J.M. Burnfield, PT, PhD, Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospital, 5401 South St, Lincoln, NE 68506 (USA).
Phys Ther. 2013 Oct;93(10):1331-41. doi: 10.2522/ptj.20120500. Epub 2013 May 2.
Workplace injuries from patient handling are prevalent. With the adoption of no-lift policies, sit-to-stand transfer devices have emerged as one tool to combat injuries. However, the therapeutic value associated with sit-to-stand transfers with the use of an assistive apparatus cannot be determined due to a lack of evidence-based data.
The aim of this study was to compare clinician-assisted, device-assisted, and the combination of clinician- and device-assisted sit-to-stand transfers in individuals who recently had a stroke.
This cross-sectional, controlled laboratory study used a repeated-measures design.
The duration, joint kinematics, and muscle activity of 4 sit-to-stand transfer conditions were compared for 10 patients with stroke. Each patient performed 4 randomized sit-to-stand transfer conditions: clinician-assisted, device-assisted with no patient effort, device-assisted with the patient's best effort, and device- and clinician-assisted.
Device-assisted transfers took nearly twice as long as clinician-assisted transfers. Hip and knee joint movement patterns were similar across all conditions. Forward trunk flexion was lacking and ankle motion was restrained during device-assisted transfers. Encouragement and guidance from the clinician during device-assisted transfers led to increased lower extremity muscle activation levels.
One lifting device and one clinician were evaluated. Clinician effort could not be controlled.
Lack of forward trunk flexion and restrained ankle movement during device-assisted transfers may dissuade clinicians from selecting this device for use as a dedicated rehabilitation tool. However, with clinician encouragement, muscle activation increased, which suggests that it is possible to safely practice transfers while challenging key leg muscles essential for standing. Future sit-to-stand devices should promote safety for the patient and clinician and encourage a movement pattern that more closely mimics normal sit-to-stand biomechanics.
患者搬运导致的工作场所受伤很常见。随着无举升政策的采用，坐站转移设备已成为一种预防受伤的工具。然而，由于缺乏基于证据的数据，无法确定使用辅助设备进行坐站转移的治疗价值。
本研究旨在比较临床医生辅助、设备辅助以及临床医生和设备联合辅助的坐站转移在近期中风患者中的效果。
这是一项横断面、对照实验室研究，采用重复测量设计。
比较了 10 名中风患者在 4 种坐站转移条件下的转移时间、关节运动学和肌肉活动。每位患者进行 4 种随机坐站转移条件：临床医生辅助、无患者用力的设备辅助、患者尽力的设备辅助以及设备和临床医生联合辅助。
设备辅助转移所需时间几乎是临床医生辅助转移的两倍。在所有条件下，髋关节和膝关节运动模式相似。在设备辅助转移过程中，缺乏向前的躯干屈曲，踝关节运动受限。在设备辅助转移过程中，临床医生的鼓励和指导导致下肢肌肉激活水平增加。
仅评估了一种举升设备和一位临床医生。临床医生的努力无法控制。
在设备辅助转移过程中缺乏向前的躯干屈曲和踝关节运动受限，可能会使临床医生不愿选择该设备作为专门的康复工具。然而，在临床医生的鼓励下，肌肉激活增加，这表明在挑战站立关键腿部肌肉的同时，可以安全地进行转移练习。未来的坐站转移设备应促进患者和临床医生的安全，并鼓励更接近正常坐站生物力学的运动模式。
