Peak hip and knee joint moments during a sit-to-stand movement are invariant to the change of seat height within the range of low to normal seat height

Shinsuke Yoshioka, Akinori Nagano, Dean C Hay, Senshi Fukashiro, Shinsuke Yoshioka, Akinori Nagano, Dean C Hay, Senshi Fukashiro

Abstract

Background: Previous studies have consistently reported that decreasing seat height increases the peak hip and knee joint moments; however, these findings may not apply to biomechanical changes at very low seat heights. The purpose of this study, therefore, was to examine the effect of a large range of seat heights on peak joint moments of the lower limb during a sit-to-stand (STS) movement.

Methods: Eight healthy young subjects participated in this experiment. Each subject was instructed to stand up from six seat heights (10, 20, 30, 40, 50 and 60 cm). Joint moments were calculated with an inverse dynamics method. The sum of the hip and knee joint moments was used as the index to indicate the mechanical load of the STS movement. The effect of seat height on the mechanical load was examined with both analytical and experimental approaches.

Results: Through the analytical approach, it was revealed that the mechanical load of STS movements from low and normal seat heights (10 to 40 cm) always reaches its peak at or near the posture in which the thigh is horizontally positioned. This finding indicates that the peak value is invariant between the low and normal seat heights. Similar results were also found in the experimental approach. There were few significant differences in the peak mechanical load and the peak hip and knee joint moments between the low and normal seat heights, while they differed significantly between the low and high seat heights.

Conclusions: This study concluded that, while the peak mechanical load and the peak hip and knee joint moments increase inversely to seat height within the range of high to normal seat height (60 to 40 cm), they are invariant to the change of seat height within the range of low to normal seat height (10 to 40 cm). These findings are useful for the design of chair, the improvement in the evaluation standard of minimum sit-to-stand height tests and the development of new muscular strength test.

Figures

Figure 1
Figure 1
Definition of the coordinate systems and the parameters regarding head-arm-trunk (HAT) and thigh segments.
Figure 2
Figure 2
Typical examples of STS movements from the seat heights of six different heights (10, 20, 30, 40, 50 and 60 cm). Time = 0 (%) indicates the instance when the buttocks lost contact with the chair (seat-off time). Time = 100 (%) indicates the finish time of each STS movement. Stick figures were drawn at 10% time intervals. The gap between the center of hip joint and the surface of chair seat is due to the existence of the thickness between the center of hip joint and the skin surface of buttocks.
Figure 3
Figure 3
Ensemble average of the mechanical load during STS movements from the seat heights of six different heights. Time = 0 and 100 (%) respectively indicates the instance of seat-off and finish time. The grey area indicates ± 1 standard deviation of the ensemble average. The mechanical load reached a peak near the time of 0%.
Figure 4
Figure 4
Ensemble average of the joint moment during STS movements from the seat heights of six different heights: (a) hip, (b) knee and (c) ankle joint moments. Time = 0 and 100 (%) respectively indicates the instance of seat-off and finish time. The grey area indicates ± 1 standard deviation of the ensemble average. The hip and knee joint moments reached a peak near the time of 0%. On the other hand, the ankle joint moment reached a peak near the time of 100%.
Figure 5
Figure 5
Average and standard deviation of the peak mechanical load. Asterisk mark (*) indicates significant difference (p < 0.05). The significant differences were found in the comparisons between the seat heights of 60 cm and lower than 60 cm (10 to 50 cm) and between the seat heights of 50 cm and lower than 50 cm.
Figure 6
Figure 6
Average and standard deviation of the peak joint moment: (a) hip, (b) knee and (c) ankle joint moments. Asterisk mark (*) indicates significant difference (p < 0.05). In the cases of the hip and knee joints, the significant differences were mainly found in the comparisons between the seat heights of 60 cm and lower than 60 cm (10 to 50 cm) and between the seat heights of 50 cm and lower than 50 cm. On the other hand, in the case of the ankle joint, the significant differences were mainly found in the comparisons between the seat heights of 10 cm and greater than 40 cm.

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