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      Effect of ankle-foot orthosis with a built-in spring on muscle activity during the sit-to-stand movement in healthy individuals

      research-article
      , RPT, PhD 1
      Journal of Physical Therapy Science
      The Society of Physical Therapy Science
      Sit-to-stand movement, Ankle-foot orthosis, Electromyography

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          Abstract

          [Purpose] This study aimed to evaluate the influence of a newly developed ankle-foot orthosis with a built-in spring on the activity of lower limb muscles during the sit-to-stand movement. [Participants and Methods] This cross-sectional study recruited 20 male volunteers. The sit-to-stand movement (rising from a chair) was performed under three conditions: no ankle-foot orthosis (NA), ankle-foot orthosis with no spring (NS), and ankle-foot orthosis with a built-in spring (SP). Muscle activity during the sit-to-stand movement was measured using surface electrodes placed on the vastus medialis, tibialis anterior, medial gastrocnemius, and soleus muscles. Root mean square and integral value were calculated from the raw data, and statistical analysis was performed using SPSS version 24.0. [Results] The electromyography data of the vastus medialis, medial gastrocnemius, and soleus muscles showed a significant decrease in muscle activity in the SP condition, whereas the activity of the tibialis anterior muscle increased significantly in the SP condition compared to that in the NA and NS conditions. [Conclusion] Our data showed that the use of an ankle-foot orthosis with a built-in spring affected not only the muscle activity at the ankle joint but also the activity of the knee joint extensor muscle. It is possible that the control of the ankle joint motion affects movement above the knee joint; this finding may help development new physical therapy techniques. Further research is warranted in this regard.

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          Most cited references15

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          Determinants of the sit-to-stand movement: a review.

          The sit-to-stand (STS) movement is a skill that helps determine the functional level of a person. Assessment of the STS movement has been done using quantitative and semiquantitative techniques. The purposes of this study were to identify the determinants of the STS movement and to describe their influence on the performance of the STS movement. A search was made using MEDLINE (1980-2001) and the Science Citation Index Expanded of the Institute for Scientific Information (1988-2001) using the key words "chair," "mobility," "rising," "sit-to-stand," and "standing." Relevant references such as textbooks, presentations, and reports also were included. Of the 160 identified studies, only those in which the determinants of STS movement performance were examined using an experimental setup (n=39) were included in this review. The literature indicates that chair seat height, use of armrests, and foot position have a major influence on the ability to do an STS movement. Using a higher chair seat resulted in lower moments at knee level (up to 60%) and hip level (up to 50%); lowering the chair seat increased the need for momentum generation or repositioning of the feet to lower the needed moments. Using the armrests lowered the moments needed at the hip by 50%, probably without influencing the range of motion of the joints. Repositioning of feet influenced the strategy of the STS movement, enabling lower maximum mean extension moments at the hip (148.8 N m versus 32.7 N m when the foot position changed from anterior to posterior). The ability to do an STS movement, according to the research reviewed, is strongly influenced by the height of the chair seat, use of armrests, and foot position. More study of the interaction among the different determinants is needed. Failing to account for these variables may lead to erroneous measurements of changes in STS performance.
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            Whole-body movements during rising to standing from sitting.

            Rising to a standing position from a sitting position is one of the most important activities of daily life. We present a total-body analysis of rising from a chair as performed by nine healthy individuals under controlled conditions. We describe four phases of this activity. Phase I is a flexion-momentum phase used to generate the initial momentum for rising. Phase II begins as the individual leaves the chair seat and ends at maximal ankle dorsiflexion. Forward momentum of the upper body is transferred to forward and upward momentum of the total body. Phase III is an extension phase during which the body rises to its full upright position. Phase IV is a stabilization phase. Kinetics and kinematics of the phases are analyzed. The phases are differentiated in terms of momentum and stability characteristics. Clinical implications of the mechanics of rising are discussed.
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              Frequency of the sit to stand task: An observational study of free-living adults.

              The sit to stand movement is a key determinant of functional independence. Knowledge of the frequency with which the sit to stand movement is performed throughout the day could inform workplace ergonomics, but has rarely been examined. Healthy adults (n=140) were recruited from the general population. Free-living activity for each participant was reported using an activity monitor. On average, participants performed 60 (+/-22) sit to stand movements each day. Participants in indoor sedentary occupations performed significantly more sit to stand movements per day than participants in outdoor active occupations (66 vs. 54; n=102; p=0.003). Participants (n=33) performed significantly more sit to stand movements on working days than on non-working days (65 vs. 55; p=0.018). This analysis provides contemporary data for sit to stand frequency in a predominantly working population, and demonstrates that work and employment have a significant effect on that frequency.
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                Author and article information

                Journal
                J Phys Ther Sci
                J Phys Ther Sci
                JPTS
                Journal of Physical Therapy Science
                The Society of Physical Therapy Science
                0915-5287
                2187-5626
                19 March 2019
                March 2019
                : 31
                : 3
                : 287-290
                Affiliations
                [1) ] Department of Physical Therapy, School of Health Science at Narita, International University of Health and Welfare: 4-3 Kouzunomori, Narita City, Chiba 286-8686, Japan
                Author notes
                Corresponding author. Masafumi Itokazu (E-mail: itokazu@ 123456iuhw.ac.jp )
                Article
                jpts-2018-398
                10.1589/jpts.31.287
                6428643
                30936647
                c0a1a123-e8e2-4dca-8e2e-f0ddf8dc1bab
                2019©by the Society of Physical Therapy Science. Published by IPEC Inc.

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (by-nc-nd) License. (CC-BY-NC-ND 4.0: https://creativecommons.org/licenses/by-nc-nd/4.0/ )

                History
                : 08 November 2018
                : 19 December 2018
                Categories
                Original Article

                sit-to-stand movement,ankle-foot orthosis,electromyography

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