower extremity to prevent falls and apraxia.

Key words: stroke, hemiplegia, sit-to-stand, foot position, biomechanics, surface electromyography, rehabilitation, review

CLC Number:

R743.3

WU Xue-jiao, ZHENG Jie-jiao, XIA Wen, LIU Cui-xian, QU Bing. Advance in Biomechanical Analysis of Sit-to-stand Movement in Hemiplegic Stroke Patients (review)[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2018, 24(3): 290-295.

References

[1] Gbiri CA, Olawale OA, Isaac SO.Stroke management: Informal caregivers' burdens and strians of caring for stroke survivors[J]. Ann Phys Rehabil Med, 2015, 58(2): 98-103.
[2] Langhorne P, Bernhardt J, Kwakkel G.Stroke rehabilitation[J]. Lancet, 2011, 377(9778): 1693-1702.
[3] Pollock A, Gray C, Culham E, et al. Interventions for improving sit-to-stand ability following stroke [J]. Cochrane Database Syst Rev, 2014, 5(5): Cd007232.
[4] Cheng PT, Wu SH, Liaw MY, et al.Symmetrical body-weight distribution training in stroke patients and its effect on fall prevention[J]. Arch Phys Med Rehabil, 2001, 82(12): 1650-1654.
[5] Cheng YY, Wei SH, Chen PY, et al.Can sit-to-stand lower limb muscle power predict fall status?[J]. Gait Posture, 2014, 40(3): 403-407.
[6] Joshua AM, Karnad SD, Nayak A, et al.Effect of foot placements during sit to stand transition on timed up and go test in stroke subjects: A cross sectional study[J]. NeuroRehabilitation, 2017, 40(3): 355-362.
[7] Roy G, Nadeau S, Gravel D, et al.The effect of foot position and chair height on the asymmetry of vertical forces during sit-to-stand and stand-to-sit tasks in individuals with hemiparesis[J]. Clin Biomech (Bristol, Avon), 2006, 21(6): 585-593.
[8] 张勤良,周旭,倪朝民,等. 性别对正常人坐-站转移过程髋关节运动学参数及足底压力的影响[J]. 中国康复医学杂志, 2012, 27(4): 320-323.
[9] Roebroeck ME, Doorenbosch CM, Harlaar J, et al.Biomechanics and muscular activity during sit-to-stand transfer[J]. Clin Biomech (Bristol, Avon), 1994, 9(4): 235-244.
[10] Ko MC, Wu LS, Lee S, et al.Whole-body vibration training improves balance control and sit-to-stand performance among middle-aged and older adults: a pilot randomized controlled trial[J]. Eur Rev Aging Phys Act, 2017, 14: 11.
[11] Cheng PT, Liaw MY, Wong MK, et al.The sit-to-stand movement in stroke patients and its correlation with falling[J]. Arch Phys Med Rehabil, 1998, 79(9): 1043-1046.
[12] Chen HB, Wei TS, Chang LW.Postural influence on Stand-to-Sit leg load sharing strategies and sitting impact forces in stroke patients[J]. Gait Posture, 2010, 32(4): 576-580.
[13] Winter DA.Biomechanics and Motor Control of Human Movement[M]. Hoboken: John Wiley & Sons, 2009.
[14] Millington PJ, Myklebust BM, Shambes GM.Biomechanical analysis of the sit-to-stand motion in elderly persons[J]. Arch Phys Med Rehabil, 1992, 73(7): 609-617.
[15] Schenkman M, Berger RA, Riley PO, et al.Whole-body movements during rising to standing from sitting[J]. Phys Ther, 1990, 70(10): 648-651.
[16] An Q, Ishikawa Y, Funato T, et al.Generation of human standing-up motion with muscle synergies using forward dynamic simulation[C]. Robotics and Automation (ICRA), 2014 IEEE International Conference on IEEE, 2014: 730-735.
[17] Lindemann U, Claus H, Stuber M, et al.Measuring power during the sit-to-stand transfer[J]. Eur J Appl Physiol, 2003, 89(5): 466-470.
[18] Cheng PT, Chen CL, Wang CM, et al.Leg muscle activation patterns of sit-to-stand movement in stroke patients[J]. Am J Phys Med Rehabil, 2004, 83(1): 10-16.
[19] Khemlani MM, Carr JH, Crosbie WJ.Muscle synergies and joint linkages in sit-to-stand under two initial foot positions[J]. Clin Biomech (Bristol, Avon), 1999, 14(4): 236-246.
[20] Kerr A, Clark A, Cooke EV, et al.Functional strength training and movement performance therapy produce analogous improvement in sit-to-stand early after stroke: early-phase randomised controlled trial[J]. Physiotherapy, 2017, 103(3): 259-265.
[21] Brière A, Nadeau S, Lauzière S, et al.Knee efforts and weight-bearing asymmetry during sit-to-stand tasks in individuals with hemiparesis and healthy controls[J]. J Electromyogr Kinesiol, 2013, 23(2): 508-515.
[22] Roy G, Nadeau S, Gravel D, et al.Side difference in the hip and knee joint moments during sit-to-stand and stand-to-sit tasks in individuals with hemiparesis[J]. Clin Biomech (Bristol, Avon), 2007, 22(7): 795-804.
[23] Gray CK, Culham E.Sit-to-stand in people with stroke: effect of lower limb constraint-induced movement strategies[J]. Stroke Res Treat, 2014, 2014: 683681.
[24] Kralj A, Jaeger RJ, Munih M.Analysis of standing up and sitting down in humans: Definitions and normative data presentation[J]. J Biomech, 1990, 23(11): 1123-1138.
[25] Bowser B, O'rourke S, Brown CN, et al. Sit-to-stand biomechanics of individuals with multiple sclerosis[J]. Clin Biomech (Bristol, Avon), 2015, 30(8): 788-794.
[26] 庄霁雯,郑洁皎,陈秀恩,等. 脑卒中平衡功能障碍治疗的研究进展[J]. 中国康复理论与实践, 2016, 22(10): 1127-1131.
[27] Tasseel-Ponche S, Yelnik AP, Bonan IV.Motor strategies of postural control after hemispheric stroke[J]. Neurophysiol Clin, 2015, 45(4-5): 327-333.
[28] 朱婷,安丙辰,梁贞文,等. 认知对姿势控制能力影响的研究进展[J]. 中华老年病研究电子杂志, 2015, 2(1): 35-38.
[29] Chou SW, Wong AM, Leong CP, et al.Postural control during sit-to stand and gait in stroke patients[J]. Am J Phys Med Rehabil, 2003, 82(1): 42-47.
[30] Goldie PA, Bach TM, Evans OM.Force platform measures for evaluating postural control: reliability and validity[J]. Arch Phys Med Rehabil, 1989, 70(7): 510-517.
[31] Lecours J, Nadeau S, Gravel D, et al.Interactions between foot placement, trunk frontal position, weight-bearing and knee moment asymmetry at seat-off during rising from a chair in healthy controls and persons with hemiparesis[J]. J Rehabil Med, 2008, 40(3): 200-207.
[32] 刘孟,倪朝民,陈进,等. 脑卒中偏瘫患者坐-站转移时足位、躯干运动及下肢负重间的关系[J]. 中国康复理论与实践, 2015, 21(9): 1082-1086.
[33] Duclos C, Nadeau S, Lecours J.Lateral trunk displacement and stability during sit-to-stand transfer in relation to foot placement in patients with hemiparesis[J]. Neurorehabil Neural Repair, 2008, 22(6): 715-722.
[34] Hirschfeld H, Thorsteinsdottir M, Olsson E.Coordinated ground forces exerted by buttocks and feet are adequately programmed for weight transfer during sit-to-stand[J]. J Neurophysiol, 1999, 82(6): 3021-3029.
[35] Chorin F, Cornu C, Beaune B, et al.Sit to stand in elderly fallers vs non-fallers: new insights from force platform and electromyography data[J]. Aging Clin Exp Res, 2016, 28(5): 871-879.
[36] Galli M, Cimolin V, Crivellini M, et al.Quantitative analysis of sit to stand movement: experimental set-up definition and application to healthy and hemiplegic adults[J]. Gait Posture, 2008, 28(1): 80-85.
[37] Brunt D, Greenberg B, Wankadia S.The effect of foot placement on sit to stand in healthy young subjects and patients with hemiplegia[J]. Arch Phys Med Rehabil, 2002, 83(7): 924-929.
[38] Camargos AC, Rodrigues-de-Paula-Goulart F, Teixeira-Salmela LF. The effects of foot position on the performance of the sit-to-stand movement with chronic stroke subjects[J]. Arch Phys Med Rehabil, 2009, 90(2): 314-319.
[39] Rocha AS, Knabben RJ, Michaelsen SM.Non-paretic lower limb constraint with a step decreases the asymmetry of vertical forces during sit-to-stand at two seat heights in subjects with hemiparesis[J]. Gait Posture, 2010, 32(4): 457-463.
[40] Nadeau SM, Boukadida A, Piotte F, et al.Weight-bearing perception during standing and sit-to-stand tasks in subacute post-stroke individuals undergoing intensive rehabilitation[J]. Ann Phys Rehabil Med, 2016, 59: e71-e72.
[41] Baillieul S, El Fatimi A, Nadeau S, et al.Is the total vertical ground reaction force time-amplitude profile an invariant during sit-to-stand movements following stroke?[J]. Ann Phys Rehabil Med, 2015, 58: e110.
[42] 刘孟,倪朝民,杨洁,等. 不同足位对脑卒中偏瘫患者坐-站转移稳定性及下肢负重的影响[J]. 中华物理医学与康复杂志, 2014, 36(3): 199-203.
[43] Luca CJD.Physiology and mathematics of myoelectric signals[J]. IEEE Trans Biomed Eng, 1979, 26(6): 313-325.
[44] Prudente C, Rodrigues-De-Paula F, Faria CD. Lower limb muscle activation during the sit-to-stand task in subjects who have had a stroke[J]. Am J Phys Med Rehabil, 2013, 92(8): 666-675.
[45] Hu PT, Lin KH, Lu TW, et al.Effect of a cane on sit-to-stand transfer in subjects with hemiparesis[J]. Am J Phys Med Rehabil, 2013, 92(3): 191-202.
[46] Lomaglio MJ, Eng JJ.Muscle strength and weight-bearing symmetry relate to sit-to-stand performance in individuals with stroke[J]. Gait Posture, 2005, 22(2): 126-131.
[47] Silva A, Sousa AS, Pinheiro R, et al.Activation timing of soleus and tibialis anterior muscles during sit-to-stand and stand-to-sit in post-stroke vs. healthy subjects[J]. Somatosens Mot Res, 2013, 30(1): 48-55.
[48] Jeyasurya J, Hf VDL, Hodgson A, et al.Comparison of seat, waist, and arm sit-to-stand assistance modalities in elderly population[J]. J Rehabil Res Dev, 2013, 50(6): 835-844.
[49] Tung FL, Yang YR, Lee CC, et al.Balance outcomes after additional sit-to-stand training in subjects with stroke: a randomized controlled trial[J]. Clin Rehabil, 2010, 24(6): 533-542.
[50] Aruin AS, Hanke T, Chaudhuri G, et al.Compelled weight bearing in persons with hemiparesis following stroke: the effect of a lift insert and goal-directed balance exercise[J]. J Rehabil Res Dev, 2000, 37(1): 65-72.
[51] Barreca S, Sigouin CS, Lambert C, et al.Effects of extra training on the ability of stroke survivors to perform an independent sit-to-stand: a randomized controlled trial[J]. J Geriatr Phys Ther, 2004, 27(2): 59-64.
[52] Janssen W, Bussmann J, Selles R, et al.Recovery of the sit-to-stand movement after stroke: a longitudinal cohort study[J]. Neurorehabil Neural Repair, 2010, 24(8): 763-769.
[53] Kim K, Kim YM, Kang DY.Repetitive sit-to-stand training with the step-foot position on the non-paretic side, and its effects on the balance and foot pressure of chronic stroke subjects[J]. J Phys Ther Sci, 2015, 27(8): 2621-2624.
[54] Farqalit R, Shahnawaz A.Effect of foot position during sit-to-stand training on balance and upright mobility in patients with chronic stroke[J]. Hong Kong Physiother J, 2013, 31(2): 75-80.
[55] Jung KS, In TS, Cho HY.Effects of sit-to-stand training combined with transcutaneous electrical stimulation on spasticity, muscle strength and balance ability in patients with stroke: A randomized controlled study[J]. Gait Posture, 2017, 54: 183-187.
[56] Britton E, Harris N, Turton A.An exploratory randomized controlled trial of assisted practice for improving sit-to-stand in stroke patients in the hospital setting[J]. Clin Rehabil, 2008, 22(5): 458-468.
[57] Fritz S, Merlorains A, Rivers E, et al.Feasibility of intensive mobility training to improve gait, balance, and mobility in persons with chronic neurological conditions: a case series[J]. J Neurol Phys Ther, 2011, 35(35): 141-147.
[58] Yoshioka S, Nagano A, Hay DC, et al.Peak hip and knee joint moments during a sit-to-stand movement are invariant to the change of seat height within the range of low to normal seat height[J]. Biomed Eng Online, 2014, 13(1): 27.
[59] Burnfield JM, Mccrory B, Shu Y, et al.Comparative kinematic and electromyographic assessment of clinician- and device-assisted sit-to-stand transfers in patients with stroke[J]. Phys Ther, 2013, 93(10): 1331-1341.

Advance in Biomechanical Analysis of Sit-to-stand Movement in Hemiplegic Stroke Patients (review)

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 15

Metrics

Comments

Recommended 0

[1]	QIAN Liguo, WU Tongxuan, ZHANG Qiaoyun, XING Jian, YANG Yanyan. Design and application effect of continuing education case library combined with case-based learning for rehabilitation therapists [J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(3): 249-257.
[2]	AN Le, QIN Xiaoxia, GU Bin, HU Guobing, TIAN Weiyi. A competency model for "dual-qualified" teachers in vocational undergraduate rehabilitation therapy programs based on the integration of rehabilitation competency framework and multi-source standards [J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(3): 258-269.
[3]	LIU Hua, WANG Liyuan, MA Xin, LI Jing, WANG Li. OBE-CDIO model of teaching for curriculum of exercise rehabilitation training [J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(3): 270-275.
[4]	LIU Xia, ZHANG Yuanmin, GE Shuhui, LIU Jinmei, SUN Chenming, WANG Yuanhui, LIU Jing, LI Wenfu. Cultivation mode of rehabilitation therapy talents in local colleges and universities under the background of New Medicine [J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(3): 276-285.
[5]	ZHU Lili, ZHAO Jiaxin, CHENG Xue, WANG Huijuan, CHEN Xiaoxia. Experiences and needs of stroke patients during rehabilitation: a qualitative meta-synthesis [J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(3): 286-293.
[6]	LIU Ping, ZHOU Nan, XUE Xiaojie, SHAO Weibo. Application of rehabilitation therapy techniques for post-stroke dysphagia: a bibliometric analysis [J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(3): 294-303.
[7]	PU Xinyu, WANG Jingxuan, WANG Hujun, XIU Anda, WANG Yingpeng. Application of repetitive peripheral magnetic stimulation in rehabilitation therapy: a bibliometric analysis [J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(3): 304-316.
[8]	YANG Ling, WANG Qinglei, WANG Jie, XU Wenjie, WANG Tong, GUO Chuan, QIAN Xue. Activation patterns and mechanism in the prefrontal cortex of post-stroke anxiety patients: a study using functional near-infrared spectroscopy [J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(3): 329-336.
[9]	ZHANG Wenjing, LI Hao, YUAN Jiajia, HU Huaining. Effect of tele-supervised home-based pulmonary music therapy on chronic obstructive pulmonary disease [J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(3): 337-344.
[10]	LIANG Guanjun, XU Huanlan, ZHANG Hewei, ZHANG Dali, GU Qin, LI Mingdi. Changes in balance and lower limb biomechanics of spastic hemiplegia under different visual deprivation and task conditions [J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(3): 345-355.
[11]	WU Shicai. Theoretical construction and practical exploration of rehabilitation ethics management [J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(2): 125-131.
[12]	HE Zhaonan, ZHANG Tingting, HE Zhaoke, MENG Lijun. Topic mining and content analysis of rehabilitation ethics research in China based on BERTopic model [J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(2): 132-141.
[13]	MENG Lijun. Challenges and reflections on ethical review of rehabilitation research for children with disabilities [J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(2): 142-150.
[14]	LI Shuiyan, LI Xiang, LI Yanhui, LU Yimeng, LI Dujuan, YANG Xiaoliang, XIE Qiuyou. Application of airway clearance techniques in critical care rehabilitation: a bibliometric analysis [J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(2): 162-173.
[15]	XIA Yan, XU Siwei, ZHU Yanyan, WANG Fengli, LIANG Sijie, LI Jingye, MEI Guangyan, XIANG Jie. Effect of personalized home-based rehabilitation under digital health model on Parkinson's disease [J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(2): 181-190.