The sit-to-stand movement in stroke patients and its correlation with falling

Objective: To use kinetic assessment of the sit-to-stand movement as a means of sorting out those stroke patients at risk for falling. Design: A retrospective study, using a force platform to assess sit-to-stand performance and to determine its correlation with falls in stroke patients. Setting: Hospital-based rehabilitation units. Methods: Thirty-three stroke patients (18 fallers, 15 nonfallers) and 25 age-matched healthy subjects were included in this study. Subjects sat in an adjustable chair with their feet on two force plates and performed the standing up/sitting down move ment at a self-paced, comfortable speed. Results: The rate of rise in force (dF/dT) was significantly lower in stroke fallers than in stroke nonfallers and healthy subjects (23.78 +/- 17.38, 55.23 +/- 31.24, and 85.96 +/- 42.4 percent body weight per second, respectively [p < .005]). The center of pressure sway in mediolateral direction during rising/sitting down was much greater in stroke fallers than in stroke nonfallers or healthy subjects (p < .05). Body weight distribution was asymmetric on the feet of stroke patients, with much more body weight on their sound side. Conclusions: The significantly lower rate of rise in force and greater postural sway while rising/sitting down may be useful in identifying stroke patients who are at risk for falling. (C) 1998 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.