Lee Su Jin, Mehta-Desai Ricky, Oh Kyunggeune, Sanford Jon, Prilutsky Boris I
a Center for Assistive Technology and Environmental Access, College of Design , Georgia Institute of Technology , Atlanta , GA , USA.
b School of Biological Sciences , Georgia Institute of Technology , Atlanta , GA , USA.
Disabil Rehabil Assist Technol. 2019 Apr;14(3):292-300. doi: 10.1080/17483107.2018.1447605. Epub 2018 Mar 9.
Kinetic characteristics of transfers to and from a toilet performed using bilateral grab bars are not fully quantified to inform grab bar design and configuration. The purpose of this study was to (1) determine effects of bilateral swing-away grab bars on peaks of ankle, knee and hip joint moments during grab bar assisted stand-to-sit and sit-to-stand transfers; and (2) determine effects of three different heights and widths of swing-away grab bars on the same kinetic characteristics.
Healthy subjects (N = 11, age 25-58 years) performed stand-to-sit and sit-to-stand transfers with and without grab bars. In transfers with grab bars, 9 grab bar configurations were tested by varying their height from the floor (0.787 m, 0.813 m, 0.838 m; 31″-33″) and width, the distance of each grab bar from the toilet's centerline (0.330 m, 0.356 m, 0.381 m; 13″-15″). Motion capture, force plate and inverse dynamics analysis were used to determine lower limb joint moments.
The use of bilateral grab bars generally reduced the peak magnitude of extension moments at lower limb joints during stand-to-sit and sit-to-stand transfers (p < .05), except the ankle joint moments during stand-to-sit transfers. Relatively few differences in peak joint moments were found between studied grab bar widths or heights.
The obtained results suggest that the studied ranges of grab bar configurations reduce moment demands on the leg joints and thus decrease difficulty and required lower limb muscle effort to perform the transfers. Implications for Rehabilitation Maximizing the benefits of assistive technology in the built environment requires a careful assessment of their spatial and configurational dimensions, especially in respect to the needs and abilities of the intended users. Examining the kinetic characteristics of transfers to and from a toilet using the swing-away grab bars is useful for informing grab bar design and configuration recommendations for assisted living and skilled nursing facilities. Our findings suggest that the swing-away grab bars located at certain ranges are a reasonable alternative to the grab bars mandated by the current Americans with Disabilities Act (ADA) Accessibility Guidelines. Future research investigating the effects of grab bars on transfer performance should consider additional factors, such as a wider range of abilities and transfer methods of the users.
使用双侧扶手进出马桶的动力学特征尚未得到充分量化，无法为扶手设计和配置提供依据。本研究的目的是：（1）确定双侧可旋转扶手在扶手辅助下从站立到坐下以及从坐到站立转移过程中对踝关节、膝关节和髋关节力矩峰值的影响；（2）确定三种不同高度和宽度的可旋转扶手对相同动力学特征的影响。
健康受试者（N = 11，年龄25 - 58岁）在有和没有扶手的情况下进行从站立到坐下以及从坐到站立的转移。在有扶手的转移过程中，通过改变扶手离地面的高度（0.787米、0.813米、0.838米；31英寸 - 33英寸）和宽度，即每个扶手离马桶中心线的距离（0.330米, 0.356米, 0.381米；13英寸 - 15英寸），测试了9种扶手配置。使用动作捕捉、测力板和逆动力学分析来确定下肢关节力矩。
使用双侧扶手通常会降低在从站立到坐下以及从坐到站立转移过程中下肢关节伸展力矩的峰值幅度（p < 0.05），从站立到坐下转移过程中的踝关节力矩除外。在所研究的扶手宽度或高度之间，关节力矩峰值的差异相对较少。
所得结果表明，所研究的扶手配置范围降低了腿部关节的力矩需求，从而降低了转移的难度以及所需的下肢肌肉力量。康复意义在建筑环境中最大化辅助技术的益处需要仔细评估其空间和配置尺寸，特别是考虑目标用户的需求和能力。研究使用可旋转扶手进出马桶的动力学特征有助于为辅助生活和专业护理设施的扶手设计和配置建议提供参考。我们的研究结果表明，位于特定范围内的可旋转扶手是当前《美国残疾人法案》（ADA）无障碍指南规定的扶手的合理替代方案。未来研究扶手对转移性能的影响时应考虑其他因素，例如用户更广泛的能力范围和转移方法。
