What is the optimal chair stand test protocol for older adults? A systematic review

Purpose: To determine the chair stand test protocol that is most suitable for older adults in clinical settings by reviewing the currently available methods.Methods: Five electronic English databases were searched and details of methods used on individuals aged ≥65 years in the included studies were compared, including the instrument used to record time, units of measurement, chair characteristics (seat height, armrests), footwear, permission to use upper extremities and walking aids, pace of performance, total number of chair stands, timing points, total number of recorded and practice tests.Results: A total of 23 eligible studies were identified. The type of instrument to record performance time, characteristics of the chair and footwear were not frequently mentioned. A majority of studies did not permit the use of the upper extremities or walking aids during assessment. The performance of five chair stands at a fast pace recorded in seconds was most common, with the majority of studies recording the initial and end time point in a seated position. The total number of performed tests and practice tests was not specified in a majority of studies.Conclusion: A feasible and safe protocol for the chair stand test is proposed for assessment of older adults.Implications for RehabilitationThe chair stand test may provide valuable information on declines in mobility in older adults.The use of the chair stand test within clinical settings of older adults may provide a measure to identify frail individuals and to determine their level of frailty.Using the proposed protocol for the chair stand test may allow for the comparability of results.

Vertical force and wrist deviation angle when using a walker to stand up and sit down

Research investigating walkers suggests that safety and assistance for the elderly with weak lower limbs were important. However, the relationship between the use of a walker and the upper limbs has received little investigation. Standing up and sitting down are important daily activities. Therefore, the aim of this study was to explore wrist deviation and vertical force among elderly individuals using a walker for assistance to stand up and sit down. In total, 64 elderly volunteers (M age = 80.22, SD = 9.36) were enrolled. Data were obtained from four load cells and a twin-axis wrist goniometer. Wrist deviation and vertical force were examined when participants used a walker with horizontal handles to assist in standing up and sitting down. Significant wrist angle deviation occurred with the use of a walker, with dorsiflexion of the right hand greater than that of the left. Males exerted significantly greater vertical force. In the sitting position, greater ulnar deviation was seen among experienced walker users, whereas during standing, experienced users exhibited greater dorsiflexion. The horizontal handles of most marketed walkers may cause user wrist deviations, suggesting researchers should pursue improvements in walker design.

Evaluation of key points in the sit-to-stand movement using two force platforms

Three key points of the sit-to-stand (STS) movement were confirmed as aspects of the ground reaction force (GRF): the onset, maximum GRF, and seat-off. 46 healthy subjects (M age = 22.2 yr., SD = 4.4) participated. During the STS movement, two vertical force platforms were used to measure the resultant GRF, defined as the whole-body force, and its two components, the buttock and leg GRFs. The onsets of the component GRFs identified the sequence of the important time points in the STS movement more precisely than the onset of the resultant GRF. Data showed that the maximum whole-body GRF, the maximum GRF of both legs, and seat-off appeared in sequence and not simultaneously.